I started having mild pain in my lower back around 2 months ago. I have a desk job and am on the seat most of the time. I started some exercises for my back and I started feeling much better. However, for the past 1 week, I have been facing some discomfort in my lower right limb. I feel a tingling sensation and numbness sometimes (especially in my right foot). There is a general heaviness in my limb that I have never felt before. I've stopped the exercises. What would be the best course of action to take? What kind of doctor would I need to visit to address this issue?

Dr. Swati NarangPhysiotherapist8yrs exp

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Thank you for describing your symptoms it helps us to rule out the cause. As per your symptoms it seems you are suffering from sciatica which is due to impingement of sciatic nerve in the lower back. As you mentioned initially you had back ache and now radiating pain its shows impingement of sciatic nerve which causes pain to the areas it passes. As asked, you can consult some neurophysiotherapist who can confirm after diagnosing. In the mean time let me help you with some precautions and home remedies which you can take and will get relief from your pain and discomfort. Precautions: 1. Avoid forward bending, if required then bend your knees first and then bend forward. 2. Avoid weight lifting. 3. Sit in chairs or car seats with proper back support. 4. Place pillow under your legs while sleeping or can opt sidelying position for sleep. 5. Get enough vit d from sun as vit d keep bones strong including spine and other bones. 6. Drink plenty of water to enhance the intervertebral disks. 7. Avoid prolonged standing. 8. Change your sitting position every 15 minutes so that it does not pain. Reatment: 1. Use of cold packs- sometimes piriformis muscle gets tight which cause impingement of sciatic nerve leading to tingling and numbness sensation down into the leg. So ice massage can be given over the area of piriformis muscle or the entire back for 15 min. Once done with cold therapy take rest for 2-3 min to relax the muscles. 2. Since the pain is radiating you can do some below mentioned exercises which will give you immediate relief from pain if done correctly. A) lie on bed on your stomach gently push up with your arms, resting on your forearms. Hold for 5 secs. Now slightly stretch your back muscles and count till 10 and relax. You might feel a slight pain initially but do not worry. Repeat it 15 times. B) now that pain must have gone. And now you can push up onto your hands fully. Slowly lower down back to floor. Perform this atleast 15 times. Again a slight pain will be there initially. Once you will complete this exercise program your pain will be relieved right away. If pain is severe while doing the exercise then stop doing the exercise and immediately consult some physio to take care further. Other exercises that can be done in sciatica pain are: 1. Straight leg raising 2. Knee to chest. 3. Hamstring stretch. 4. Back extensors stretches and strengthening. 5. Gluteal stretch. All the above can be done for 10-15 times with the hold (stretch) time of 5 -6 secs if you did not understand or have any doubt regarding the above treatment plan, good luck and get well soon. 

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