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Non-surgical treatments for sciatica

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Thanks for joining us July 27 for a live chat on non-surgical treatments for sciatica with Dr. Steven Cohen of Johns Hopkins. Injury to the sciatic nerve will cause leg pain, weakness, numbness, or tingling, according to the U.S. National Library of Medicine. Treatments vary, depending on the underlying cause, but can include over-the-counter pain killers and physical therapy.

Cohen is an associate professor and researcher with Hopkins School of Medicine and professor of anesthesiology at Uniformed Services University of the Health Sciences and director of Pain Research at Walter Reed Army Medical Center. Read the transcript below. More transcripts of health chats on pain can be found at baltimoresun.com/healthchat.

Note: Comments made here are for informational purposes only and do not represent or substitute as medical advice. Patients are advised to consult their own physician or pharmacist for advice, diagnosis and treatment.

 Health chat: Non-surgical treatments for sciatica(07/27/2011) 
10:48
Baltimore Sun Health: 
Hi, Dr. Cohen will be joining us at noon, but feel free to add your questions to the queue now.
Wednesday July 27, 2011 10:48 Baltimore Sun Health
12:02
Steven P. Cohen: 
Good Afternoon Everyone,
Thank you for joining our chat. I hope to get to as many questions as possible.
Wednesday July 27, 2011 12:02 Steven P. Cohen
12:02
Baltimore Sun Health: 
Welcome to our live chat on non-surgical treatments for sciatica with Dr. Steven Cohen of Johns Hopkins. Add your questions and we'll get to them one at a time within the hour. It's always helpful for Dr. Cohen to be as specific as you can about your issue.
Wednesday July 27, 2011 12:02 Baltimore Sun Health
12:02
[Comment From Jo AnneJo Anne: ] 
What is considered an injury to the sciatic nerve? I had laser spine surgery last Sept. 2010 to relieve the pain from a disc bulge at L5-S1 and still have numbness and tingling in my left foot and lower leg. Will the numbness ever go away? Are there other treatments to ease the numbness? An MRI last week confirmed another central disc protrusion at L5-S1 that is abuting the S1 nerve and causing extreme pain. Are there other options (other than surgery) that will relieve this new pain? I am a 64 year old female. Thank you very much.
Wednesday July 27, 2011 12:02 Jo Anne
12:03
Steven P. Cohen: 
The medical term “sciatica” is somewhat of a misnomer because it usually (> 95% of cases) indicates irritation and inflammation of the nerve roots that come together to form the sciatic nerve, the largest nerve in the body, but not the nerve itself. Occasionally, people can develop true ‘sciatica’, which often occurs when the nerve itself becomes irritated by the piriformis muscle, which connects the lower spine to the hip. The source of the injury can be mechanical (e.g. a disc in your back herniates, causing nerve compression) or chemical (inflammatory molecules called `cytokines¿ leak out of degenerated discs to inflame nerve roots).

Numbness, like pain, indicates nerve damage, but is often more difficult to treat. Each nerve contains many nerve fibers, which serve different roles. Generally, injury to the smaller nerve fibers (called C and A-delta) result in pain, while an insult to the larger fibers that transmit sensation can cause numbness. Because pain often results from injured pain fibers inappropriately firing off signals to the brain, it may be easier to treat than numbness. If you¿ve had numbness for 10 months, some of it may resolve, but there is a strong chance you will never regain full sensation. Because it involves the same mechanisms as pain, treatments for numbness are very similar and include anticonvulsant drugs and epidural steroid injections. The evidence for percutaneous or non-invasive disc decompression (including laser surgery) is unfortunately still anecdotal and not based on high-level evidence. Among these treatments, the strongest evidence is for a drug called chymopapain that is available throughout Europe and other continents, but is no longer being used here.
