Integrative healthcare solution for Sciatica

Sciatica is basically the experience of sharp and shooting pain through the gluteus and down the leg. Sciatica occurs when there is an impingement of the sciatic nerve which is compressed by the discs of the lumbar spine.

While there are numerous causes of sciatica, the most common are:

• lumbar bulging disc
• spine degeneration
• facet joint injuries
• piriformis syndrome
• spinal stenosis
• spondylolisthesis
• sacroiliac dysfunction

It is important to manage the pain and manage the inflammation.

Conventional therapeutic protocols include physiotherapy guided exercises such as McKenzie extensions and core strengthening exercises. However, the inclusion of integrative healthcare solution such as Remedial Massage Therapy can dramatically improve clinical outcomes.

An experienced Remedial Massage practitioner has a range of techniques at their disposal such as:

• PNF Stretching
• Soft –tissue release
• Myofascial release
• Muscle Energy technique

If the problem still persists and /or becomes severe then consultation with a GP for anti-inflammatory medication for pain management or a CT-guided periradicular nerve root injection is highly recommended.

Continuum of care should still include the aforementioned complementary therapies and also consider the incorporation of Complementary and Alternative Medicine (CAM) Therapies such as Yoga (similar to MET principle), Bowen treatment and Acupuncture to resolve the issue.

Alternative to Fish oil

Fish oil is one of the best supplements that are often prescribed by CAM practitioners. Omega-3 fatty acids possess highly beneficial effects for modulating risk of prevalent diseases.

But what are the alternatives for people who are allergic to fish oil, or suffer from ‘fish burps’ or do not like the ‘after taste’ of fish oil.

Alternatives to consider include the plant-based:

• Flaxseed oil
• Evening Primrose oil
• Borage oil
• Black Currant oil
• Chia seeds
• Algal oils

Due to the decline in fish species and number and the risk of ocean –borne contaminants, alternative sources of these fatty acids are required. Plant oils contain low amounts of long-chain omega-3 polyunsaturated fatty acids.

Algae are in abundance in the oceans’ ecosystems and thus algal oil may be the better alternative. When CAM practitioners seek integrative medicine resources such as vitamins, herbs and other supplements, they should also consider environmental sustainability and act accordingly.

Important lifestyle advice for women – Avoid Vaginal douching

Vaginal douching is washing or cleaning out the vagina with water or other mixtures of fluids. In the United States, about one in four women 15 to 44 years old douche. Doctors do not recommend douching as it can lead to various women’s health issues.

There are many debates in regards to the pros and cons for vaginal douching. For example, US research suggests vaginal douching exposes women to potential hazardous endocrine-disrupting chemicals.

A clinical study examined urine sample from over 700 women. Results showed urine samples obtained from women who regularly douched had a greater concentration of phthalate metabolites present in their urine which also affect hormonal action.

Not only is vaginal douching harmful, but also the use of other fragranced products utilised around the vaginal area have adverse effects. Diethyl phthalate (DEP) and di-n-butyl phthalate (DnBP), are both common constituents found in fragranced products. Both the constituents are associated with having adverse effects on reproduction, the developmental system and the endocrine system.

Another survey analysis was conducted by the researchers to investigate the use of feminine hygiene products in females aged 20 to 48. From the results, 52% of the women who douched within the last month had a significant increased concentration of DEP metabolites in their urine when compared to women who had never douched. Also, as douche frequency increased, the concentration of DEP metabolites in the urine also significantly increased. As shown by the results, women who douched twice a month or multiple times, they had 152% higher metabolites in their urine.

Other external feminine products such as tampons, sanitary napkin, sprays and wipes were also examined. Fortunately, no links were established between phthalates and such feminine products. On the other hand, intravaginal products are associated with an increased risk to hazardous chemicals.

In conclusion, the cons of douching outweigh the pros of douching. So the best lifestyle advice for women is to limit the use of vaginal douching, as it is hazardous and can cause pelvic inflammatory disease, infertility, cervical cancer, bacterial vagionisis and other women’s health issue.

The importance of Iodine in Diet

Evidenced–based medicine has shown that not having enough iodine in one’s diet can be detrimental to one’s health.

11% of the US population is classified to be iodine deficient. Despite the availability of supplementation, simple supplementation may not be enough to resolve this problem.

The intake of iodine has significantly dropped between 1974 and 1991. During the period 1974-1982, the average daily intake of iodine for2 year olds was approximately 621ug. From 1982- 1991, there has been a drop of 248ug in the average daily intake.

Contributing factors include:

• Post - 1982, the baking industry limited its use of iodine based caking agents and used bromide based agents as an alternative
• Most processed foods do not now use iodised salt
• Reduction in levels of iodine in milk because of changes in treatment methods
• Reduced use of salt in cooking and iodised table salt
• Fluoridation of water

A diet lacking in iodine can lead to iodine deficiency disorders (IDDs). IDDs can lead to:

• Goter
• Mental imbalances e.g. depression, anxiety
• Mental retardation (in extreme cases, and particular in children of mothers who have had an iodine deficiency)
• Fetal hypothyroidism
• Autism
• Slow brain function
• Slow metabolism
• Lowered immune function
• Fibrocystic breast disease

See part 2 on how to get enough iodine into your diet !

