Sciatica Joint Injection

Sciatica Leg Pain Relief

{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0Arial;}{\f1\fnil\fcharset0 Calibri;}} {\*\generator Msftedit;}\viewkind4\uc1\pard\sa200\sl276\slmult1\qj\lang9\fs36Hi, I'm Paula Moore The Chiropractor and I'm going to show you a sciatica leg pain reliefexercise. It should be know that the majority of people who come to see me as patients whohave been diagnosed with sciatica, don't have true sciatica. They do have leg pain thatis mimicking sciatica. In other words, it is running through the buttocks and down thethight, right down to the ankle but it stems from a different place. It's not the sciaticnerve. It is from a tight muscle in the buttocks, known as the piriformis muscle. It clampsdown over the sciatic nerve giving you sciaticlike

symtoms. \parYou chiropractor can tell the difference between these two. True sciatica and a piriformismuscle problem. I'm going to show you a stretch to get rid of the piriformis muscle problemand the resultant leg pain. If you do this stretch and notice your leg pain startingto decrease, you probably didn't have true sciatica and that's great, because sciaticais harder to treat. \par So you want to sit fairly close to the walland swing your legs up so your heels touch the wall. If you leg pain is on the left,then take your left ankle and place it over your left knee. Now some of you might findthat this position is already very difficult

to get into because your piriformis musclehas become very tight. If you want to increase the stretch, shuffle up closer to the wallwith your buttocks. If you want to deepen the stretch yet again, slide your right foot down thewall so that your knee is bent. You can increase the stretch by gently bringing the left kneetoward your opposite shoulder. That is the perfect position to lie in for the next sixtyseconds using your breathing to relax. \par Do the stretch on both sides, even if yoursymptoms are only on the left, as you need to stay symmetrical. 60 seconds on both sides.Remember to increase the stretch by pulling your knee gently toward the opposite shoulderor by sliding the opposite leg down the wall.

\parAny questions please send my an email to posture tutorials . Thanks for watching.\par\pard\sa200\sl276\slmult1\f1\fs22\par }.

Diagnosis and Treatment of the Sacroiliac Joint Charles Harvey MD

My name is Charles Fredrick Harvey, MD. I'ma neurosurgeon in Kankakee, Illinois, employed by Riverside Medical Group. I'm going to betalking about the diagnosis and treatment of the sacroiliac joint. I first became interestedin the sacroiliac joint as a spine surgeon because I had patients coming and tellingme that they had pain in their back going down their leg. I couldn't account for thatpain easily with the MRI findings that I saw. The sacroiliac joint is the main joint connectingthe spine with the pelvis. It allows energy transfer between the torso and the legs.I see three major categories of patients with sacroiliac pain. One category is patientswho've had trauma, for example, a fall on

the buttock, a twisting injury or even a caraccident. A second category is women who have pain that's persistent in the back of thepelvis after pregnancy. In my personal experience, out of my first 100 patients with sacroiliacsurgery, 24 of them have previous lumbar spine surgery. About 20% of patients who come totheir with lowback pain actually have pain coming from the sacroiliac joint. Studieshave shown that patients who have persistent back pain after lumbar surgery frequentlyhave sacroiliac joint disorders as a source of their pain.Patients with sacroiliac joint pain have disability and pain comparable to lumbar stenosis, kneearthritis or hip arthritis. The degree of

disability can be worse than asthma, heartfailure or COPD. The diagnosis of sacroiliac joint pain requires care and attention. Thisisn't something where simple xrays or an MRI or a CAT scan clearly demonstrate thediagnosis. Symptoms of SI joint pain can include lowback pain radiating into the buttock orleg, hip pain, groin pain, a feeling that the leg is giving away, trouble with sleepingor pain rolling over in bed, trouble with sitting especially putting pressure on theaffected side and pain going from sitting to standing.The pattern of pain can be similar between facet pain, sciatica, disk herniation or sacroiliacjoint pain. Careful physical exam by a trained

physician can help determine whether painis coming from the hip, the low back or the sacroiliac joint. Some patients find thattheir pain is worse when they stand on the affected leg or with prolonged walking. Otherpatients complained of pain with sexual intercourse or changing positions. Patients sometimesdescribe that their pain is better if they shift their weight away from the affectedside, they lie on the unaffected side and some patients have relief from a back braceor sacroiliac belt. A set of five physical examination maneuversthat put specific stress on the sacroiliac joint help us narrow down the diagnosis anddemonstrate that the sacroiliac joint is the

cause of the pain. If the patient's history,physical examination and pain provocation tests suggest the SI joint is the source ofthe pain then we consider diagnostic SI injections. A diagnostic injection is done under Xrayguidance to make sure that the injection is in the right place. We use Lidocaine or Novocainelike when you go to the dentist's office. If there is 50 to 75 percent improvement inthe pain, even briefly, that's the sign that the sacroiliac joint is the source of thepain. The patient is asked to keep track of theirpain before the procedure and after and sometimes keep a pain diary for the first few hoursafter the injection. If they have significant

improvement then we like to think that's thespot that's causing the pain. Most patients with sacroiliac pain do not need surgery.The range of treatment options available to a patient include medications, physical therapy,external support like a brace or a sacroiliac belt, therapeutic SI injections where Cortisoneis added, radio frequency ablation is another possible treatment that is given by some painmanagement physicians. Traditional open sacroiliac fusion is a bigsurgery, relatively bloody and has a long recovery. Recent advances in minimally invasivesacroiliac fusion offer a new option. The iFuse implant system is a technique for minimallyinvasivestabilization and fusion of the sacroiliac

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