Sciatica or sciatic neuralgia is a commoncondition in which one of the spinal nerve roots of the sciatic nerve is compressed resultingin lower back, buttock and leg pain. Sciatic nerve is a large nerve derived from 5 spinalnerve roots: L4, L5, S1, S2 and S3. It runs from the lumbar spine through the buttockdown the leg and the foot on the posterior aspect. There is one sciatic nerve on eachside of the body. Typically, only one side of the body is affected.A typical sciatica pain is described as a sharp shooting pain in the lower back, downthe buttock, thigh and leg on one side of the body. There may also be numbness, burningand tingling sensations. The pain can get
worse with sitting, moving, sneezing, or coughing.The patterns of pain depend on which nerve root is compressed, and follow the dermatomedistribution. The most common cause of sciatica is a herniatedspinal disc. The spinal disc is a soft elastic cushion that sits in between the vertebraeof the spine. With age, the discs become rigid and may crack, the gellike center of thedisc may protrude out and become a herniation outside the normal boundaries of the disc.Disc herniation presses on the nerve root as it exits the spine.In majority of the cases the condition resolves by itself after a few weeks of rest and conservativetreatment. Pain relief, nonsteroidal antiinflammatory
drugs and muscle relaxants may be prescribed.Stretching exercises and physical therapy may be recommended.Surgery may be needed if the pain doesn't go away after 3 months or more of conservativetreatments. The herniated disc may be removed in a procedure called discectomy. Or, in anotherprocedure called laminotomy, part of the bone of the vertebrae may be cut to make room forthe nerve.
3 Steps to Permanent Relief for SI Joint and Pelvic Pain
Today we are going to cover the 3 steps topermanent relief for pelvic and SI joint pain. Now what is SI joint painé The SI joint, ifyou do have SI joint pain, is pain on either side of the tailbone where the tailbone connectsto the pelvis. So this is a drawing of the pelvis. This is your tailbone. This isyour lumbar spine or your lower back, the bones in your lower back called vertebraesitting on top of your tailbone. Then on either side of that you have your right hip or yourleft hip if we are looking at a person from the front. When we see somebody with SI jointpain, they will typically have pain on that given side. 70% of the time, it is on theright side. Don't ask me why that is but
70% of the time we know it is on the right. You canalso get shooting groin pain, buttocks pain and symptoms down the outside of the leg thatis affected. It might be pain, numbness, tingling, burning. Typically, that personsuffers from a heaviness as well. It can also cause some incontinence and leaking issuesas along to effect sexual performance as well. It can be absolutely devastating ifthe pelvic problem is bad enough. Fortunately, most people just have pain on one side. Sowhat can you do about ité That person who has SI joint problems typically has troublerolling over in bed, getting in and out of a car, crossing one leg over the other. Usuallythey have trouble sitting for long periods
of time especially if it is on a couch or a softsurface. So it can be absolutely devastating. Now what are the steps to permanent relieffor thaté Number 1 is this. Most people when we seethem if they are going to try exercises on their own and they only have a little bitof SI joint pain or pelvic pain, they are doing stretches. Yes, there is a very basic stretchwhich most people show me on Day 1. It is a piriformis stretch which is where you grabthe knee and pull it up and across to the opposite shoulder. It will give the personwho suffers pelvic or SI joint problems and pain temporary relief. However, long termwe don't want to stretch. We want to
strengthen or stabilize. Why is thaté Whensomebody has an SI joint problem, so the center of gravity of your entire body is inthe center of your pelvis. That needs to move the right way and it needs to be stable whenyou are doing day to day activities. If it is not stable enough, what will happen is thejoint will move so far that it becomes stuck. So if we are looking at the tailbone, we havethe tailbone and we have the pelvis and you get a normal gliding day to day. If morestress, more force is put through the pelvis than the pelvis itself can handle, that SIjoint can handle, what will happen is you actually become stuck. Now that creates allsorts of problems for the muscle around it.
What most people do is try to stretch theirway out of it. The problem is not stretching and it is not flexibility. It is actuallya stability issue. If we want to stabilize, we need to do strengthening exercises. If you go on ourYouTube channel, on the Madden PT official YouTube channel, there is a tutorialcalled Top 3 Exercises for SI Joint and Pelvic Stability. They are very low grade, kindergartenlevelexercises where you can at least begin stabilizing the muscles that controlyour pelvis. But we don't want to stretch, we want to think stabilize. Step 2 is we want to take a look at our habits.So what are some habits that lead to
pelvic instability and problemsé Number oneis standing with the weight shifted. So if I'm standing like this with my weight shiftedside to side for long periods of time, what that does is over years and years and yearsit weakens the ligaments which are tissue that hold joints together that we can't control.Think about somebody with an ankle sprain. They sprained a ligament. They stretchedthe ligament but it is not a muscle. It is different than a muscle. There are littlehabits that we do. If I stand like this and let's say I weigh 175 pounds and if I'm standinglike this, I have 150 pounds on one side and 25 pounds on the other. Where if I'm standingbalanced, I have 87 Â½ pounds on each
Lumbar Spine Selective Nerve Root Block Injection pain management movies
You will be lying on your front. Your skinwill be cleaned. A small needle will be used to inject some local anesthetic to numb theskin. This may sting for a couple of seconds. The tip of a needle will be placed next tothe spinal nerve. Fluoroscopy, an XRay TV, is often used to guide the needle to the correctlocation. Some contrast dye may be injected to check the exact position of the needletip using fluoroscopy. Then the medication will be injected around the spinal nerve,the needle removed and a small bandage placed on the skin.