Dr. Liu Yuze's advice to the world-on sciatica

"Holding the remote control, staring at the TV, immersed in the arms of the sofa, sitting for two or three hours, getting up with backache." Do you think this scene is very common? Yes, uncle's posture is like this now ... because of modern people's incorrect living habits-including sitting posture, standing posture, work habits, wrong exercise methods and so on. Of the 10 patients who came to the clinic of spinal neurosurgery, probably, (what? ! What about the other half? The other half is due to shoulder and neck pain ...) And because of the appearance of Google God and the publicity of the media, every patient who comes will probably tell me the diagnosis directly: doctor, I feel uncomfortable. What about sciatica? Is it a bone spur? Xi Ma Ai Jia (Taiwanese)

In fact, the well-known "sciatica" is just a symptom, and there are many reasons for this symptom, which cannot be explained by "long bone spur" alone. Just as we say "headache", does a headache necessarily mean a brain tumor? Of course not! Of course, a brain tumor may cause a headache, but does it feel like your head is going to explode when you see your child's failing report card? ! So these pains are only superficial symptoms, mainly telling us that there is something wrong with our body! Deal with it quickly! Only by finding the root cause, finding out the reason, and then prescribing the right medicine, can this problem be fundamentally solved.

What is sciatic nerve? The so-called "sciatic nerve" (yellow strip structure as shown above) is the largest, thickest and longest nerve in the human body, which is mainly responsible for the muscle movement and skin sensation of the posterior thigh, the whole calf and foot. Its source consists of the fourth and fifth lumbar nerves and the first three sacral nerves, and then passes through the pelvic floor, through the buttocks and the back of thighs, branches below the knee, and finally reaches the soles of the feet. On this path, as long as a certain part of the nerve is oppressed and damaged, it will cause discomfort below oppression. The higher the position of the injury, the wider the range of symptoms. The so-called sciatica generally refers to the injury of the sciatic nerve at or near the lumbar spine, resulting in a pain that is transmitted downward along the sciatic nerve, usually from the hip to the back of the thigh and sometimes to the calf.

Patients feel that the human body has no limits. In fact, the initial symptoms of each patient are actually different. Only mild dull pain, like the feeling of muscle stiffness after cramping; Some will have severe pain and will continue from the lower back to the soles of the feet; Some patients can only cause discomfort in certain postures, such as coughing, sneezing and other abdominal exertion or sedentary; Others have been suffering. At the same time, patients often feel tingling in their limbs, and even feel dull pain in their feet like wearing thick pants, and they are unaware of temperature changes, scratching and pinching. In addition to the symptoms of feet, patients often have back pain, which leads to the inability to stand upright or bend over normally, thus affecting sitting and standing posture. The whole person is really "not sitting or standing"!

Dr. Liu Yuze: Generally speaking, the symptoms are mainly unilateral, but as the saying goes, "it never rains but it pours", and a few people have bilateral symptoms. What about the ischium? With the aggravation of menstrual damage, patients will have muscle weakness. , atrophy, unable to walk for a long time, and even serious incontinence.

Uncle 543 in the outpatient clinic loves to talk rubbish. ...

* * Many mothers, uncles, aunts and uncles come to the clinic, and the first sentence will be: doctor! I have low back pain and my feet are numb. Is it a bone spur?

I have to say: Uncle is nearsighted and presbyopic, but he can't get X-rays and MRI. I really can't tell if you/your waist has any bone spurs. ...

All right! Many people think that ischium? Menstrual pain is disc herniation or spinal long bone spur, although it is also a common cause! But in fact, it has many causes, as long as it will cause "sciatica compression injury", it will produce the so-called sciatica. If we divide by location:

Lumbar problems: such as lumbar spinal stenosis, spondylolisthesis, disc herniation between the fourth and fifth lumbar vertebrae and between the fifth lumbar vertebrae and the recommended vertebrae, so-called "bone spurs" caused by degeneration and wear of vertebral bodies, trauma, spinal tumors, etc.

Inflammation of gluteal fascia: For example, patients with piriformis syndrome, sometimes inflammation of gluteus medius or gluteus minimus will also have a feeling similar to sciatica.

So the spur is definitely not an evil nest ~

* * Now that information is developed, databases such as Google and Wiki are easy to search. Many patients and even their families actually check the relevant information online first to see what problems they may have and what tests they need to do. Many patients will directly say when they come to see a doctor, doctor, I think there is something wrong with my intervertebral disc and I want to do that thing called% $&# examination!

Uncle will gently explain at this time (ㄅㄨˋㄕㄨㄤˇ): do XXXX first, then arrange XXXX, and finally decide to do XXXX! (Definitely not because it will be deleted ...)

Every inspection has its importance and significance. General X-ray examination can initially let doctors rule out whether there are bone problems. Computed tomography can further tell us the condition of bone tissue. Magnetic resonance vibration can show the lesions of cartilage and soft tissue. Electroencephalography can tell us what's wrong with this nerve. Each exam has its own advantages and disadvantages, advantages and limitations, and each exam requires different time and arrangements. When to choose which kind of examination, the doctor needs to confirm whether it is really sciatica, the scope of influence and the possible diagnosis through consultation and physical examination before arranging the examination. Only in this way can we find out the reason accurately.

