Low Back Pain Sciatica

The Associated Chambers of Commerce and Industry of India (ASSOCHAM), the apex trade association of the country, as part of its 'Illness to Wellness' campaign and in the light of the forthcoming 'World Diabetes Day' on Saturday unveiled a report on the findings of a National Level Survey conducted on the state of Diabetes in India. The release was followed by a webinar on "Diabetes Free India" organized with the objective of cascading awareness and disseminating wisdom on diabetes management and its prevention, which was attended by a panel of eminent experts and doctors from across the country. The survey report entitled "Diabetes in India" was produced by ASSOCHAM and the Delhi-based think tank, Thought Arbitrage Research Institute (TARI). The survey was designed and conducted by IMRB-Kantar and covered 2,33,672 people and 673 public health offices in 21 state clusters covering appropriate regions and age segments. The key findings of the survey relate to the burden of diabetes and its primary causes or risk factors which lead to its rise and increasing spread in the country. According to the report, the prevalence of diabetes cases in India almost doubled from 42.6 million cases in 2005 to 85.4 cases in 2019. Globally, on the other hand, the prevalence of diabetes increased from 273.4 cases in 2005 to 460 million cases in 2019. Small wonder then that India has the dubious distinction of becoming the global hub for diabetes cases with prevalence of cases increasing from 15.6 per cent to 18.6 per cent cases in the same interval. Globally, diabetes accounts for 70.9 million DALYs (Disability-Adjusted Life Years) and 36.7 YLDs (Years Lived with Disability) in 2019. In India, diabetes accounts for 12.8 million DALYs, 6.7 million YLDs and 0.3 million deaths during the same time-period. In terms of risk factors for diabetes, dietary habits related to high intake of junk / fried foods, most common in younger people today, has highest relative risk of 47 per cent. The next highest risk factors as elicited by the survey report relate to low physical activity (38 per cent), low intake of fruits and vegetables (28 per cent), and other causes such as stress, pollution, and high consumption of alcohol and carbonated/ sugary drinks. Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Over the time, uncontrolled diabetes leads to serious body's systems damage, especially the nerves and blood vessels. There are ample studies conducted by RSSDI (Research Society for the Study of Diabetes in India) which emphatically depict and highlights that diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation. The survey outlines the prevalence landscape of diabetes in that it accounts for 25 per cent of all NCDs in India at a rate of 2.9 percent. The disease incidence increases significantly in individuals above 35 years of age and affects men more than women. The report also finds that about 16.8 per cent of the male adult population (15 years) and 14.6 per cent of the female adult population (15 years) on average are estimated to be diabetic. Prevalence of diabetes is highest in southern states including Puducherry, Kerala, Tamil Nadu, Andhra Pradesh and Telangana and lowest in Uttar Pradesh and Rajasthan. In terms of sufferers seeking treatment for diabetes, the survey presented some important insights in this regard too. About 7 per cent of the respondents who were suffering from diabetes stated that they were not seeking any treatment at all. However, more than 56 per cent of the respondents stated that they are seeking treatment for more than one year, a fact testifying to the indisputable and inevitable morbidity of this disease. Diabetes is proven through studies to be associated with a high risk of cardiac arrest and there have been substantial increases in new cases of diabetes during the Covid-19 pandemic due to various reasons. In the current situation, diabetes has become a serious health concern since large numbers of patients are already vulnerable to the coronavirus. Thus, diabetic patients affected by Covid-19 can cause a major health crisis. Reports show that large occurrence of diabetes makes