Wednesday July 27, 2011 12:03 Steven P. Cohen
12:03
[Comment From Judy L.Judy L.: ] 
I have had sciatica for approx 10 years. I take Hydrocodone and I have already tried PT several times. The only time it is relieved is right after I receive my epedora (sp?) shots in my back, and then it lasts for approx 2 months. The pain dr., who is very respectiveable and has been in practice for over 30 yrs., but I just found him, only wants to give the shots every 4-6 months. It has been about 12 weeks since my last one, and now the sciatica is back and hurts until after my 2nd or 3rd pain dose of the day. I am able to do my housework, except vacuum. After buying the new O-Cedar mop I have been able to do the kitchen & bathroom floors., my husband helps out a lot, he does the vacuum....now is there something else I can do...thank you very much....and to say Sciatica hurts. is putting it mildly...it is an awful pain....we live in Ocean City, and I cannot walk the boardwalk only when and after my shots.....so thank you for listening
Wednesday July 27, 2011 12:03 Judy L.
12:04
Steven P. Cohen: 
Epidural steroid injections (ESI) have been used for more over 50 years to treat sciatica. Many doctors limit the number of ESI to 3 in a 6-month period. This is done not only to limit the dose of steroids which can cause serious side effects in high doses, but because of the ¿law of diminishing returns¿. But all ESI aren¿t equal. Some, like transforaminal ESI, which involves placing the needle close to the inflamed nerve root(s) that is causing the leg pain, have been shown in some studies to work better than traditional interlaminar ESI, possibly because the medication is injected closer to where the problem lies. Medications, such as antidepressants (nortriptyline, duloxetine) can also be beneficial for sciatica. I encourage you to continue to stay active, as a regular exercise program can prevent progression of your symptoms.
Wednesday July 27, 2011 12:04 Steven P. Cohen
12:04
[Comment From PaulPaul: ] 
I was involved in an automobile accident in August of '06. I had back surgery to release two pinched nerves and a discetomy. It was later revealed that I had damage to the Sciatic Nerve. I have all the symptoms etc.. When I'm driving I can feel like the nerve being pinched and causing more pain and I'm unable to get comfortable. Is there anything I can do to alleviate this pain and feeling?
Wednesday July 27, 2011 12:04 Paul
12:05
Steven P. Cohen: 
Sitting increases the stress on the discs that separate our spinal bones, so many people with back pain feel worse with sitting. But this is not the same as ¿neuropathic¿ pain, or pain arising from nerve injury. An important question is, ¿have you ever had any tests to assess your nerve function?¿ The main distinction that needs to be made in people who have back pain is whether or not it involves nerve injury (neuropathic pain) or degeneration/ injury to the structural components of the spine (mechanical pain). Studies have estimated that about one-third of people with chronic low back pain have mostly ¿neuropathic pain¿. This is important because it affects how your pain should be treated. For example, epidural steroid injections and anticonvulsants like gabapentin work better for nerve pain than mechanical pain. Often, the two occur together because degenerated discs are more likely to herniate. If sitting makes your pain worse, it may be coming from your discs, not the nerves. The sacroiliac joint, which connects your spine to your pelvis, is also commonly injured in car accidents. Pain from the sacroiliac joint can shoot into your leg just like sciatica, and is often worsened when rising from a sitting position. The best way to figure out if your sacroiliac joint is the source of your pain is by diagnostic blocks, which involve injecting local anesthetic numbing medication into the joint.
Wednesday July 27, 2011 12:05 Steven P. Cohen
12:05
[Comment From RobertRobert: ] 
Several months ago I was experiencing pain on the inside of my right leg above the knee and also below the groin. It was particularly troublesome when driving for more than half an hour. My doctor thought it was sciatica and sent me to physical therapy. The therapist thought it was the hamstring muscles and conducted the therapy accordingly. She also said that doctors often mistakenly diagnose hamstring problems for sciatica issues. After numerous PT treatments, the pain is mostly gone. My question is, how do you know if the pain is from the hamstring or the sciatica?
