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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Sharp Pain In The Thighs

Hi, a 65 yo Fe w/ a hx of LaminectomyL4-5 in 1973,fusion L5- S1in 1976. With rehab worked in NICU,LATER AS NNP& skied for 10 yrs.so it was successful tho periodic episodes of sciatica treated w / rehab . In Nov 2015 was seen by orthopedic surgeon for tx L hip pain from standing up fr low chairx45 min. Snap & sharp pain. Over a wk then lower back spasm w mod pain left L4-5. Radiation only down L mid thigh... stabbing.. PT TOOK-6-7 mos w ~ 70 improvement. Finally, several falls this spring on L side , & buttock. Packed in ice , did not think need to be seen. Past wk Ortho saw me after was incontinent sev times at nite, & inc lower back pain but no radiation. W hile I saw a pelvic MRI ,saw no X ray. until this wk. This wk..l saw it.... a mild thoracic scoliosis now had a mid thoracic Upper S curve BUt my vertebrae from L 3--S1 were. collapsed! .No spaces left! I was stunned... Mom had severe scoliosis in 50 s. In sev days since I saw him, 2 episodes of incontinence, ...to almost ongoing leaking & voiding Q a15 min. Painfulradiation now down L leg. ..... It just occurred to me that perhaps with Inc sx, over this wk inc,pres on cord. I can t walk without cane & ice in use much of time, I stumble,but no paralysis. should I get this ck,d in am vs 2 wks. Tho some might say 65 yo , W MCI, I still want a life (with rehab)is their something to be done noe ...would brace help. email: bangert.diana @icloud.com. Thank- --you so much. ortho or ER MD .
Wed, 28 Dec 2016
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General & Family Physician 's  Response
Hello Dear. You need to have a follow up consultation with your orthopedic surgeon.

Sciatica treatment focuses on addressing the symptoms and the underlying cause of the pain. Often, combination of non-surgical treatments and a structured exercise program may be needed to relieve the pain.

6 Most Common Causes of Sciatica:
1. Lumbar herniated disc
2. Degenerative disc disease
3. Isthmic spondylolisthesis
4. Lumbar spinal stenosis
5. Piriformis syndrome
6. Sacroiliac joint dysfunction

Nonsurgical Treatment for Sciatica:

The goals of nonsurgical sciatica treatments are to relieve pain and any neurological symptoms caused by a compressed nerve root. There is a broad range of options available for sciatica treatment. One or more of the treatments below are usually recommended in conjunction with specific exercises.

1. Heat/ice:
For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some find more relief with heat. The two may be alternated. It is best to apply ice with a cloth or towel placed between the ice and skin to avoid an ice burn.

2. Pain medications:
Over-the-counter or prescription medications are often effective in reducing or relieving sciatica pain. Nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen), or oral steroids can reduce the inflammation that is usually part of the cause of pain. Muscle relaxants or narcotic medications may also be prescribed for the short term (a few days and up to 2 weeks) to alleviate pain.

3. Epidural steroid injections:

If the pain is severe, an epidural steroid injection can reduce inflammation. Unlike oral medications, an injection goes directly into the painful area around the sciatic nerve to address the inflammation that may be causing pain.

While the effects tend to be temporary (providing pain relief for as little as one week or up to a year), and it does not work for everyone, an epidural steroid injection can be effective in relieving acute sciatic pain. Importantly, it can provide sufficient relief to allow a patient to progress with a conditioning and exercise program.

Alternative Sciatica Treatment:

In addition to standard medical treatments, several alternative treatments have also been shown to provide effective sciatica pain relief for many patients. Some of the more common forms of alternative care for sciatica include chiropractic manipulation, acupuncture, cognitive behavior therapy, and massage therapy.

1. Chiropractic/manual manipulation:

Spinal adjustments and manual manipulation performed by appropriately trained health professionals, such as chiropractors and osteopathic physicians, are focused on providing better spinal column alignment, which in turn is designed to help address a number of underlying conditions that can cause sciatic nerve pain.

Manual manipulation by appropriately trained health professionals can create a better healing environment and should not be painful.

2. Acupuncture:

This practice is centered on the philosophy of achieving or maintaining well-being through the open flow of energy via specific pathways in the body. Hair-thin needles (which are usually not felt) are inserted into the skin near the area of pain.

Acupuncture has been approved by the U.S. Food and Drug Administration (FDA) as a treatment for back pain, and the National Institutes of Health has recognized acupuncture as effective in relieving back pain, including sciatica.

3. Cognitive behavior therapy:

This therapy for taking control and changing self-defeating behaviors can be helpful in managing sciatica pain, particularly in the short term. Sessions with a therapist may be face-to-face or online.

4. Massage therapy:

Certain forms of massage therapy have been shown to have a number of benefits for back pain, including increased blood circulation, muscle relaxation, and release of endorphins (the body’s natural pain relievers).

Treatment for Recurring Sciatica Pain
For most people, the good news is that sciatica typically gets better on its own, and the healing process usually will only take a few days or weeks.

