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Need Help for Severe Sciatica pain
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skyranger posted:
My husband is 62 years old, about 60 pounds overweight; we are more inclined to alternative/homeopathic therapies. He is experiencing severe sciatica pain and doctors have prescribed both anti inflamitories and pain medication "Lyrica". He has a one stent and my issue is the long term side effects and addictive nature of this medicine. He is on a strict diet to lose weight and is doing swimming therapy as much as possible. Can anyone help give us a more natural roadmap back to health? We are currently in Europe for next 3 months. Much thanks in advance.
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Peter Abaci, MD responded:
Hi Skyranger,

There are a lot of good options to help your husband's sciatica problem. It sounds like he is already on a weight-loss program, and hopefully over time this will help improve his condition considerably. Excessive weight can have a big impact on the health of the spine. There are many, many foods out there with potent anti-inflammatory properties that can be good for both his sciatica and heart health. As an FYI, Lyrica sometimes causes significant weight-gain.

It seems like Europeans do a lot more walking than Americans. The extra walking may be difficult for your husband at first, but over time, this may help develop his muscles and decrease his weight to the point that he will start to feel better. One form of exercise and rehab that I have found particularly beneficial for folks with spine problems is Pilates. As this is now popular in parts of Europe, you may find someone who is appropriate to work with your husband. Consult the Pilates Method Alliance for recommendations near you.

Another option to try to get some more immediate relief would be a course of several sessions of acupuncture. In some cases, certain supplements can be seen as viable alternatives to prescription medications. Some to consider include fish oils, ginger, turmeric, and cherries have helpful properties and are still in season.

For more detailed information on finding a more natural "roadmap" consider checking out my book "Take Charge Of Your Chronic Pain." This might be a helpful tool to have, especially while you are away from your usual doctors.

Hope you have a great trip!
 
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cweinbl responded:
Sorry to hear about your husband's pain. I've lived with severe sciatica for more than 40 years. I know what it's like.

1. Lyrica is not a narcotic. It does not have the same addictive properties.

2. The big question here is not what to do about your husband's pain, but WHY he is having it. What is causing the sciatica? Is it from osteophytes (bone spur), herniated disc, bulging disc (degenerative disc disease), tumor, pathological vascular growth or something else? Diagnosis precedes treatment. Sciatica is not a diagnosis in itself. It's a diagnosis fragment. The real question is what is causing it. A tumor left undiagnosed can become life threatening. I'm certainly not suggesting that a tumor is the cause of your husband's sciatica. But it must be ruled out with an MRI or CAT-scan.

3. Please be careful using words like "addictive." People routinely misunderstand it. The rate of addiction among chronic pain patients using narcotics is between 1% and 3%. In fact two new comprehensive research studies found the addiction rate at well under 2% (http://updates.pain-topics.org/2011/01/study-finds-low-risk-of-rx-opioid-use.html and http://www.ncbi.nlm.nih.gov/pubmed/20091598?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1 ). Unless your husband has a history of addiction disorder, his chance of becoming addicted is between slim and none. Some people misunderstand the difference between addiction (a psychological disorder) and tolerance and withdrawal (physical conditions). There is a ton of data about this on the Internet.

4. Homeopathic cures have almost no usefulness with sciatica. The cure lies in freeing up the nerve root from whatever is compressing it (bone, disc, tumor, etc.). Lyrica is appropriate. But it only treats the symptoms. The same applies to homeopathic options. It is better to treat the disease than the symptoms, especially if the cause of the sciatica is a tumor.

5. Has your husband had a CAT-scan or MRI? If so, what was the result? If not, please request an appropriate referral for this kind of radiological diagnostic tool. And beware that X-ray is not very useful here, because X-rays do not visualize soft tissue, like extruded disc material or a tumor.

6. Meanwhile, if your husband cannot tolerate the pain, please request a narcotic. Used as directed narcotics are safe, effective and (as mentioned above) there is almost no chance of addiction. Just one narcotic added 9 additional wonderful years to my career. And having used narcotics for more than 40 years, I can say that they are completely safe. Opiates are a natural substance in the body. They damage no internal organs.

Best of luck to you and your husband.
cweinbl csw2@bex.net
 
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annette030 responded:
Keep in mind when you are closer to coming home from Europe that the US does not treat supplements the same as drugs, like they do in many places in Europe. There is little to no quality control checking here.You have to be willing to trust the companies that are making money by selling you supplements to begin with.

Lyrica is not addictive as far as I know. I take gabapentin, an older, but closely related, drug. I can take it or not, all I have is more pain and increased symptoms, but no withdrawal problems or urge to take it.

It sounds like your husband is doing the right things for most cases of sciatica by losing weight and swimming.

I have had it twice, and it can be self limiting. You don't say how long he has had it? Or why he has it? My cases were probably from poor injection site choice by a nurse giving me a shot for something unrelated.

Take care, Annette


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