it a serious comorbidity in Covid-19 patients. Diabetes also imposes a substantial burden on society in the form of higher medical costs, lost productivity, premature mortality, and intangible costs in the form of reduced quality of life. Setting the tone for the panel discussion at the webinar, Anil Rajput, Chairperson, ASSOCHAM CSR Council, said: "This year marks the 100th anniversary of the discovery of insulin. It is, however, unfortunate that diabetes has been underrated as a global public health issue. This needs to be addressed on priority and we as a nation need to take urgent important steps to address this challenge. It is a fact that diabetes is one of the top three NCDs in India and with each year the burden of this disease is rising." Dr. Banshi Saboo, President, Research Society for Study of Diabetes in India (RSSDI), said: "Diabetes prevention must be part of a larger national mission. Students should be taught 'Health Science' as a subject in schools which can help in preventing this disease and creating awareness about healthy lifestyles among our future generations. We must also change the age limit for the cyclical three-year testing protocol for sugar from 30 years presently to 25 years of age." Dr. (Col.) Sudhir Tripathi, Chairperson and HOD, Endocrinology and Metabolism, Sir Ganga Ram Hospital New Delhi, said: "Diabetes can be prevented even at the pregnancy stage. Healthy mothers give birth to healthy children. We must also educate and inform people that this disease is reversible with healthy lifestyle and timely interventions. Babies who are healthier, not obese, have a far lesser risk of developing diabetes in adulthood. It is advised that we must now have a National Diabetes Month in November to spread awareness and access about diabetes amongst people." Dr. Dinesh Agarwal, Senior Consultant Internist and Head of Department, Department of Medicine Marwari Hospitals, Vice Chairman, RSSDI Assam Chapter, said: "One of the key risk factors and causes of diabetes is stress and junk food. Even children undergo a huge amount of stress these days due to a highly competitive and strained environment. It is a fact that stress leads to hormonal changes which in turn can trigger diabetes in individuals. Add to this the fact that lack of exercise among both children and adults lead to an onset of the disease which could have easily avoided by following simple steps." Dr. Rajesh Kesari, Founder and Director, Total Care Control, Delhi-NCR, said: "Diabetes free India is a dream for all of us. Diabetes, a chronic disease, has so many affected all of us either as families or as individuals. It is important to control this disease because not only does it cause many other diseases or co-morbidities and complications to take place, but also leads to a huge economic burden. The interesting aspect here is that 95 per cent of diabetes can be prevented, and it is important that we all work towards this." The webinar was addressed by Shri Anil Rajput, Chairperson, ASSOCHAM CSR Council; Dr. Kaushik Dutta, Founder and Co-Director, Thought Arbitrage Research Institute (TARI), New Delhi and eminent doctors which included - Dr. Banshi Saboo, President, Research Society for Study of Diabetes in India (RSSDI), Dr. (Col.) Sudhir Tripathi, Chairperson and HOD, Endocrinology and Metabolism, Sir Ganga Ram Hospital New Delhi, Dr. Dinesh Agarwal, Senior Consultant Internist and Head of Department, Department of Medicine Marwari Hospitals, Vice Chairman, RSSDI Assam Chapter, and Dr. Rajesh Kesari, Founder and Director, Total Care Control, Delhi-NCR. Read More► Is Pregnancy Related Low Back Pain Sciatica?

