Sciatica

20th February, 2009 - Posted by ross - No Comments

Diagram of Sciatic nerve

Diagram of Sciatic nerve

Sciatica is the term for pain down the back of the leg, typically occurring along the course of the sciatic nerve.

This large nerve is composed of several nerve roots which originate from the spinal cord at various levels in the lower lumbar spine. The nerve roots unite at the lumbosacral plexus to form the sciatic nerve which courses posterior to the hip joint and passes down the back of the leg, giving off nerve branches as it descends.

Sciatica can occur as a result of compression or irritation of the sciatic nerve at any point along its course. The most common cause of sciatica is a prolapsed intervertebral disc. The disc prolapse most often occurs in the lumbar spine, often but not always in the lower lumbar region. The disc prolapse (disc herniation or “slipped disc”) may result in compression of one or more lumbar nerve roots (which contribute to the sciatic nerve) and this nerve root compression results in sciatica. Although the pain is felt radiating down the back of the leg, the source of the pain is usually, but not always, in the back. With sciatica, there may or may not be associated back pain. Compression of a lumbar nerve root giving rise to sciatica may be due to causes other than a disc prolapse. It may be due to osteophyte (new bone) impingement (the osteophyte formation arising due to degenerative disc disease) and may also occur as a complication of facet joint arthritis. The facet joints are small joints between the posterior elements of adjacent vertebrae.

Treatments

Sciatica can be of variable intensity ranging from mild to very severe. If symptoms are mild they may respond to simple pain killers/analgesics such as paracetemol. If symptoms are more severe and persistent, professional advice from your GP is required.

Treaments may include stronger analgesics, available from an online chemist if appropriate, bed rest, and physiotherapy. Your GP may suggest an X-Ray or other form of imaging/scan depending on the clinical history and examination. In the majority of instances symptoms will settle down over a period of time. The natural history of a disc prolapse is that in the majority of cases it will reduce in size and symptoms will disappear. However, if symptoms are very intense and unremitting, or if symptoms are perhaps milder but interfering with everyday life, your doctor may refer you to a specialist for a further opinion and advice concerning the need or otherwise for surgery.

Further references

www.backdoctor.org.uk
http://en.wikipedia.org/wiki/Sciatica
www.bbc.co.uk/health/conditions/sciatica1.shtml
www.sciaticaclinic.com

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Posted on: February 20, 2009

Filed under: Uncategorized

Sore Throat

23rd December, 2008 - Posted by Andy - No Comments

sore-throatA sore throat (acute pharyngitis) is one of the most common winter complaints, and is a symptom of infection, usually viral, or of an irritation of the pharynx - the back portion of the mouth behind the tongue. The irritation may be a local throat infection or the result of post-nasal drip caused by discharge from allergies, sinusitis, or a head cold.

Children are especially susceptible to sore throats because their immune systems are not mature enough to fend off flu and cold viruses. They are also exposed to viruses from sneezing and coughing classmates.

Viral pharyngitis may develop gradually. It is often accompanied by the flu or a cold, and body aches. If a fever is present, it will generally be in the range of 101 degrees F or below. A bacterial sore throat may be associated with swollen and tender lymph nodes in the neck. Fever is typically 102 degrees F or higher. The throat may appear extremely red and have either white or yellow spots at the back.

CAUSES
Almost everyone is susceptible to pharyngitis at one time or another. Frequent episodes can be the sign of underlying disorders or chronic disease such as diabetes, malnutrition, or immune disorders.

Sore throats caused by a cold or flu virus are usually self-limiting, and will clear on their own in a few days. Viral infections do not respond to antibiotics, although their symptoms can be relieved by self-help measures.

About 10 to 15 percent of sore throats are caused by bacterial infections, either streptococcus (strep throat) or staphylococcus bacteria. Bacterial infections should be treated with doctor-prescribed antibiotics, rest, and self-treatment. Without a throat culture, differentiation between a viral sore throat and one caused by bacteria is difficult.

TREATMENTS

Self Help
To treat sore throat pain, one should follow time and tested procedures such as good diet, adequate rest, and plenty of liquids.

In terms of OTC medicines, many throat lozenges, some of which contain mild anaesthetics, provide temporary relief of sore throat symptoms. Gargling several times a day with a mixture of 1 teaspoon of salt stirred into 8 ounces of warm water can also temporarily soothe a sore throat, break up congestion, and help flush out bacteria if present. A cup of tea or hot chocolate can relieve a sore throat by warming the irritated membranes.

Use a humidifier or a cool-mist vaporizer in your bedroom at night and keep your nasal membranes and throat lining moist.

Cool-air vaporizers have received bad press because improperly maintained machines may send dust mites and mold spores all over a room. In the case of ultrasonic humidifiers, they can coat furniture with a fine, white film. This can trigger allergies, colds, flu, and sore throats. However, if you clean the water tank according to instructions, these machines may help alleviate more health problems than they cause.

People with cold-congested noses tend to breathe through their mouths. To prevent this from causing a dry, sore throat; drink extra liquids throughout the day.

Over-the-counter nasal sprays may temporarily halt mucus production, but do not use them for more than three days because you may suffer from the “rebound effect.” As the body builds a tolerance, these sprays lose effectiveness, causing a dramatic increase in mucus secretion and nasal discomfort.

To help relieve the pain and inflammation of sore throat, you can consider acetaminophen, ibuprofen, or aspirin tablets as directed. Children should not take aspirin because of its link with Reye’s syndrome, a potentially life-threatening disorder.

Acute Sore throat
Contact your doctor if your sore throat persists for more than three days or if you have any other concerns. You may have a bacterial infection and benefit from antibiotic or other treatment. Also, if you have an accompanying earache, call your doctor.

Similarly see your GP immediately if the sore throat symptoms suddenly cause your voice to change to what is called “a hot potato” voice. This muffled tone sounds as if you have hot french fries in your mouth and cannot fully enunciate.

This could indicate that an abscess has formed in the throat and pus is collecting beyond the wall of the tonsils. Both the tongue and throat may swell. Other symptoms include a fever of 103 degrees F, with swollen, tender glands in the neck, and difficulty swallowing.

A tonsillectomy may be recommended for a child who has:

- Three or more strep throats per year
- More than five non-strep sore throats per year that require doctor visits
- Enlarged tonsils that interfere with night time breathing

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[Sources: NIH, NHS direct]

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Posted on: December 23, 2008

Filed under: General

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