Sciatic Nerve Usmle

Top 3 Exercises for Sciatica and Pinched Nerve

Have you heard of sciaticaé A lot of peoplecomplain about nerve pain down the back of their leg. Usually the cause is withinthe lower back or pelvis. I'm going to give you 2 stretches today for the sciatic nerve. Itis the largest nerve in the body. It runs down the back of the leg and splits into two behindthe knee. It runs the whole way to the foot. It can cause shooting pain, numbness, tingling,dead leg feeling or the feeling that your leg is falling asleep. The first exercise is this. It is called flossing.We are going to sit up nice and straight here. What you are going to do is straightenthe affected leg or the leg with pain.

Stretch that leg out and look up at the sametime. As you are doing this, if you are doing it right and you are doing it on thepainful leg, it could actually make the symptoms travel down your leg. That is ok.You are putting a stretch on the nerve. We are going to hold that 5 seconds. Then bendyour knee and look down. 5 second hold here. 5 second hold, 10 times each way. Thisis called flossing. The next exercise is called a slump stretch.Same idea here, as you are doing this exercise, you could experience increased symptomsdown the leg and that is ok. Outside of the flossing or this exercise,no other exercise should increase the pain

travelling down the leg. Everything else shouldactually decrease the pain in the leg and you will experience more pain in yourlower back. What we do is this: Feet against the wall, knees straight, fingers interlockedbehind the head. Then you are going to slump forward. So bring your elbows in. Thereyou go. This should cause pretty sharp symptoms down the back of your leg. It iscalled the slump stretch and it is ok to feel increased pain down the back of the leg. Wehold this for 30 seconds and we do 3 of them in the . Now if that is too difficult,if that is too advanced, here is what you can do: Place your arms behind you and situp and arch your back. What you want to

try to do is if that is too much for you,if that is too intense, you can place your arms behind your back and simply arch your back.Rock your pelvis forward. That will do the same exact thing but it is a little less intensethan interlocking your fingers behind your neck and leaning forward. This is a littlemore basic. So you can modify. The same idea though 30 seconds, 3 times. If you canat least get yourself to sit up straight with the legs straight, feet flat against the wall,you are in good shape. The third exercise you should do for sciaticaor symptoms running down your leg is this: Realize that with symptoms travelling downyour leg, often there isnt a problem within

the leg. The problem is within the lower backor the pelvis. The sciatic nerve, the nerve roots where it originates is in your lowerback. If you are getting pressure on the nerve roots there either from disc degeneration,from a herniated disc or, as is also common, a problem within the pelvis and the sacroiliacjoint. If you have a problem there that is putting increased pressure on the nerve, thatis what creates the symptoms in your leg. You can think about it like this: if you havea long garden hose and there is water running through it and you pinch one end,obviously at the other end you are going to have less water flow. Same idea in your body.If you pinch that sciatic nerve, that is

what creates the symptoms. That is what changeswhat you are feeling down your leg. The solution isn't to continually addressthe problems in your leg. Or to put heat on your leg or ice on your leg. The solution is torelieve the pressure on the other end of the garden hose or the other end of the sciaticnerve. So what you need to do is figure out what is causing the symptoms down your leg.A good Physical Therapist can help you do that and they can decipher through testingwhether it is coming from arthritis or disc degeneration or stenosis in your back, a herniateddisc or a problem in your pelvis. So the third exercise that you should be doingis the 3 exercises that are addressing the

Nerves 4 Dermatome Man

This is my frienddermatome man. Dermatome man is a map. He's a map of allthe spinal nerves and the parts of spinal nervethat actually innervate skin. And you'll notice that he hasstripes on him, and the stripes representthe different spinal nerves that are sending somesort of sensory fiber or that are carryingsome sort of sensory fiber

in their spinal nerve highwayto this area of skin. Now, I see that I havethe unlabeled version of dermatome man here. I have one dermatome memorizedand that is the belly button. This isthe skinof the belly button, that stripe of dermatome man,the sensory neurons that come from this stripearound your belly button, travel through spinal nerve T10.

Interestingly, the sensoryinformation from your appendix also travels through T10 and,if you think about that, that it hasal significance, because there's a concept calledreferred pain where you actually sometimesperceive visceral pain, like pain in a structure likethe appendix or your small intestineor your heart, you perceive it as pain inone of your dermatomes.

Patients will sometimes come into a 's office and say, oh my god, my belly button. There's something wrong withmy belly button. It really hurts. And the will look atthe belly button and be like, dog pound, you don't haveanything wrong with your belly button. It looks just fine.

But, knowing that the samespinal nerve is carrying fibers from the skin aroundyour belly button, as well as from your appendix, your brain sometimes getsthe messages mixed up and interprets the message asmy belly button hurts even though it's actuallymy appendix hurts. It's a reallyinteresting phenomenon. You will not have to memorizedermatome man.

I recommend throwing a labeledpicture of dermatome man in your external brain, andthat's so that you can actually have it to refer to. On an exam I would definitelyhave a picture of dermatome man for you to refer to if I weregoing to ask you questions about that. A question could be somethinglikeI'm going to have to use the T10 once againbecause I don't know

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