Low back pain effects approximately 50 to 80 per cent of pregnant women. There are numerous etiologies for pregnancy-related back pain, such as mechanical effects of gravid uterus, positional stressors, and hormonal effects resulting in pain at pubic symphysis and sacroiliac joint. Lumbar radiculopathy or true sciatica is rare and accounts only for 1 per cent of low back pain in pregnancy. What is Sciatica? Sciatica is also known as lumbo-sacral radicular syndrome defined as a radiating pain along the course of the sciatic nerve. The pain travels from the lower back, buttocks, posterior of the thigh, leg and the foot. It can be a deep, dull pain or a shooting, sharp pain. Sciatic pain can range from mild to severe. It often resolves with treatment. Causes of Sciatica During Pregnancy Sciatic pain is typically caused by lumbar spine problems, such as: A bulging or herniated disc Spinal narrowing or stenosis, Osteoarthritis or degenerative disc disease Spondylolisthesis These situations can put pressure on the sciatic nerve, causing symptoms. Sciatica due to a herniated disc during pregnancy isn't common. But, sciatic-like symptoms are common with low back pain in pregnancy. Sciatic like symptoms can also be caused by Muscle tension and unstable joints Pelvic bone pain Sacroiliac (SI) joint dysfunction Piriformis Syndrome Pelvic Girdle Pain (pelvic bone pain) Pelvic Girdle Pain (PGP) describes pain in the joints that make up your pelvic girdle; this includes the symphysis pubis joint (SPJ) at the front and the sacroiliac joints (SIJ) at the back. Majority of pregnancy-related low back pain is PGP and is often misdiagnosed as sciatica. PGP discomfort is often felt over the pubic bone at the front, below your tummy, or across one side of your lower back, or both sides. At the front, below your tummy, or across one side of your lower back, or both sides. A diagnosis of PGP can be reached based on certain signs and symptoms that you may experience during the pregnancy or afterwards. Having one or more of them may indicate the need for a physiotherapy assessment followed by advice on appropriate management. You may experience pain in all or some of the areas shaded in the diagrams above. You may also experience the following: Difficulty Walking Pain when standing on one leg (e.g. Climbing stairs, dressing, or getting in or out of the bath) Pain or difficulty moving your legs apart (e.g. Getting in or out of the car) Clicking or grinding in the pelvic area you may hear or feel this Limited or painful hip movements (e.g. turning over in bed) Difficulty lying in some positions (e.g. On your back or side) Pain during normal activities of daily life Pain and difficulty during sexual intercourse With PGP, the degree of discomfort you are feeling may vary from being intermittent and irritating, to being very upsetting. Piriformis Syndrome This is a problem with one of the main stabilizing muscles in the buttocks. This is a common cause of sciatic pain during pregnancy and can present with PGP. This is due to the tightness of the muscle and change in posture in pregnancy. Piriformis syndrome can be due to both muscle pain from the baby's weight that can also add stress to SI joint because it puts extra pressure on your pelvis and hip joints. Occasionally, the position of your baby can add pressure to your sciatic nerve. Causes Obesity or weight gain (including weight gained during pregnancy) Prolonged sitting can also increase risk of developing sciatic pain Muscle tension and stress to the pelvic joints, sacroiliac joint problem Symptoms of Sciatic Pain During Pregnancy Occasional or constant pain in one side of your buttocks or leg Pain along the sciatic nerve path, from the buttocks down the back of your thigh and to the foot Sharp, shooting, or burning pain Numbness, pins and needles, or weakness in the affected leg or foot Difficulty walking, standing, or sitting Activities to Avoid Avoid sitting for long periods Avoid doing pain exaggerating activity Forward bending Do not lift heavy weights often and beyond your ability General Advice Warm packs or cold packs depending on the comfort Rest from the pain exaggerating activity Upright posture Managing weight gain during pregnancy Sleeping on the side that is not affected Use a pillow for comfort and support Stretches (as per recommend by your physiotherapist) If the symptoms persist it is recommended to consult your Obstetrician and get referred to see a physiotherapist. These sign and symptoms should not be dismissed as normal aches and pain. (Shazia Shadab, Senior Physiotherapist, Cloudnine Group of Hospitals (Jayanagar))(By Shazia Shadab) Read More► Why Are Cancer Cases Rising in India?