Wednesday July 27, 2011 12:05 Robert
12:06
Steven P. Cohen: 
One of the reasons back pain is the leading cause of disability in the world in people under 45 years of age is because it¿s very difficult to identify the source of pain. If one of the lower discs is causing sciatica, a good history and physical exam can detect it in over 80% of cases. Your symptoms would be very atypical for sciatica. A normal MRI, or nerve tests that demonstrated no abnormality would also suggest a non-spinal source of pain. But sometimes the best way to tell is by your response to treatment. Hamstring exercises would probably not be very effective in relieving true sciatica, whereas treatments such as epidural steroid injections would not do much to relieve muscle pain. It sounds like your physical therapist made the right call, but most cases of uncomplicated sciatica will also resolve naturally, so we may never know for sure.
Wednesday July 27, 2011 12:06 Steven P. Cohen
12:06
[Comment From MichelleMichelle: ] 
My roommate has had pain, stiffness, and numbness in his leg for over a decade. It is rock hard to the touch. He says he went to the doctor many years ago and they mentioned surgery. I am wondering if since then, there have been non-surgical treatments developed.
Wednesday July 27, 2011 12:06 Michelle
12:07
Steven P. Cohen: 
From your description, it¿s not possible to know what¿s going on here. He may have peripheral vascular disease, which can cause numbness and nerve damage because the nerves in the leg are deprived of oxygen. It may be secondary to spine problems, but without more information one cannot make that diagnosis. There is also a condition called ¿complex regional pain syndrome¿, in which one experiences symptoms (e.g. pain) and signs (e.g. temperature or color changes) that are out of proportion to the event that caused it. Your roommate should be examined by a physician to rule out something serious.
Wednesday July 27, 2011 12:07 Steven P. Cohen
12:07
[Comment From CatherineCatherine: ] 
I had surgery for a broken hip on March 7, 2011 which left me with sciatic nerve damage resulting in a drop foot. How common is this? I see a neurologist and a neurosurgeon who monitor my progress every 3 months and I see a physical therapist 2 or 3 times a week. The hip has healed satisfactorily, but the foot is regaining little feeling and incremental movement slowly. I was in extreme pain in my leg and foot for 2 1/2 months which is under control with Cymbalta and Gabapentin (generic of Neurotin) leaving me with residual pain in the foot only. Do you have other recommendations?
Wednesday July 27, 2011 12:07 Catherine
12:08
Steven P. Cohen: 
Chronic pain after surgery is quite common, and underappreciated by many surgeons and doctors. After hip surgery, some studies estimate that between 10% and 35% of people will have chronic pain. Many studies have (somewhat arbitrarily) defined ¿permanent¿ nerve damage after a procedure as pain lasting more than a year. Since you are now at 4 months, you may fall in that category, so there is still a good chance you will regain some function. You may have something called ¿complex regional pain syndrome¿ (CRPS), which is basically ongoing pain that is disproportionate to the inciting event. When CRPS follows injury to a major nerve, it is called CRPS type II (formerly known as causalgia), to distinguish it from CRPS I. This was first described in wounded soldiers. Surgery is probably the #1 cause of CRPS. Physical therapy (desensitization, range of motion etc.) is a cornerstone of treatment for CRPS. Some experts advocate sympathetic nerve blocks, which can help determine the cause of pain (i.e. which part of the nervous system is involved), and sometimes provides long-term relief. Some doctors use them to facilitate physical therapy. The medications used to treat CRPS, or chronic postsurgical pain, are generally the same ones used to treat other forms of ¿nerve pain¿. However, studies have shown that other drugs may be effective as well, such as high doses of bisphosphonates, which are traditionally used to treat osteoporosis.
Wednesday July 27, 2011 12:08 Steven P. Cohen
12:08
[Comment From Doris DavisDoris Davis: ] 
I have pain in my lower back and it goes down my buttocks to my toes. Ice usually is the best thing that helps with the pain and tiggling feel. What else could I do to minimize my attacks?
