The Pain & Injury Doctor ONLINE Newsletter

Here is your latest pain relief tip. If it doesn’t apply to you, still take note because life is full of surprises. If you know someone who is dealing with this type of pain, please forward this email to that person– thanks!

How to Manage Sciatica

What is Happening:

Most cases of sciatica involve a bulging disc in the low back pressing on the L5, S1 or S2 nerve root, left or right side; less commonly on both sides. The S1 nerve root is one of several that form the sciatic nerve, the largest/ thickest nerve in the body that controls muscle contraction and sensation in the legs.

Nerve roots may also be pinched by a thickened spinal ligament or an osteophyte (bone spur) in the foramen (hole) where the nerve comes out of the spine. This is called lateral canal stenosis.

Recommended Home-Therapy Products Covered in Today’s Issue:

 

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Other Causes of Sciatica

Sciatica can also arise from tight muscles in the buttock (hip rotator muscles) squeezing it. If you had a fall or injury that misaligned your sacrum, lumbar spine or hip joint it could throw those butt (gluteal) muscles out of balance, causing them to scissor the sciatic nerve where it passes between these muscles.

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Lastly, the worse kind of sciatica is from spinal stenosis. This is when the central spinal canal in the lumbar spine narrows, pinching the nerves that lead to the legs. The canal narrows due to degenerative joint disease in the lumbar spine. People in this group walk in a crouched forward position, because it seems to provide relief. If you have spinal canal stenosis and your symptoms are unbearable, get a consultation from a spinal surgeon on your options.

Self Treatment for Sciatica

If you have some low back pain along with sciatica, or a history of it, chances are your sciatica is due to a bulging disc. The strategy then is to reduce the bulging disc; i.e. decrease its size so that it doesn’t pinch the nerve.

Lumbar extension exercises at various angles can be helpful in reducing bulging lumbar discs. The key is to find the right angle, as all disc bulges don’t behave the same in response to certain movements. The correct movement causes the lumbar vertebrae to “pinch” the bulge back to center.

Do home spinal decompression. The Back Bubble and Nubax Trio  work well for this:

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Back Bubble Spinal Decompression Device

The Back Bubble uses the weight of your legs (in sitting position) or torso (in supine position–shown here) to decompress your lumbar discs. Its patented, oversize inflatable harness makes it very comfortable to use.

Set it up at home or in your office at the proper height, sit in the harness and simply bend your knees to generate the decompressive force. You can also use it while lying on your back, legs up. All it takes is about ten minutes per day.

Watch the Back Bubble in action.

More Information…

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Shiatsu Pillow Massager with Heat

Although this massager is designed for the neck and lower back, you can sit on it as well, and massage your glutes.  The infrared heat penetrates and relaxes the muscles and sciatic nerve.

More Information…

Use the PosturePump elliptical back rocker. This is a device that separates discs and extends the lumbar spine in the non-weight bearing position (while lying down).:

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PosturePump Elliptical Back Rocker

The elliptical back rocker is designed to reduce disc bulges by spreading lumbar vertebrae apart while extending the lumbar spine in an arc using special “elliptical” air bladders inflated by hand pumps. The pumping action draws in fluids and nutrients into thinning/ bulging discs, rehydrating them. This can slow down degenerative disc disease. It is a good device to have for low back pain prevention.  Watch this video to see the PosturePump in action.

More Information…

If your sciatica is caused by pinching of the sciatic nerve in the buttock by your butt muscles, stretch your gluteal muscles (piriformis) muscle to lengthen.

There are several ways to do it. One is to cross your legs while sitting (bad leg on top), clasp your hand over the top knee and pull it up and in the direction of the opposite shoulder (may be difficult if you have a large belly). Hold for about 15 seconds; relax. Repeat 6 times twice a day.

You can also use a power massager like the Max2 Percussion Massager to “shake” the spasm out of the piriformis muscle. This is called Tonic Vibrational Reflex. Watch this video where I demonstrate this technique:

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Max2 Percussion Massager

This is a professional grade vibration massager with two treatment heads.   The Max2’s action is strong enough to generate the tonic vibrational reflex, resulting in immediate relief.

More Information…

For soothing, deep-penetrating infrared heat, get a TDP Infrard Lamp:

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TDP Infrared Lamp

This is what acupuncturists and physical therapists use as a heat modality for thick muscles. Infrared light penetrates deep into muscle tissue, all the way down to the sciatic nerve. It increases cellular ATP production (energy) which enhances healing of injured tissues and reduces inflammation. The heat increases local circulation, delivering more oxygen and nutrients to the treated area. Great for treating thick muscles, the shoulder joints, knees, hips, deep nerves and spinal muscles.

More Information…

Recommended Lifestyle Changes

Sciatica often affects those who sit frequently, for long hours. Sitting places a lot of pressure on the discs and promotes bad posture. It also places pressure on the sciatic nerve, especially if you don’t have much fat in the buttocks for cushioning and if you have a hard chair. Wearing a thick wallet in your back pocket can cause more pressure to the nerve.

One of the best ways to reduce the bad effects of sitting is to use a stand up desk. Many employers will pay for this, since studies are coming out showing how prolonged sitting damages health over time. The VariDesk is an affordable option for a standing desk, and I highly recommend using it if you have a desk job.  Use it in the standing position 2 hours a day, then increase the time as you get comfortable with standing while working.

Other Tips to Relieve Sciatica Pain

-Strengthen your back and butt muscles by doing kettlebell swings.
-Seek out an Active Release Technique (ART) practitioner. This is a special massage designed to normalize muscle contraction and joint movement.
-Roll a high density foam roller under your buttock muscles to stretch and massage them:

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Trigger Point Grid Foam Roller

Use the GRID to roll through tight muscles, knots and kinks to reduce soreness and improve mobility. Studies show that using a foam roller can provide users with benefits such as decreased muscle and joint pain, increased circulation and flexibility, improved range-of-motion, better balance and improved gait.

For sciatica, place it on the floor and sit on it making contact with the affected gluteal muscles, and using your feet to push, roll it underneath back and forth. Then, place it under your affected hamstring and repeat.

More Information…


BOTTOM LINE: Sciatica and related shooting leg pain is caused by compression of one of the spinal nerve roots that form the sciatica nerve, or direct compression the the nerve itself, usually in the buttocks. Check with a specialist to determine what is causing yours so that you can initiate the proper self-treatment methods.  Decreasing disc bulging or reducing piriformis muscle spasm are the two basic approaches for most cases of sciatica.

On rare occasions, sciatica/leg pain can be caused by a brain tumor affecting the neurons of the sciatic nerve.

These are some of the products I recommend to my patients suffering from sciatica.  They are generally safe to use, but check with your doctor. ~Dr. Perez

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For more detailed, step-by-step guidance on permanently resolving chronic muscle and joint pain, visit

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The information contained in this email and on www.PainandInjuryDoctor.com is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as a medical directive. It is provided as a sharing of knowledge and information from the research and experience of Dan Perez, D.C. Every person is unique, and individual cases of pain are therefore unique. Dr. Perez encourages readers of PainandInjuryDoctor.com to use available sources of information to help them make a more educated and informed decision regarding their health, in partnership with one or more qualified health care professionals.

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