Sciatica is the term given to pain down the leg, which is caused by irritation of the main nerve into the leg, the sciatic nerve. This pain tends to be caused where the nerves pass through and emerge from the lower bones of the spine (lumbar vertebrae). Much of the advice regarding this condition is the same as that for low back pain.

Symptoms

In sciatica, there is a pain down into the leg, which travels below the knee, and may involve the foot. There may be numbness and there may be weakness of the lower leg muscles.

These symptoms may come on their own, but are often combined with low back pain. The order in which the symptoms appear may vary. Sometimes the back pain comes before the sciatica, and sometimes will follow.

As with low back pain, there is a group of features  which health professionals  use to highlight the need to act more quickly, because they may suggest a problem which is not as straightforward as simple back pain or sciatica. If you fit into one of these groups or are concerned, you should see your health professional  soon:

• You are younger than 20 or older than 55 when you get the problem for the first time.
• The pain follows a violent injury, such as a road traffic accident.
• The pain is constant and getting worse.
• The pain is in the back of the chest.
• You have had cancer in the past or at present.
• You are on steroids.
• You are a drug abuser, or have HIV.
• You are generally unwell in yourself.
• You have lost significant weight recently.
• You continue to have great difficulty bending forwards.
• You have developed a number of problems in your nervous system (eg numbness, loss of power, etc).
• You have developed an obvious structural deformity of your spine.

Anyway, it is probably wise to see your doctor if you develop sciatica. Certainly you should consult him or her if you are not able to adequately control the pain with simple painkillers and/or  Non Steroidal Anti-Inflammatory Drugs (NSAIDs), Anti-inflammatory drugs, or if the pain carries on for more than two weeks.

Causes

The most common cause of true sciatica is a "slipped disc". The discs (or inter-vertebral discs) are the cushions which separate the bones of the spine (vertebrae). Your doctor may refer to a slipped disc as a prolapsed intervertebral disc (PID) or a herniated nucleus pulposus.

The intervertebral disc looks a bit like a draughts/checkers piece in shape. The ring around the outside is tough and fibrous, and the centre is rather more like the consistency of a chewy sweet. These discs allow for some flexibility between the bones of the spine, and also act as shock absorbers.

The pressures within the discs can reach high levels when we bend or twist, even without carrying a heavy load. If we add to that a heavy load, especially held out at arms' length, the pressures rise even higher.

If part of the fibrous outer ring of the disc is rather weaker than the rest, the softer centre (nucleus pulposus) may push its way through, bulging outwards. If this bulge presses against a nerve which is running from the main, central nervous system to one of the legs, it causes symptoms in that leg.

Sciatica occurs when the herniated disc presses against the nerves which go to make up the sciatic nerve. This is more likely to cause problems when the nerve is squashed by this, usually between the disc and an adjacent bone.

Nerves have many functions, transmitting messages around the body, rather like a telephone system. They allow us to feel things that happen to us, such as things we touch or that touch us, hot and cold, and pain, and they cause our body to do things, eg making your leg muscles contract when you want to walk. Thus, when a nerve is squashed, it may malfunction, and we might feel pain, numbness, pins and needles, and we might find our limbs do not work in the way they should.

Other things can cause irritation of or pressure on a nerve in the spine. Sometimes this may be a rough and enlarged part of one of the vertebrae, brought about by ageing, and sometimes rarer conditions, infections and tumours are to blame. Most times the cause is nothing too serious, but one of the reasons for seeing your health professional if the pain persists, is to make sure that serious and treatable causes have been ruled out.

Treatment

The key points about most back pain and sciatica are:

Do not worry - it will usually get better  within a few days, or possibly a few weeks with massage & exercise.

Stay active, and if at all possible, stay at work.

The pain may force you to rest, but this is a result of the pain, and not a good treatment for back pain and sciatica. If you have to take to your bed, limit it, if possible.

Use simple pain killers, such as paracetamol or ibuprofen if necessary.

Avoid activities likely to put unnecessary strain on your back.

If it seems to be lasting more than a few days, consider seeing a physiotherapist, chiropractor or osteopath. You may wish to consult your  health professional prior to this.

If you do have to be off work, keep this to a minimum, and do not expect to be pain free before you go back.