Wednesday July 27, 2011 12:08 Doris Davis
12:09
Steven P. Cohen: 
There is weak evidence (mostly anecdotal) that Vitamin D deficiency may cause musculoskeletal symptoms including low back pain, and that Vitamin D supplementation in these people may improve their symptoms. However, there is really no evidence that Vitamin D can improve sciatica, which is caused by nerve irritation. Treatments for this can include epidural steroid injections, drugs such as anticonvulsants (gabapentin) and antidepressants (nortriptyline) and physical therapy.
Wednesday July 27, 2011 12:09 Steven P. Cohen
12:09
[Comment From Rachel S.Rachel S.: ] 
Ive always suffered with sciatica, hip and piriformis muscle pain and Im now pregnant. whats the best way to treat while pregnant?
Wednesday July 27, 2011 12:09 Rachel S.
12:09
Steven P. Cohen: 
Pregnancy can worsen many types of back pain, including sacroiliac joint pain, piriformis syndrome and classical sciatica. Unfortunately, pregnancy limits the drugs that can be used for back pain due to nerve irritation (sciatica) because of their potential for causing problems in fetuses. Sacroiliac joint and piriformis muscle injections probably need to be done under fluoroscopy to ensure they get to where the medication is needed, which also poses risks to fetuses. Epidural steroid injections can be done without fluoroscopy, though they are less accurate. I would definitely continue to do your normal exercises to include core stabilization, abdominal strengthening and aerobics, with the guidance of your obstetrician. In addition, there are many conservative treatments such as heat, ice, TENS etc. that can be helpful.
Wednesday July 27, 2011 12:09 Steven P. Cohen
12:10
[Comment From christichristi: ] 
Will this problem cause muscle loss?
Wednesday July 27, 2011 12:10 christi
12:11
Steven P. Cohen: 
If you are referring to sciatica, then the answer is "yes", you can have muscle loss. The nerve roots involved in sciatica transmit not only pain signals but also control muscle function, so that some people can have "muscle wasting". This is why it's important to exercise and keep physically active.
Wednesday July 27, 2011 12:11 Steven P. Cohen
12:12
[Comment From DarleneDarlene: ] 
I have been seeing a chiropractor for the past 2 months to try and relieve the numb pain I have in my right leg. It is helping a little but he did not give me any exercises to do. Was just wondering what I can be doing to help it go along faster.
Wednesday July 27, 2011 12:12 Darlene
12:13
Steven P. Cohen: 
There is reasonable evidence that spinal manipulation is effective for acute sciatica, but much weaker evidence that it is helpful for chronic symptoms. Exercise is important for any type of back pain and should include core stabilization, strengthening of your abdominal muscles, stretching of your gluteal muscles and hamstrings, and a low-impact aerobic program.
Wednesday July 27, 2011 12:13 Steven P. Cohen
12:14
Baltimore Sun Health: 
For those new to our live chats, we have an archive on our discussions of many pain topics (neck, back, knee, shingles, etc.) here: http://bsun.md/p4jNu2
Wednesday July 27, 2011 12:14 Baltimore Sun Health
12:15
[Comment From IreneIrene: ] 
Dr. Cohen, I have been dealing with sciatica for 15 years now, and I currently have nerve pain and numbness in my left foot possible as a result of this condition. I have had a nerve test about 3 years to determine the extent[that's something I care not experience again with definitive results] so what can you recommend. I am currently a prescription vitamin B which helps a little, but I'm not flourishing. I am 59 years old and don't wont to lose my foot.
Wednesday July 27, 2011 12:15 Irene
12:17
Steven P. Cohen: 
Most people who are treated for sciatica do not get these nerve tests, as the diagnosis is made clinically and by MRI. If your foot pain is being caused by sciatica, there is really no chance you will "lose it". Treatments include medications (e.g. gabapentin, antidepressants), epidural steroid injections, and alternative treatments (e.g. acupuncture).
Wednesday July 27, 2011 12:17 Steven P. Cohen
12:17
[Comment From BenBen: ] 
I have pain in lower back. comes around the hips and down the front of my thigh towards my knee. Is this sciatica?
