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Sciatica Treatment by Physiotherapists

Physiotherapy Treatment of Sciatica by Jonathan Blood Smyth Sciatica results from a structure impinging on a lumbar nerve root, causing compression and/or inflammation enough to cause neurological changes in the skin, reflexes and muscles served by the affected nerve. Not a common syndrome, it is estimated that 3-5% of the population suffer this kind of problem at some time. It affects men and women equally with men most susceptible in their forties and women in their fifties.?? Up to a quarter have symptoms which last more than six weeks and referral to physiotherapists for acute management is routine.


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Chill out. Ice will be your best friend when you are suffering from sciatica. Placing a cold pack or ice pack on the lower spine, tailbone and/or buttock for 20 minutes once every 2-3 hours will help reduce swelling and also reduce pain. It is important to use ice exclusively at the onset of sciatica, as it has been found to decrease the length of time needed for healing.

Sciatica is quite simply irritation of the sciatic nerve. This can happen several different ways at a few different points in the nerve's journey from the low back to and through the leg.

Stretch yourself. Relaxing the muscles in the lower back, buttocks and upper legs through stretching will help reduce the strain on the sciatic nerve and the joints throughout the lower back and pelvis. Always stretch gently and avoid any further stretching if it causes sharp pain or if it aggravates your problem.

Get it straight. Your posture plays an important role in the health of your spine. Sitting and standing as straight as is comfortably possible will help to reduce the effects of nerve irritation and get your nerves healing quicker and more completely. Avoid sitting in soft couches or chairs, as they will not give you the support that you need to sit well. Instead, drag a kitchen chair into the living room and spend your time sitting in a more supportive chair. Use a back support cushions in every chair you sit in; whether at work, in the car or at home to help support your back properly.

Sciatica usually comes on quickly after an aggravating activity or posture, along with some back pain but this can go off when the leg pain starts. Sciatica is worsened by sneezing, sitting and coughing and is better lying down or standing. The pain is in the buttock and either down the back of the leg or the side and down into the foot. In 5% of cases the affected nerves are the first, second or third lumbar, which give front of thigh pain not beyond the knee. The full picture may sometimes not be present, with individuals describing discrete areas of pain such as the foot only.

I wanted to take the time to share with you a few sciatica stretches and information that you can use to help you. Sciatica is actually a symptom of back pain, but often people will refer directly to the symptom. Back pain is a nightmare for those people that have it. It affects everything you do because your back is central in that movement. You can roll over in bed and be caught with sharp pain. You could lean into the refrigerator to grab something and you'll have sharp pains go up your spine. It's really a horrible thing to have to live with. I'm going to talk to you about sciatica stretches and information.

Take a break from your regular exercise routine to give your sciatic nerve a break. If you simply must exercise, try non-impact exercises of the upper body, like resistive exercise band exercise or exercise ball exercises. Swimming may be a helpful alternative to your regular routine as well.

If after 4-5 days you choose to alternate ice and heat, keep it off from the spine and limit heat use, especially with a heating pad, to no more than 20 minutes. Avoid sleeping while applying heat, as it can cause burns and can dry out the tissues, slowing the healing process.

A thorough history performed by the physio will uncover any red flags, an indication of a possibly serious underlying medical condition responsible for the pain. Loss of weight or appetite, severe pain at night, a history of cancer, unwellness or fever, bowel or bladder control difficulties, young or older patients, all these things ring warning bells and the physio will refer the patient on to a medical specialist for evaluation. The location, nature and response to activities and postures of the pain will be noted by the physiotherapist.

Even if you end up seeking professional help to deal with sciatica, incorporating practical home care can help shorten your recovery time and get you out of pain quicker. If pain in your buttocks and legs is something that you would rather avoid than deal with again, use these tips regularly to give yourself the best chance of preventing sciatica for years to come.

A lot of people don't understand what is happening, but it's really quite simple. There is some sort of nerve being pinched in some manner. This could be happening from a spinal disc compressing too far and a nerve gets pinched. It can also happen from a tight back muscle that literally strains a nerve to the point of pain. Essentially some nerve, for whatever reason, is getting too much pressure on it and you end up with sciatica.

Microdiscectomy Alternative A newer, less invasive form of discectomy is also now available. This procedure is called a microdiscectomy and uses special magnifying and muscle-spreading instruments to allow the surgeon to view and operate on the herniated disc region. The surgeon can then perform the procedure through a smaller incision and cause less damage to the surrounding muscle and tissue.

Physiotherapists use a variety of therapies to treat sciatica, with McKenzie technique being a mainstream technique for discogenic pains. Mobilisation and manipulation techniques, core stability work, myofascial release, specific exercises, manual techniques, soft tissue work and massage, analgesia, patient education, rest, the best position to relieve extreme sciatica pain and advice are all used as treatments. Most sufferers settle without investigation or surgery and a long term exercise programme is useful once the problem has settled.