To adjust to the seasonal changes one needs to go back to basics and give heed to the concept of Rituacharya, an ancient Ayurvedic practice that derives its connotation from two words 'Ritu' meaning season (6 seasons) and 'Charya' meaning a regimen or a discipline. The practice of Rituacharya basically teaches one to acclimatise his lifestyle to the seasonal transitions that are experienced by physiology due to the changes that take place in the environment that surrounds him. This process usually takes 14 days, a phase when the current seasonal effect starts feigning and a new season starts setting in. It then becomes extremely crucial for one to cope with the biological and mental impact that this phase of approximately 14 days that affects one's overall wellbeing. As per the teachings of Ayurveda, each of us embodies a dominant natural constitution comprised of: either Vata, Pitta, or Kapha (or a combination of any of the two constitutions). Vata constitution is comprised of the qualities of air and space, Pitta by fire and water, and Kapha type body by water and earth. Each season pacifies or ignites these energies within us, meaning that our system can get imbalanced, if we do not take the right measure to adapt our bodies to the changing weather conditions. For example, during the monsoon season as we are currently experiencing, the sky is cloudy and it rains. The strength of the body decreases during this season and Vata dosha starts to become prominent as Pitta dosha is slowly accumulated. The digestive Agni is also dampened by the waters. Diet recommendations: Inclusion of Sour, salty and oily (unctuous) foods are best for this time. Among cereals, one should consume old barley, rice, wheat, etc. Meat soup, Yusha (soup), etc. are ideal to provide warmth to the body. As waterborne diseases are prevalent now, it is advised to take medicated or boiled water. One must consume churned preparations that are high in water content. Vata-oriented foods are drying and best for this season. At this time, one must not consume foods that are heavy and hard to digest, like meat, etc. Lifestyle: Only use boiled water for the bath to avoid skin infections. Massage the body with warm oil after bath. Actions to avoid are getting wet in the rain, sexual indulgence, heavy exercise and sleeping during the day. Likewise, during the autumn or Sharad, the earth (mud) is moist and the Sun shines brightly in a clear sky which may sometimes have white clouds. Strength returns to medium, while the Pitta dosha accumulated in the rains starts to melt in the Sun. Digestive Agni starts to get rekindled. Diet recommendations: Sweet, bitter and astringent are the tastes to favour during this season. Foods that are cold and light to digest are best during this part of the year. Pitta-pacifying foods should be consumed now. Wheat, green gram, sugar candy, honey, Patola (Trichosanthes dioxide), the flesh of animals of dry land (Jangala Mamsa) are great dietary choices for this season. Avoid hot, salty and sour foods as well as foods that are oily and heavy. One should avoid overeating, eating fish and sleeping during the day during this period. Lifestyle recommendations: Only eat when you feel hungry. Purify the water you drink by placing it in the Sun and the water used for bathing should be placed under the moonlight. Application of cooling pastes such as sandalwood to the body may deem beneficial. Balance your doshas by soaking in the moonlight during the first 3 hours of the night. Sleeping during the day, overexposure to sunlight is best avoided. Read More► Home Remedies to Fight Hormonal Acne

Chennai, Aug 17 (IANS) Even as Tamil Nadu has the capacity to vaccinate eight lakh people a day, the number of inoculations stand at 2.4 lakh a day. The shortage of vaccine, according to health officials, is the major reason for the less daily vaccinated count.Health department officials said that the reduced count of inoculation is due to the shortage of vaccines in the state and that the department was trying to overcome this with a fresh quota of more doses of vaccines.According to a document of the Union Health Ministry, as on August 2, the state stood at eighth position in the number of 45 plus category people having taken a single dose of vaccine. It is to be noted here that the first seven states in this list have administered the first dose of vaccine to more than 1 crore people.The figures of the Union Health Ministry as of August 2 reveals that the state has administered a single dose of vaccine to 83,58,273 people which is much less when compared to other states who are leading in the list.Tamil Nadu has gone three steps behind on the number of people who have been administered both the doses of the vaccine and stood at 11 in the overall ratings as far the document of the Union health ministry is concerned.According to the data, the state has administered 97.91 lakh doses to people in the age group of 18-44 which is again the eighth position among the overall ratings.The state Finance Minister P.T.R. Thiagarajan had in the Budget speech said that the state is vaccinating 2.4 lakh people a day while it has a capacity to vaccinate 8 lakh people a day. With the state allowing more areas to reopen, the vaccination has to be done on a priority basis to save the people from getting the disease.The state, according to senior health officials, has trained manpower and administered vaccines to 69 lakh children in a one-week polio drive during the pandemic. A senior health official said, "We have to receive more vaccines and must make use of facilities and trained manpower to the maximum so that more people are given vaccines and this is the only way to overcome a third wave of the pandemic if it hits."State Health Minister Ma Subramanian told IANS, "The government is constantly in touch with the Union health ministry and we will receive more allocations of the vaccine in a few day's time. The team is working around the clock and is closely monitoring the situation, we will overcome the vaccine shortage soon and increase the rate of inoculation in a few day's time."--IANSaal/dpb