Wednesday July 27, 2011 12:17 Ben
12:19
Steven P. Cohen: 
Since the large majority of cases of sciatica involved the 2 lowest discs, this presentation would be atypical. But many other conditions can cause your symptoms such as degenerative discs, facet joint pain (e.g. arthritis), and sacroiliac joint pain.
Wednesday July 27, 2011 12:19 Steven P. Cohen
12:19
[Comment From PatriciaPatricia: ] 
Dr. Cohen, I have had sciatica for years and it has gotten much worse. My orthopaedic surgeon recommened physical therapy. Is there something else you can recommend? I also am bone on bone in my knee.
Wednesday July 27, 2011 12:19 Patricia
12:21
Steven P. Cohen: 
Again, other treatments for sciatica include epidural steroid injections, medications, and alternative treatments such as chiropractic and acupuncture. For a very small percentage of patients, minimally invasive procedures that remove part of the disc can be helpful, though the evidence supporting most of these is not based on well-conducted studies.
Wednesday July 27, 2011 12:21 Steven P. Cohen
12:21
[Comment From AndreaAndrea: ] 
My 80 yr old mother-in-law starting PT for sciatica. Wonders about the effectiveness. Normally a good sleeper, she cannot sleep at night due to pain. Recently she fell due to leg weakness. She would chat herself but is working, (Yes, working today). Thanks
Wednesday July 27, 2011 12:21 Andrea
12:26
Steven P. Cohen: 
A very common cause of "sciatica" in elderly people is from spinal stenosis. Although treatments such as epidural steroid injections and medications can be helpful, they may not be as effective as in younger people whose symptoms come from a herniated disc. Recently, a procedure known by its acronym "MILD", which stands for minimally invasive lumbar decompression, has been advocated, but currently the evidence supporting this is based on a few case series. Basically, spinal stenosis is caused by a narrowing of the spinal canal that contains the nerve roots that go the legs, and this procedure expands that spinal canal.

I would encourage an exercise program and possibly even talking to the physical therapist about "fall reduction" training. In addition, many medications that are effective for sciatica such as duloxetine have the added benefit of helping with sleep.
Wednesday July 27, 2011 12:26 Steven P. Cohen
12:26
[Comment From JeanneJeanne: ] 
Can piriformis syndrome be totally resolved with stretching? So far so good for me after 2 months. No more numbness but will it last. Is this all I should be doing?
Wednesday July 27, 2011 12:26 Jeanne
12:29
Steven P. Cohen: 
For those of you who don't know, piriformis syndrome is when a muscle in the buttocks irritates the sciatic nerve, causing buttocks and leg pain. Unlike classical sciatica which results from irritation of the nerve roots that come together to form the sciatic nerve, this involves inflammation of the sciatic nerve itself. Stretching can go a long way towards resolving piriformis syndrome, though if you don't change what you did to cause it, it may recur. If your pain returns, injections done with local anesthetic, steroids and even Botox can also be helpful.
Wednesday July 27, 2011 12:29 Steven P. Cohen
12:29
[Comment From JonesJones: ] 
I get a tingling, numbness, restless sensation in one of my legs every few years that generally lasts a few days, sometimes a few weeks. Could this be Sciatica or something like restless leg syndrome? Or neither?
Wednesday July 27, 2011 12:29 Jones
12:33
Steven P. Cohen: 
There is some overlap between sciatica and restless leg syndrome, which often feels like a "tickling" sensation in the muscles. Although this can occur in the arms or even torso, it usually occurs in the legs, especially at night or during resting periods. Interestingly, some of the treatments for sciatica and restless leg syndrome overlaps as well, such as anticonvulsant drugs. Numbness is usually associated with nerve damage (i.e. sciatica), though some people with restless leg syndrome describe changes in sensation.