Herniated Discs Here is a simplified explanation of what happens with a ruptured or herniated disc. The disc itself is kind of like a soft jelly-filled donut. The outer wall of the disc is called the annulus fibrosus and the inner part of the disc -- the jelly part -- is called the nucleus pulposus. When the outer part of the disc becomes weakened, it can tear and allow some of the inner nucleus pulposus to leak out. When this inner jelly presses on the surrounding nerve tissue it can weakness, tingling and pain in the back and legs.

Get some sleep. Sleep is one of the most critical components in helping start and in maintaining a healing process. When you sleep, your body does its best work of healing and repairs the damage done throughout the day. Following any injury or during any illness, regular sleep is critical in helping your body get the upper hand.

Frequently sciatic nerve pain is a result of the joints in your lower spine being poorly aligned and putting pressure or stretching on the nerves as they come off from your spine. This problem is called a subluxation and is diagnosed and treated by chiropractors. Sciatica can also commonly occur due to spasm of a muscle in the buttock called the piriformis muscle. The sciatic nerve passes under this muscle as it travels through the pelvis near the hip down to the back of your leg. This problem is frequently treated by physical therapists, chiropractors and massage therapists.

Have you ever experienced a literal pain in the butt that continues all the way down your leg? Has it ever felt like someone was sticking a hot poker into your leg? If either of these scenarios is familiar to you, you've probably suffered from sciatica, a pain in the sciatic nerve. No one experiencing sciatica wants it to stick around any longer than, well, at all, so let's not delay in discovering how you can make your leg pain a distant memory.

A discectomy is an invasive surgical procedure that removes herniated disc material that is protruding into the spinal canal and pressing upon nerve tissue. This pressure can cause numbness, weakness, tingling, or mild to severe pain in the back and leg.

Put on some relief. Topical analgesics can help alleviate some of the bite of the pain of sciatica while helping soothe the spasm in the muscles of the low back, buttocks and upper leg. Getting even temporary relief from your sciatica can help your healing process by providing you an opportunity to rest or sleep.

About the Author:

Jonathan Blood Smyth is a Superintendent Physiotherapist at an NHS hospital in the South-West of the UK. He specialises in orthopaedic conditions and looking after joint replacements as well as managing chronic pain. Visit the website he edits if you are looking for physiotherapists in Manchester.

Move it! While sitting in a straight-back chair is helpful in supporting your lower back and spine, be sure that you aren't sitting for any longer than 15-20 minutes at a time. Lack of movement in the joints of the spine especially can cause further damage, stiffness and muscle strain. Getting up and moving frequently, even if only to stretch or walk gently around the room will help to keep circulation fresh and facilitate a quicker recovery. Be sure that you stay well within your limits; if you are pushing yourself too hard and it is causing pain, then stop and give yourself a rest.

 
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Stretching the piriformis muscle can be done several different ways. However, when your sciatic nerve is screaming, the easiest stretch involves lying on your back with your knees bent and pulling one knee at a time up towards the opposite shoulder and holding it for 5-30 seconds. You will know you are getting a good stretch when you feel a mild stretch in the buttocks near the hip.

Get professional help. It is always a good idea to seek help from a chiropractor, medical doctor, physical therapist or massage therapist when you experience pain in the low back and/or legs. Waiting too long to effectively treat a condition involving your nerves can cause problems as mild as missing time from work all the way up to irreversible nerve damage. It is wise to effectively and completely deal with any problems involving your nerves, as doing so will help prevent similar problems from rearing their ugly head again down the road.

Drink like a fish. To drink like a fish, you need to drink what a fish drinks: water, lots and lots of water. When your body isn't hydrated properly, the tissues become tacky and adhesions form. If adhesions form, this slows the healing process and causes increased scar formation. Adhesions can form between your sciatic nerve and the surrounding tissues, causing your healing process to be incomplete and leaving you vulnerable to frequent, repeated sciatic episodes.

Go for a massage. It stands to reason that if your sciatica is due to irritation of the sciatic nerve from spasm of your piriformis, hamstring or lower back muscles, deep tissue massage can be of great benefit to you. Getting a massage or even using a massager at home that is able to get into the deeper tissues of the buttocks and low back may help relieve some or all of your sciatic pain. At the very least, it can help to reduce the stress that commonly accumulates when you are in pain.

About the Author:

For more information on discectomy alternatives see DRX9000 spinal decompression for sciatica at http://www.drx9000-spinal-decompression.com, a popular site with free info on the DRX9000 and other back pain treatments.