If the pain is severe and very disabling, and you cannot control it with simple pain killers and/or anti-inflammatory medicine your doctor may suggest you have an epidural injection, which is an injection into the spine, which soothes the nerves that are causing the pain.

In a minority of cases, the sciatica does not settle, or complications arise. This may lead your doctor to recommend surgery, which will involve trimming back bone or disc material which is pressing on the nerve or nerves. This is not undertaken lightly, and will be guided by the results of a CT or MRI scan.

What is a muscle cramp?
A muscle cramp is a painful spasm of your muscle. It's caused by a prolonged tightening of that muscle, leading to it being shortened. The spasm can last from a few seconds to 15 minutes.
You do not have any control of this spasm and the muscle often feels hard and painful. Muscle cramps, especially in the legs, are very common. The small muscles of the feet are also sometimes affected. The muscle may remain tender for up to 24 hours after a leg cramp.
Cramp often occurs as a result of using your muscles a lot. It is common in athletes, especially long distance runners, and tennis and football players.
Cramp often happens after you have sweated a lot. Sweat is high in sodium and loss of sodium upsets the way your muscle works.
It can also occur with repetitive movements, such as writing (writer's cramp). It can also happen when you lie in an awkward position (night cramp). Night cramps may wake you from sleep.
You can relieve the pain of muscle cramp by stretching and gently massaging the muscle. Grasp your muscle with one hand and pull back on your toes with the other to point the toes upwards. This helps to relieve the spasm.
Regular calf stretching exercises will often prevent leg cramps and quinine tablets may help.
Drink plenty of fluid before, during and after exercising or playing sport, and make sure you warm up properly before you begin.

What are leg cramps?
A leg cramp is a pain that comes from a muscle in the leg. It is due to a muscle spasm which is when a muscle contracts too hard. It usually occurs in one of the calf muscles, below and behind a knee. The small muscles of the feet are sometimes affected.
A cramp pain typically lasts a few minutes. In some cases it lasts just seconds, but in some cases it can last up to 10 minutes. The severity of the pain varies. The muscle may remain tender for up to 24 hours after a leg cramp. Leg cramps usually occur when you are resting - most commonly at night when in bed. (They are often called night cramps.) They may wake you from sleep. It can become a distressing condition if your sleep is regularly disturbed.

Who gets leg cramps?
Many people have an occasional leg cramp. However, they occur frequently in some people. They are more common in older people. About 1 in 3 people over the age of 60, and about half of people over the age of 80 have regular leg cramps. About 4 in 10 people who have leg cramps have at least three per week. They occur every day in some cases.

What causes leg cramp?
Unknown cause (idiopathic leg cramps)
In most cases the cause is not known. One theory is that cramps occur when a muscle that is already in a shortened position is stimulated to contract. As the muscle is already shortened, to contract further may cause the muscle to go into spasm. This commonly happens at night in bed as the natural position we lie in is with the knees slightly bent (flexed), and with feet pointing slightly downwards. In this position the calf muscle is relatively shortened and prone to cramps. This theory explains why stretching exercises may cure the problem.
Secondary causes
In some cases, the cramps may be a symptom of another condition or problem. For example:

• Some medicines can cause cramps as a side-effect, or make cramps occur more often. These include: diuretics ('water tablets'), nifedipine, cimetidine, salbutamol, terbutaline, lithium, clofibrate, penicillamine, morphine (withdrawal), phenothiazines, and nicotinic acid.
• Over-exertion of muscles.
• Dehydration.
• Conditions that cause alterations in the balance of salts in the bloodstream (such as a high or low sodium or potassium level).
• Some people who have renal (kidney) dialysis get leg cramps.
• Pregnancy - usually in the later stages.
• An untreated under-active thyroid gland.
• Peripheral vascular disease (narrowing of the leg arteries which causes poor circulation).
• Cirrhosis of the liver is a rare cause.
• Lead poisoning.
• Sarcoidosis.
• Rare disorders of nerves.
• Excess alcohol.