L-theanine Supplementation

L- theanine is a supplement which is a commonly advocated as food and nutrition advice.

But what is it?

Is it useful remedy?

L-Theanine is an amino acid that is not categorised in either the common essential or common non-essential amino acids. This amino acid is a non-dietary amino acid that also has similar characteristics to L-Ornithine or L-Citrulline. In addition, L-theanine is similar structurally to glutamine, GABA and glutamate. Clinical research studies on 2 healthy male volunteers have shown that L-theanine supplementation promote the release of alpha waves related to mental relaxation and concentration.

Research has further revealed that L-theanine:

• has relaxation properties
• improves attention
• relieves stress
• non- sedative

Such properties make it have a significant supplement in reducing the effect of several stimulants. When combined with caffeine, the addition promotes cognition and attention. Other research has suggested L-Theanine aids healthy sleeping, however it is not recommended to be used as a first line treatment.

L-Theanine itself can be an effective supplement that can be formulated in an ‘Integrative healthcare solution’. However, L-Theanine can also be consumed by drinking green tea which is commonly advocated as healthy food and nutrition advice. Green tea is the only natural food form of L-Theanine. Moreover, ingestion of green and black tea also has significant health benefits including benefits to cardiovascular and cognitive benefits.

So if you do suffer from acute insomnia, L-theanine can be a useful integrative healthcare solution, especially when consumed in the form of green tea.

Why Integrative health care solutions is the best approach for Smoking cessation

Quitting smoking is the most common lifestyle advice given to any smoker.

Varenicline is a non-nicotine drug for smoking cessation. It is an agonist of the nicotine acetylcholine receptor, and has been found useful in its effect in promoting smoking cessation. Some studies have shown that varenicline is more beneficial than nicotine replacement therapy for smoking cessation. Varenicline has been shown to increase chances of successful smoking cessation for up to 12 months by 50% compared with non pharmaceutical interventions. Furthermore, it has been shown to be more effective than Bupropion which was the first non-nicotinic drug for smoking cessation.

However, it should be noted that for successful smoking cessation pharmaceutical intervention is often co-prescribed with other therapies such as Hypnotherapy, Cognitive behaviour therapy (CBT), exercise therapy etc. This is a good example of applying ‘Integrative healthcare solutions’ to improve efficacy.

An important consideration is that nicotine replacement therapy and non-nicotine based drugs do not work for everyone, so is there a better alternative? Some research studies have suggested that Cytisine may be more effective than nicotine agonist and is a low-cost treatment that may be effective in aiding smoking cessation.

Confined strictly in Europe, a plant alkaloid called cytisine discovered several decades ago is used for smoking cessation. Cytisine is a partial agonist of alpha4beta2 nicotinic acetylcholine receptors.

As far back as the 1960’s, cytisine was introduced to assist individuals to quit smoking. However at that time, no evidence was provided showing its beneficial effects. Nevertheless, advancements in studies and efficacy studies have revealed its impact on smoking cessation.

A 2011 efficacy study by West et al highlighted the usefulness of cytisine. Individuals participating in this study were divided into either the cytisine receiving group or the placebo group. Results showed the abstinence rate for the cytisine group was 8.4% and 2.4% in the placebo group. Typically, treatment involving cytisine requires consumption of 1.5mg tablets for 25 days. The quantity of tablet consumed varies over this period. Initially, 6 tablets are taken for the first three days, then 2 tablets for the remaining 22 days.  Moreover, cytisine is an affordable treatment, costing approximately $10 per treatment.

The Health Research Council of New Zealand funded the trial conducted from 2011-2014 involving 1310 long-term smokers in New Zealand. The researchers tested the effectiveness of both nicotine replacement and cytisine therapies over a period of 6 months. Participants were divided into two groups where they either received nicotine replacement or cytisine. After a period of one month, results showed 40% of the participants in the cytisine group to be smoke free, whereas only 31% were smoke free in the nicotine replacement group.  Despite relapses present in both groups, continuous withdrawal was shown more in the cytisine group rather than the nicotine replacement group. Although cytisine was shown to be a better treatment than nicotine replacement, it did have more adverse effects than the nicotine replacement group.

In conclusion, cytisine has demonstrated its effectiveness over short periods (6-months) and is a much cheaper treatment option, but the long-term effects of cytisine are unknown and its adverse affects i.e. nausea, sleep disorders and vomiting must be considered.

So for now, Varenicline products like Champix and other brands are the conventional pharmaceutical treatment options, but integrative healthcare solutions using hypnotherapy, behaviour modification therapy, energy medicine, yoga  and other lifestyle modification advices may be a much wiser approach that not only address the side-effects of pharmaceutical intervention but more pertinently address the deeper issues of nicotine dependency.