The great forces which we impose on the low back mean the lumbar intervertebral discs suffer structural changes and prolapses. Many activities involve a significant level of leverage, such as flexing over, performing movements in an upright position and lifting with the arms away from the body. This greatly magnifies the forces on the discs and due to their fluid mechanics they suffer 3-5 times the loads on the skeleton. This can cause the disc walls to degenerate, giving weak areas and predisposing to prolapse at some time.

This article is not meant to replace the advice of your personal health care provider. Be sure to consult with your physician to explore all your back pain treatment options before taking any medical course of action.

The better you take care of yourself, the greater health and vitality you will enjoy.


About the Author:

Dr. Nick Preston is a chiropractor focused on helping families enjoy greater health and founder of Wisdom and Health. If you want to learn more about sciatica and find products designed to help you, check out www.wisdomandhealth.com/sciatica.html. You can also find products which will help you quickly make your leg pain a distant memory.

The physiotherapist begins with postural observation of the patient which can show an inability to stand up or a thoracic shift to one side. Spinal movements are performed and the pattern of movement limitation noted, with a full neurological examination of the lower limbs. The physio is looking for deficits in muscle power, reflexes or feeling which are related to the specific nerve root involved. The straight leg raise may be performed to check the stretch reaction of the spinal nerve.

Before being considered for either type of surgery, the doctor will typically have an imaging study performed such as an MRI (magnetic resonance imaging) or a CT (computed tomography) scan in order to help diagnose the specific cause of the problem. Discectomy and microdiscectomy procedures are normally done in a hospital under general anesthesia. In some cases discectomy can be performed in an outpatient surgical center.

Discectomy surgery is a common treatment for herniated or ruptured discs of the lumbar spine and may be used for back pain sufferers who have not responded to traditional non-surgical treatments such as anti-inflammatory medication, physical therapy, traction, spinal decompression, and epidural steroid injections.

Disc prolapse can result in the internal nuclear material being extruded past the outer disc wall, physically compressing the nerve root which runs nearby. The nuclear material is also chemically irritating to the nerve structure and these irritants make the nerve and nearby structures swell, partly blocking the local circulation and the nerve's message transmission. Disc prolapse is typically the cause of proper sciatica but the size of the prolapse is not closely related to the amount of pain the person suffers.

Give it a rest. Exercise is a great asset to getting and staying healthy, but when your sciatic nerve is unhappy, exercise will frequently flare up your problem and slow your progress. Especially if the piriformis muscle is involved, exercise which causes pounding, such as walking, running, tennis, basketball, soccer, etc., will flare the piriformis spasm and put additional strain on the spine in the lower part of the back.

To understand and defeat the beast that is sciatica, it will be helpful to understand what it is and what causes it. The sciatic nerve is the largest nerve in your body, which starts in the low back and travels all the way down your legs to the bottom of your feet. It controls nearly everything within your legs: from the large hamstring and quadriceps muscles in your upper legs to the smallest blood vessels in the bottom of your feet.

The sciatica stretches and information I want to share with you are great. The best one you can do is lying on your back and pulling your knees up to your chest. The point of this is to stretch out the lower back and should take the pressure off the nerves. Another stretch is grabbing onto something above your head and allowing your legs to go weak. This forces the back to stretch out and takes a lot of tension off of it.

If you aren't able to get in to the chiropractor or physical therapist right away or you hope to help improve your situation at least in part on your own, here are some tips to help relieve the pain associated with sciatica.

As a result, the patient can experience less pain and a quicker recovery. Not all patients are able undergo discectomies or microdiscectomies. A lot has to do with the particular nature of the patient's herniated disc.

The McKenzie technique works on pain centralisation, the tendency for pain to move towards the back from the legs, suggesting a disc problem, and many physios use this technique. Pain in the front of the thigh and over the knee can be referred from the hip joint, so the physiotherapist will assess the lower limb joints to check the diagnosis. A thorough examination informs the physiotherapist of the likely diagnosis and how they might treat the syndrome, or that the patient needs to be referred to a medical practitioner for a consultation and investigation.

What Happens In A Discectomy? In a traditional discectomy -- often referred to as an open discectomy -- an incision is made in the patient's back over the herniated disc region. Muscle tissue around the herniated disc is removed and a retractor may be used to keep the muscle tissue and skin out of the way which gives the surgeon better access to the surgical area. In some cases, some of the vertebrae bone -- called the lamina -- may need to be removed to allow the surgeon better access to the disc. This procedure is called a laminectomy. Once the herniated disc fragments have been removed, the muscle tissue is put back and the surgical incision is closed with sutures.


Learn the Sciatica Stretches That Work


Kimberly Griggs

 
 
     
 
 





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