With the above conditions the cramps would just be one of various other symptoms. Therefore, if you are otherwise well, and have no other unexplained symptoms, then the leg cramps are likely to be idiopathic (unknown cause) and not due to a secondary cause.
Note: leg cramps are different to a condition called restless legs syndrome. In this condition the legs can be uncomfortable, you feel creeping sensations in the legs, and it is relieved by walking about.

What is the treatment for a leg cramp?
Stretching and massaging the affected muscle (usually a calf muscle) can usually relieve an attack of cramp. Most cramps soon ease off. Painkillers are not usually helpful for a sudden attack of cramp. Taking Root Ginger or drinking lots of tonic water helps. Massaging the legs with specific oils often helps too.

What are the options for preventing leg cramps?
If cramps do not occur often, then no particular treatment is usually needed. However, if you have frequent cramps, you may wish to consider ways of preventing them.
Consider your medication (where appropriate) or other conditions
Tell your doctor if you take any of the medicines listed above. It may be causing the leg cramps, or making them recur more often. Alternative medicines may be available.

Stretching exercises
Stretching exercises are commonly advised. However, there is a lack of good research evidence to prove that it works. One research study concluded that stretching exercises did reduce the number and severity of cramps, but another study did not confirm this. So, as it may help, it is worth trying if you are able to do the exercises. If it works, you will not need any tablets to prevent the leg cramps.
At first, do stretching exercises of affected muscles for about five minutes, three times a day. Do the last exercise shortly before bedtime. If the cramps ease off, you may then only need to do the exercise once or twice a day to keep the cramps away.
To stretch calf muscles, stand about 60-90 cm from a wall. Then, keeping the soles of your feet flat on the floor, bend forward and lean on the wall. You will feel your calf muscles stretch. Do this several times, each time for as long as you can manage.

A detoxification diet should only be undertaken if the advice of a health professional has first been obtained.
It is strongly recommended that you use only organically grown foods.
There is no calorie counting on this diet and, you can eat as much as you want of all the listed foods.
Detoxification aims to cleanse the system and remove the body of toxins that can contribute to many types of ill-health. Regulating the acid/alkali balance will help regulate the weight and whilst you may loose a few pounds on the diet, you will soon regain them if they are needed.

This detoxification is a Three week programme but you may adapt it to suit your circumstances.

The first week is cleansing, the second to re-educate your appetite and the third to reinforce the new dietary regime. It is necessary to drink at least 6 - 8 glasses of spring or filtered water daily.

It is during the first 3 days that most major detoxification takes place. Toxins stored in the fat cells are released and sent to the liver for deactivation and elimination. Some cleansing reactions may take place during this time, with symptoms such as aching joints, bad breath, dizziness, headaches and spots or boils. Do not concern yourself unduly with these symptoms as they will diminish over the next few days, as the liver cleanses the blood.
You may find that you are depressed , uptight or irritable during this time but remember it will not last for long and the benefits will be worthwhile.

During this detoxification herbal teas like Chamomile, Fennel and Peppermint may be drunk freely. Water is best drunk hot, warm or at least at room temperature and can have a slice of lemon added to it. Avoid, coffee, tea and all stimulants. DO NOT DISCONTINUE PRESCRIPTION MEDICATION WITHOUT SPECIFIC ADVICE.

WEEK 1.

Before beginning this detox programme, it is a good idea to prepare your self by eating raw fruit and vegetables for one or two days prior to the start.

Day 1.
Choose one of the following foods and eat as much as you want all day (dont forget the fluids):

Apples:
They can be green or red. Eat the skins as well as the flesh. Eat about 5lbs per day either as the whole fruit or juiced with a little water if required.

Grapes:
They can be green or white. Eat about 5 - 7lbs a day of the whole fruit, pips and skins included, again you may juice them with a little water if required.

Melon:
Any of the types on the market, or a mixture of types, up to 6lbs per day. If you eat water melon you can also juice the rinds. This is a very bitter digestive tonic drink and takes some getting used to.

Tropical Fruit:
Kiwi fruit, mango, papaya and pineapple all contain extremely cleansing digestive enzymes which are good for this type of detox. At least 5lbs of the combined fruits are needed per day.

Vegetables:
A mixture of steamed vegetables, conserving the liquid to be eaten with the vegetables. Use only carrot, swede, and turnip. Eat up to 6lbs of veg per day.