* * People in Taiwan Province Province really like taking medicine, so once something goes wrong, everyone first asks: Doctor, is there any medicine that can protect nerves, eliminate bone spurs and relieve symptoms?

Everyone should have a cognition: it is seven-point poison! If there is such a panacea, nothing will hurt you, will I still sit with you? ! Uncle has sold medicine. ...

Of course, depending on the diagnosis, there are also drugs that can be used to relieve symptoms.

If the pain is caused by tissue inflammation, anti-inflammatory painkillers and muscle relaxants are really helpful. Some patients with chronic pain can also be relieved to some extent by using tricyclic antidepressants and antispasmodics. Even local steroid injection and epidural drug injection can temporarily relieve the discomfort of patients. Push harder and continue to use opium drugs, and the pain will definitely fly away!

However, this is a temporary solution, not a permanent cure!

You know, Rome was not built in a day, and fat people were not eaten in a day! God gave us this body. After decades of abuse, abuse and improper use, it finally couldn't stand it and roared: pain! This tells us: it's time to rest, and some behavior habits need to be changed, otherwise it will be GG! !

Therefore, in the acute phase, proper rest, changing normal living habits and postures, and regular exercise are the fundamental ways to solve the pain problem!

* * If the patient does have lumbar problems, surgery can also be considered, which is inevitable. The patient will definitely ask: Do you have to have surgery? Are there any other treatments?

When do you need surgery? In fact, it is similar to the indication of cervical surgery:

Generally speaking, there are the following situations that require surgery:

First, persistent pain, and after rest, medication, rehabilitation and other conservative treatment is invalid.

Second, the symptoms not only continue to worsen, but also have symptoms of nervous system besides pain, including abnormal sensation, poor strength and even incontinence. Patients may feel unstable, limping, etc.

Third, if the above symptoms develop rapidly in a short time, you may even consider emergency surgery.

As a surgeon, this is a bit unorthodox, but the feeling after so many years is:

Surgery can really solve some problems, but inevitably, it will also create new problems!

Just like the equivalent exchange in alchemy, we only exchange the relief of symptoms at a more acceptable and less influential price. Therefore, surgery is usually not the first line of treatment. After all, the original is the best, and it's best not to scratch if it's okay! Of course, if you have to have an operation, don't hesitate When you can't open it, you will suffer! Sometimes the symptoms drag on for too long, not only will the postoperative recovery time be longer, but it will even leave permanent damage, so it will not be worth the candle! !

* * Sometimes patients from other departments or hospitals come to the clinic and complain to my uncle: The previous doctor said that I had a problem with my lumbar spine, but he just asked me to do rehabilitation, and it didn't work several times.

Folks! Remember uncle's words:

How much time did you spend raising these symptoms today? You have to spend twice as much time to relieve them!

This is the "double return" of Naoki in Nakazawa Tomohide!

As mentioned earlier, the use of drugs is often a palliative, not a permanent cure. Nowadays, symptoms are suppressed by the efficacy of drugs. If you continue your original life, work habits, posture, pain will soon find you again.

Acupuncture, traction rehabilitation, hyperthermia and other therapies can also alleviate the symptoms of patients to a certain extent, but if you continue your original life, work habits and posture, the pain will soon come to you again.

Surgery can really improve symptoms in some cases. But if you continue your old life, work habits, posture, pain will soon find you again.

Did you see the bright spot? Because it is very important, I repeated it three times! ! All these treatments just give us a chance: a chance to take care of our bodies! If you/you want to achieve the effect once and for all only by drugs, rehabilitation or surgery, it is absolutely insane!

* * Then, everyone came to the clinic to listen to the uncle's explanation and health education. The most common words are: Ah, is it so serious? I've been doing this since off-year, and it used to be no problem! Doctor, don't scare people!

If it's not that serious, why don't you/you have nothing to pay to come to the clinic and listen to me? Make friends?

My uncle used to say: human life is deteriorating every second! But the damage accumulated by improper use of the body is increasing year by year! 18 The movements and postures that you can do at the age of 48 will definitely be "cool for a while and painful for a lifetime"! !

"Pain" is not a disease, but a warning! ! Just like a baby can't talk, it can only be expressed by crying; Our organs and tissues can't speak, so once something goes wrong, we can only express it with pain! The more severe the pain, the more severe the body curse, and the more accumulated damage! !

Therefore, when there is discomfort somewhere in the body, the first thing to do is definitely not to find a doctor quickly (uncle is not Takeshi Kaneshiro, don't look for me in a hurry, lest you wake up); Instead, we should think about whether there are problems with our living/working habits and attitudes. After all, the body is your own, and you have to bear most of the responsibility! !

finally ...

Let me advise you one thing:

Please take care of yourself, the parts are not well matched, and you may not be able to buy them if you have money!

Place? Scion? After the pain? In addition to doctors, it is also important for patients to cooperate with themselves. Such as: standing, sitting, sleeping, moving things, etc. Have the right posture, in addition, some strengthen abdominal muscles and back muscles? Exercise also needs to be done persistently. "Prevention is better than cure? Having strong muscle strength and correct knowledge/posture is the best way to stay away from sciatica! !

There are six ways to stay away from sciatica without drugs.