Overall, the vast majority of episodes of sciatica pain subside within a 6- to 12-week time span. Following initial pain relief, a program of physical therapy and exercise should usually be pursued to alleviate pain and prevent or minimize any ongoing sciatic pain.

An ergonomic assessment of the workplace also may be helpful in recommending safer lifting or posture, depending on the nature of the job, and/or patient education on lifestyle factors that contribute to spine problems.

Medical Professionals Who Treat Sciatica:

There are a number of types of nonsurgical spine care professionals who specialize in treating sciatica symptoms, such as chiropractors, physiatrists (physical medicine and rehabilitation specialists), pain management specialists, and physical therapists, all of whom may have specialized training to provide pain relief and help prevent future recurrences of sciatica.

Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you.
All the best
With warm regards
Dr Sanjay Kini
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Suggest Treatment For Sharp Pain In The Thighs

Hello Dear. You need to have a follow up consultation with your orthopedic surgeon. Sciatica treatment focuses on addressing the symptoms and the underlying cause of the pain. Often, combination of non-surgical treatments and a structured exercise program may be needed to relieve the pain. 6 Most Common Causes of Sciatica: 1. Lumbar herniated disc 2. Degenerative disc disease 3. Isthmic spondylolisthesis 4. Lumbar spinal stenosis 5. Piriformis syndrome 6. Sacroiliac joint dysfunction Nonsurgical Treatment for Sciatica: The goals of nonsurgical sciatica treatments are to relieve pain and any neurological symptoms caused by a compressed nerve root. There is a broad range of options available for sciatica treatment. One or more of the treatments below are usually recommended in conjunction with specific exercises. 1. Heat/ice: For acute sciatic pain, heat and/or ice packs are readily available and can help alleviate the leg pain, especially in the initial phase. Usually ice or heat is applied for approximately 20 minutes, and repeated every two hours. Most people use ice first, but some find more relief with heat. The two may be alternated. It is best to apply ice with a cloth or towel placed between the ice and skin to avoid an ice burn. 2. Pain medications: Over-the-counter or prescription medications are often effective in reducing or relieving sciatica pain. Nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen), or oral steroids can reduce the inflammation that is usually part of the cause of pain. Muscle relaxants or narcotic medications may also be prescribed for the short term (a few days and up to 2 weeks) to alleviate pain. 3. Epidural steroid injections: If the pain is severe, an epidural steroid injection can reduce inflammation. Unlike oral medications, an injection goes directly into the painful area around the sciatic nerve to address the inflammation that may be causing pain. While the effects tend to be temporary (providing pain relief for as little as one week or up to a year), and it does not work for everyone, an epidural steroid injection can be effective in relieving acute sciatic pain. Importantly, it can provide sufficient relief to allow a patient to progress with a conditioning and exercise program. Alternative Sciatica Treatment: In addition to standard medical treatments, several alternative treatments have also been shown to provide effective sciatica pain relief for many patients. Some of the more common forms of alternative care for sciatica include chiropractic manipulation, acupuncture, cognitive behavior therapy, and massage therapy. 1. Chiropractic/manual manipulation: Spinal adjustments and manual manipulation performed by appropriately trained health professionals, such as chiropractors and osteopathic physicians, are focused on providing better spinal column alignment, which in turn is designed to help address a number of underlying conditions that can cause sciatic nerve pain. Manual manipulation by appropriately trained health professionals can create a better healing environment and should not be painful. 2. Acupuncture: This practice is centered on the philosophy of achieving or maintaining well-being through the open flow of energy via specific pathways in the body. Hair-thin needles (which are usually not felt) are inserted into the skin near the area of pain. Acupuncture has been approved by the U.S. Food and Drug Administration (FDA) as a treatment for back pain, and the National Institutes of Health has recognized acupuncture as effective in relieving back pain, including sciatica. 3. Cognitive behavior therapy: This therapy for taking control and changing self-defeating behaviors can be helpful in managing sciatica pain, particularly in the short term. Sessions with a therapist may be face-to-face or online. 4. Massage therapy: Certain forms of massage therapy have been shown to have a number of benefits for back pain, including increased blood circulation, muscle relaxation, and release of endorphins (the body’s natural pain relievers). Treatment for Recurring Sciatica Pain For most people, the good news is that sciatica typically gets better on its own, and the healing process usually will only take a few days or weeks. Overall, the vast majority of episodes of sciatica pain subside within a 6- to 12-week time span. Following initial pain relief, a program of physical therapy and exercise should usually be pursued to alleviate pain and prevent or minimize any ongoing sciatic pain. An ergonomic assessment of the workplace also may be helpful in recommending safer lifting or posture, depending on the nature of the job, and/or patient education on lifestyle factors that contribute to spine problems. Medical Professionals Who Treat Sciatica: There are a number of types of nonsurgical spine care professionals who specialize in treating sciatica symptoms, such as chiropractors, physiatrists (physical medicine and rehabilitation specialists), pain management specialists, and physical therapists, all of whom may have specialized training to provide pain relief and help prevent future recurrences of sciatica. Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you. All the best With warm regards Dr Sanjay Kini