Vegetable Juice:
A very cleansing and alkaline mixture is made from 1 Litre carrot juice plus 1 litre of a mixture of beetroot, celery and parsley. Make it up to 3 litres with water, drinking a cupful every 45minutes and when it is finished complete the day with plain water.

Brown Rice:
This fast is very boring because all you eat is plain rice which I suggest is steamed. It is difficult but often works for people who need a more solid type of food fast. Eat as much as you can consume.

Days 2 & 3.

Use the same food choice as Day 1, but iot is also possible to take, for example, grapes on days 1 & 2, apples on day 3, or apples on day 1 and vegtable juice on days 2 & 3, and so on. DO NOT mix fruit and vegtables in one day.

Herbal prescriptions that you have been given can be continued throughout the fast.
You may continue this fast for up to a week , often people find 3 days are all that they can manage. 

Day 4.

Assuming you have done a 3 day fast as above, today you may break the fast by introducing fresh raw foods.

Suggested Meal Plan To Break Fast:

Breakfast: Fresh fruit Salad (Any combination) sprinkled with ground almonds. 
Fruit juice or herb tea to drink.

Lunch:
A large mixed salad dressed with olive or flax oil and lemon juice. Add seeds and sprouts if desired.
Seaweeds are a good mineral source and help to remove toxins. There are many kinds available now.
Fruit juice or herb tea to drink.

Evening Meal:
Same as lunch.

Snacks:
Fruit, raw veggie sticks, small amounts of nuts and seeds.

DO NOT EAT HEAVY FOODS TOO SOON.

Days 5,6 & 7.

Follow the plan as for day4, taking as many days like this to break the fast as those number of days that you fasted. This should take you to the end of the week.

Second Week (Days 8-14).

The aim of this week is to gradually introduce some cooked foods, but to still totally avoid all foods of animal origin as they are the most toxic and clogging to the system. Still continue to eat at least half of all your food raw . Small amounts of grain may be added, but wheat should be avoided as it is hard to digest even if you are not allergic to it.
If you want you may now add back in any supplements that you have been taking.

Foods To Avoid:

Dairy (Milk, butter, cheese, cream, yoghurt), Meat and all meat products, sugar and anything containing added sugar, salt, coffee, tea (except herbal kinds), soft drinks, chips, sweets, canned foods, cakes, pastries, bread, alcohol and anything that is not completely natural.

Suggested Meal Plan:

Breakfast.

Fresh fruit salad
OR Porridge
OR Muesli
Fresh fruit juice to drink.

Lunch.

Home made vegetable soup sprinkled with ground nuts.
Rice cakes or rye crackers spread with tahini or bean spread.
Mixed salad with an olive oil and lemon juice dressing.
Fruit juice or herb tea.

Evening meal.

A selection of steamed vegetables including at least 2 green leafy ones, one orange one and one red one.
Sprinkle with sesame seeds, herbs and olive or flax oil.
Eat with a mixed salad.
Plain brown rice, millet or buckwheat.
Fruit for dessert.
Fruit juice or herb tea to drink.

Towards the end of the week you may re-introduce well cooked beans.

Third Week.

Repeat week 2 with the addition of a little more protein and if you wish some animal products. 
Yoghurt, cottage cheese, tofu, beans, soya milk and a little butter may be added back in.
Still avoid milk, margarine, sugar, salt, coffee, tea, and all processed foods. Meat and meat products are not recommended, but a little fish or corn fed chicken is acceptable. Carry on eating lots of raw foods and lightly steamed ones and steer clear of rich sauces and dressings.
If you are not allergic to wheat, you may re-introduce it but in small amounts.

By the end of this week you should have much more energy and be feeling really good with healthy clear skin. DO NOT SLIP BACK INTO YOUR OLD WAYS.
Although week 3 is a guideline for healthy eating, it does not mean that you cannot allow yourself the odd treat here and there, as long as it is in moderation and you keep your basic diet healthy.

If you do have the odd occassion when things go wrong or you have to eat the wrong foods, you can adapt the detoxification programme to suit your needs, either one day of fasting once a month, or a few day 4@s or whatever. Use your own judgement as to how much or how often you use all or part of the programme.