Wednesday July 27, 2011 12:33 Steven P. Cohen
12:34
[Comment From patpat: ] 
Impression:1. There is degeneration of the intervertebral disks from L2 through S1 manifest by variable degrees of disk desiccation and generalized annular bulging. Ther is degenerative facet arthrosis at L4-L5 and L5 and S-1. There is degenerative spondylosisthesis at L4-5 and L5-S1.2. The combination of disk bulging, facet hypertrophy, and spondylolisthesis causes moderate canal and marked right foraminal stenosis and mild to moderate left foraminal stenosis at L4-L53. There is moderate right and mild left foramen narrowing at L5-S1 as wellImpression:1. There is degeneration of the intervertebral disks from L2 through S1 manifest by variable degrees of disk desiccation and generalized annular bulging. Ther is degenerative facet arthrosis at L4-L5 and L5 and S-1. There is degenerative spondylosisthesis at L4-5 and L5-S1.2. The combination of disk bulging, facet hypertrophy, and spondylolisthesis causes moderate canal and marked right foraminal stenosis and mild to moderate left foraminal stenosis at L4-L53. There is moderate right and mild left foramen narrowing at L5-S1 as wellHi....I had 2 epidurals this spring for sciatica , left side, hard to sit. They didn't work, so pain mgmt doc said he couldn't help me. Plus i already had about 10 epidurals in 2 yrs ( facet joint arthritis), etc...went to ortho spine, and he said fuse L4, L5, and S1
Wednesday July 27, 2011 12:34 pat
12:34
[Comment From patpat: ] 
i am UN willing to do this
Wednesday July 27, 2011 12:34 pat
12:36
Steven P. Cohen: 
You don't really say what your symptoms are, but since most people at a certain age have abnormal MRI findings even without back pain, a good general rule is to treat a person's symptoms, rather than MRI abnormalities. If you had straightforward sciatica (i.e. pain shooting into the leg), then there is very little evidence to support a spinal fusion over a decompression operation, which is a much small surgery.
Wednesday July 27, 2011 12:36 Steven P. Cohen
12:37
[Comment From DevenDeven: ] 
My mother has had severe sciatica for years and I was wondering, what kinds of surgery are used for treatment?
Wednesday July 27, 2011 12:37 Deven
12:39
Steven P. Cohen: 
It depends on her MRI findings, but open procedures can include removing part of the spinal bone (laminectomy), opening up the foramina where the nerve roots exit the spinal canal (foraminotomy), and removing part of the disc. Occasionally, the disc can be removed by a percutaneous route (i.e. through the skin without cutting someone open), though this may helpful in only a small percentage of people. As I noted above, a new procedure known as MILD may help some people with spinal stenosis, though more research is needed in this area.
Wednesday July 27, 2011 12:39 Steven P. Cohen
12:39
[Comment From Bill T. WinterBill T. Winter: ] 
Is there an over-the-counter medicine you recommend for dealing with this pain?
Wednesday July 27, 2011 12:39 Bill T. Winter
12:41
Steven P. Cohen: 
You don't mention the type of pain you are having, but antiinflammatory drugs and acetaminophen tend to be better for musculoskeletal back pain than "true sciatica".
Wednesday July 27, 2011 12:41 Steven P. Cohen
12:41
[Comment From JonJon: ] 
I take pain relievers constantly to help me get through my day. Without it I am in so much pain. My girlfriend worries I could hurt my stomach by doing so. What should I do?
Wednesday July 27, 2011 12:41 Jon
12:45
Steven P. Cohen: 
It really depends on what type of pain you're having and what type of pain relievers you're referring to. Antiinflammatory drugs such as ibuprofen quite frequently cause stomach discomfort, which can be reduced by using other drugs such as Protonix at the same time. Of course you should take care not to exceed the prescribed dose, and to tell your doctor about any side effects your are experiencing. They also have new formulations (e.g. celecoxib and meloxicam) that may have cause less stomach irritation. If you have sciatica, you should consider other medications that may work better for this type of pain such as antidepressants and anticonvulsants, which are less likely to irritate your stomach.
