4. Discussion
consequent increase, Pain, rhinorrhea, chronic neuropathic pain, agitation, low back pain, trunk muscle, withdrawal syndrome, insomnia, sciatica, nausea, lumbar pain, ulcerative colitis, diarrhea, hyperalgesia, vomiting, muscle fatigue, mitochondrial damage, sciatic pain, piloerection, neuropathy, arthritis, pain, constipation, dizziness, disability
ULCERATIVE COLITIS, NEUROPATHY, CHRONIC LOW BACK PAIN, HERNIATED DISCS, NERVE DEGENERATION, ARTHRITIS, CHRONIC PAIN, OXIDATIVE STRESS
During this study, we tried to evaluate the effectiveness of the rehabilitation treatment combined with the administration of ALA, ALC, Resveratrol, and Cholecalciferol in the treatment of sciatica due to herniated discs in young patients. Efficacy was evaluated in terms of pain resolution, postural alterations, intake of painkillers, and quality of life.From the results obtained, we observed how the rehabilitation treatment combined with the administration of supplements (ALA, ALC, Resveratrol, Cholecalciferol) showed statistically superior improvements in terms of reduction in pain and disability related to back pain, in the short term and above all in the long term, in the latter case also observing a significant improvement in terms of quality of life.There are many non-pharmacological therapies for sciatic pain, and these include acupuncture, physical therapy, massage therapy, yoga, cognitive behavioral therapy or progressive relaxation, spinal manipulation, and intensive interdisciplinary rehabilitation. These treatments aim to control pain and above all to functionally recover patients, and although the level of evidence supporting the different therapies is discreet, at the moment, there is no consensus on their indication as first-choice treatments [In addition to this, agents with antioxidant action, such as ALA and Resveratrol, have recently been identified as first-line treatment for chronic neuropathic pain [ALA can neutralize free radicals, but it also increases glutathione synthesis, regenerates other important antioxidants, and prevents the formation of glycosylated end products and mitochondrial damage from oxidative stress. Several studies have reported that ALA prevents oxidative damage to nerve tissue and nerve degeneration. Furthermore, ALA counteracts proinflammatory factors (including IL-6 and TNFα), thus reducing the overall inflammatory load. Indeed, recent reviews provide convincing evidence of the usefulness of ALA as an anti-inflammatory ally in several conditions such as acute and chronic pain, neuropathy, and ulcerative colitis [Resveratrol is a widely used inhibitor of the WNT/β-catenin pathway, which plays a crucial role in many biological processes. It has shown anti-inflammatory effects in a rat arthritis model and also has well-described antioxidant properties [ALC has important physiological and pharmacological actions due to its wide distribution in many tissues, including the brain [In line with our results, numerous studies have demonstrated how combinations of antioxidant (ALA and Resveratrol) and neurotrophic (LAC) agents can contribute to pain control, reducing the use of analgesic drugs and improving the safety profile of the treatments used [An important observation from our research was the significant short-term reduction in the intake of painkillers. This is an important aspect to underline considering the multiple side effects resulting from their use. Among these, the most common are constipation, nausea, sedation, vomiting, and dizziness. Furthermore, with prolonged use of these drugs, many patients develop a physical and psychological dependence on opioids and the sudden cessation of the drug causes an unpleasant withdrawal syndrome (with agitation, insomnia, diarrhea, rhinorrhea, piloerection, and hyperalgesia) [In the second part of our study, through stabilometric evaluation, we investigated any postural alterations that may be found in patients with sciatica. Recent studies indicate that patients with chronic low back pain have a decrease in postural control, manifesting balance problems. Postural balance is controlled by sensory information, central processing, and neuromuscular responses. Alterations in proprioception are identified as one of the possible causes of alterations in postural balance in subjects with low back pain. This type of pain is associated with decreased proprioception and muscle strength, which can affect the quality of information and compromise the relationship between postural responses and sensory responses to information [Our data showed that the group subjected to the rehabilitation treatment combined with the administration of ALA, Resveratrol, LAC, and Cholecalciferol presented fewer perturbations in the frontal plane in the long term, without showing particularly significant improvements in all the other stabilometric parameters, both short and long term.Pain represents the main factor responsible for changes in postural control, regardless of the intensity of the pain. This determines an alteration of the upright position which determines an increased activation of the lumbar muscles, with consequent increase in muscle fatigue [In addition to pain, the impaired postural control found in patients with sciatic pain could result from a reduction in proprioceptive acuity, restrictive trunk movement, and protective trunk muscle strategies [Several systematic reviews [Lemos et al. [Our study was not without limitations. The first is represented by the small sample size which does not allow the results obtained to be generalized. Another limitation may be represented by the lack of evaluation between the different entities of lumbar pain and the postural alterations present in patients with sciatica. Finally, a further limitation may be represented by the failure to evaluate the stabilometric examination with eyes closed.