Good Luck.

Lumbago is a term used by medical people to describe non-specific general lower back pain, the exact cause is often unknown but can come from overuse, lifting heavy objects improperly or exercising without proper training.

The pain is in the lumbar region of the back, it is often severe and can happen after twisting or lifting awkwardly.  Symptoms can include Pain (which does not radiate down the legs), stiffness in the back, usually worse in the morning after sleeping and Scoliosis of the spine, an S shaped curvature.

Resting on a firm surface, applying heat, sports massage with specific essential oils and moving around as much as possible in between resting, will all help, specific gentle exercises are essential.  Anti-inflammatory whether orthodox or herbal will help, a TENS machine can be useful.

It can recur especially if when it is better the patient stops doing the prescribed exercises etc., it pays to keep them going even if there is no problem.

Remedial Massage is one of the most important steps to take but needs to be undertaken by someone experienced in this kind of area.

What is Gout? Gout causes attacks of painful inflammation in one or more joints. The pain can be severe. It affects about 1 in 200 adults. Men are more commonly affected than women. A first attack of gout typically develops in middle age, but it sometimes occurs in younger people

What causes gout?

Gout is caused by a chemical in the blood called uric acid (urate). Uric acid is usually harmless, and is made in the body from certain foods. It is passed out with the urine. The amount of uric acid in the blood builds up in some people. From time to time the level may become too high. When the level of uric acid becomes high tiny grit-like crystals of uric acid may form. The crystals typically collect in a joint. This causes inflammation, swelling, and pain - a gout attack.
Note: some people have a high level of uric acid but do not form crystals or have gout. Also, rarely, some people with a normal level of uric acid have gout attacks. However, as a rule, the higher the level of uric acid, the greater the chance of forming crystals and developing gout.
In most cases there is no apparent reason for the build up of uric acid. In some people, the build up of uric acid may have a known cause. For example:
If you drink too much alcohol it can cause uric acid to build up.
Some medicines such as diuretics ('water tablets'), low dose aspirin, and some used as chemotherapy for cancer may raise the level of uric acid.
More uric acid is made than usual in illnesses where the cells of the body have a rapid turnover. For example, severe psoriasis and some blood disorders.
Certain foods may 'tip the balance' to raise your uric acid higher than normal. In particular, eating heart, herring, sardines, or mussels frequently may increase the level of uric acid. However, eating a normal balanced diet should not have much effect on the uric acid level.

What are the symptoms of gout?

Gout usually occurs in 'attacks'. An attack typically develops quickly over a few hours. It usually causes severe pain in one joint. The base of the big toe is the most commonly affected joint. Walking can be very painful and even the weight of bedclothes can hurt.
However, any joint can be affected. Sometimes two or more joints are affected. Affected joints usually swell, and the nearby skin may look red and inflamed. If left untreated, a gout attack may last several days, but usually goes completely within 7-10 days. Less severe attacks can occur which may be mistaken at first for other forms of arthritis. Weeks, months or even years may go by between attacks. Some people only ever have one attack.
Is gout serious?
Although a gout attack can be very painful, it is uncommon to cause other problems even if it is not treated. Joint damage may occur if you have recurring attacks. In a few people, uric acid crystals form kidney stones. Sometimes the crystals form bumps (tophi) under the skin. These are usually harmless and painless, but sometimes form in awkward places such as at the end of fingers.
How is gout diagnosed?
Gout is usually diagnosed if you have the typical symptoms and a raised blood level of uric acid. If there is doubt as to the cause of the pain and swelling, your doctor may take some fluid out of a swollen joint. This is done with a needle and syringe. The fluid is looked at under the microscope. Crystals of urate (uric acid) can be seen in the fluid to confirm the diagnosis of gout.

What can I do if I have recurring gout attacks?

If you drink a lot of alcohol then it may help if you reduced the amount that you drink, You do not need to stop drinking alcohol altogether but cutting down may help if you drink a lot.
If you are taking any medicines, check whether they are a cause of gout (see above). An alternative medicine may be available.
If you are overweight, try to lose some weight, this can help to lower the uric acid.
Have your blood pressure checked at least once a year, high blood pressure is more common in people with gout.