Wednesday July 27, 2011 12:45 Steven P. Cohen
12:45
Baltimore Sun Health: 
Thanks for all your questions so far. We have a little bit more time if you'd like to ask Dr. Cohen any further questions about non-surgical treatments for sciatica. Please submit them now.
Wednesday July 27, 2011 12:45 Baltimore Sun Health
12:45
[Comment From batboy145batboy145: ] 
I've read about the exercises that doctors recommend for patients with Sciatica on the Web, but doing them is too painful and intense. Are there any "beginner" exercises that won't hurt as much?
Wednesday July 27, 2011 12:45 batboy145
12:50
Steven P. Cohen: 
This question underscores the key difference difference between "acute" and "chronic" back pain. Acute pain is a signal to your body that there is a potential for tissue damage, so the prudent thing is to avoid things that worsen the pain. But for chronic pain, there is no threat for additional tissue injury, so that pain itself becomes the "disease". In this context, it is important to try to work through a little discomfort at the beginning so that you can gradually increase the amount you can do. I would recommend consulting a physical therapist or rehabilitation doctor to see what you can do based on your overall level of health and physical condition.
Wednesday July 27, 2011 12:50 Steven P. Cohen
12:51
[Comment From delhamdelham: ] 
how concerned should i be that the pain in my lower back has increased over the past 6 months?
Wednesday July 27, 2011 12:51 delham
12:56
Steven P. Cohen: 
It depends. Certainly, the development of completely new symptoms, especially when they signify nerve injury (e.g. numbness) is more concerning than just worsening of your chronic symptoms and warrants attention. If you've had pain for many years and this basically the same character discomfort only worse, it may indicate that your condition or disease is worsening. In either case, you should consult with your doctor.
Wednesday July 27, 2011 12:56 Steven P. Cohen
12:57
[Comment From CarolCarol: ] 
Does losing weight have any impact on Sciatica?
Wednesday July 27, 2011 12:57 Carol
1:00
Steven P. Cohen: 
Yes, being overweight places more stress on all of the structures in your spine including the discs, facet joints that connect the spinal bones to each other, sacroiliac joints that connect your pelvis to your spine, and muscles. Being overweight can also predispose you to "deconditioning" which can worsen your pain. The negative effects of being overweight can worsen not only mechanical causes of pain (e.g. degenerative diseases of the joints and disc), but also sciatica.
Wednesday July 27, 2011 1:00 Steven P. Cohen
1:00
[Comment From patpat: ] 
I also have psoriatric arthrits, just diagnosed few yrs ago, and RA 17 years...could they affect lower back issues
Wednesday July 27, 2011 1:00 pat
1:02
Steven P. Cohen: 
Yes, these inflammatory conditions dramatically increase your risk for back pain due to both facet joint degeneration and sacroiliac joint pain. However, FDA-approved drugs that modulate your immune system can also help with your pain.
Wednesday July 27, 2011 1:02 Steven P. Cohen
1:02
[Comment From AndrewAndrew: ] 
my wife is pregnant and has been complaining about lower back pain and a numbness in one of her legs. should we be alarmed? or should we just wait and see if it continues after she delivers? Thankz!
Wednesday July 27, 2011 1:02 Andrew
1:04
Steven P. Cohen: 
As I mentioned earlier, pregnancy, because of the increased weight gain, change in posture, and hormonal changes can increase the chance of back pain. Frequently, this resolves after delivery as the body returns to normal. But if it persists for over a month after delivery, then I'd seek medical attention.
Wednesday July 27, 2011 1:04 Steven P. Cohen
1:04
Baltimore Sun Health: 
OK, we're going to wrap things up. Sorry that we couldn't get to everyone, but thanks for participating. Great questions! And thanks to Dr. Cohen for taking the time to provide answers. Don't forget to visit www.baltimoresun.com/healthchat for archives of previous discussions, as well as upcoming chats.
Wednesday July 27, 2011 1:04 Baltimore Sun Health
1:05
 

 
 
 
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