What is the treatment for a gout attack?

An ice pack (or pack of frozen peas) held against the inflamed joint may ease the pain until the other treatments start to work.
Wrap the ice pack (or peas) in a towel to avoid direct skin contact and ice-burn, apply for about 20 minutes, then stop. (It should not be applied for long periods.)
Repeat as often as required BUT.... Make sure the temperature of the affected part has returned to normal before applying again.
It is believed by some that cherries/juice can be beneficial to people suffering from gout/arthritis, this is because they can help counteract high uric acid levels in the blood, known as hyperuricemia.

Uric acid is a salt contained in the blood; it normally dissolves, like sugar in a warm drink. It then passes out through the kidneys and out through the urine, if the body increases the amount of uric acid it makes, the kidneys cannot get rid of enough of it, and if it doesn't dissolve properly it builds up in the blood and forms crystals, in some people this eventually settles in the fluid surrounding the joints, leading to pain, swelling, stiffness, heat/redness.
A change in the blood chemistry is thought to be the cause, although some foods which are high in purines and eaten in excess are thought to contribute to the change in blood chemistry, this is because there may be an enzyme defect that makes it hard for the body to break down purines.

It is believed that a high protein low carb diet can aggravate and worsen gout and arthritis.
Some beneficial foods to eat are tofu and eggs. Limit high fat foods and oils, alcohol, especially Beer. Drink plenty of fresh water, warm if possible.

The following foods have very high purine levels, and should be avoided completely:

• Anchovies
• Bouillon
• Brains
• Broth
• Consommé
• Dried pulses
• Goose
• Gravy
• Heart
• Herring
• Kidneys
• Liver
• Mackerel
• Meat extracts
• Mincemeat
• Mussels
• Partridge
• Roe
• Sardines
• Scallops
• Shrimp
• Sweetbreads
• Yeast (baker’s and brewer’s)
• Yeast extracts (e.g., Marmite, Vegemite)
   

These foods have high purine levels

• Fish
• Shellfish
• Poultry
• Meat (except those with very high purine content, noted above, or those with moderately high purine levels, noted below)

These foods have moderately high purine levels

• Asparagus
• Cauliflower
• Pulses
• Lentils
• Mushrooms
• Porridge
• Peas (dried)
• Soya
• Spinach
• Tripe
   

Best bets

• Drinks (carbonated)
• Butter
• Cereals and cereal products
• Cheese (all kinds)
• Cocoa (however, caffeine is prohibited in Lesch-Nyhan Syndrome)
• Corn
• Cornbread
• Eggs
• Fruit juices
• Fruits
• Gelatine
• Ice cream
• Milk
• Noodles
• Nuts
• Refined wheat flour
• Tapioca
• Vegetables (except those noted above)
• White bread and biscuits (but not whole wheat, which is moderately high in purines)
• White rice

• Vitex agnus - castus (Chaste berry) stimulates and regulates pituitary gland function.
• Dioscorea villosa (Wild Yam) well known for its powerful hormonal normalizing action.
• Salvia officinalis (Sage) reduces sweats and can eliminate them together with other herbs.
• Dang Gui (Chinese angelica) good for oestrogen rebalance and regulating the heart.
• Leonurus cardiaca (Motherwort) Tonic for the heart and works really well with Sage.
• Cimicifuga racemosa (Black Cohosh) reduces breast pain and stress.
• Nelumbinis nuciferae (Lotus Leaf) Excellent for sweating and mood swings.

• Soya Isoflavones - Nutritionally supports the body's natural oestrogen. 100mg high strength x1 per day.
• Evening Primrose Oil - 3,000 mg per day
• Vitamin B Complex - 50mg per day
• Zinc (as a citrate) 15mg per day.
• Magnesium -200mg per day ( If insomnia is a problem)
• Vitamin C - 500 - 1000mg per day ( Useful in constipation and heavy bleeding)

• Both plenty of rest and exercise are necessary.
• Rest ensures that hormones do not accumulate in the body and cause imbalance.
• Exercise helps reduce stress and weight control. Excess body fat can interfere with metabolism.
• Exposing the body to sunlight helps regulate the pineal gland which controls cyclical processes in the body.