Sciatica Joint Pain Treatment

Standing Stretches Lower Back and Sciatic Pain Stay Fit Personal Training Tarpon Springs FL

Hey everyone! It is Matt Barber. NASM Certifiedcorrective exercise specialist. Today I am going to be talking about stretches for thelower extremities. Simply, these four stretches are going to show you how you can alleviatelower back pain if you do them on a regular basis. I know many of you out there have lowerback pain. Ok, so the first of the four stretches is a complex of muscles called the hip flexormuscles. They lie here in the front of the thigh up near the hip. One of the main hipflexor muscles, called the psoas, originates directly in the lumbar spine. So if that muscleis tight, and it is tight on most people, then that muscle puts a lot of stress on thelower back region. So, the way we stretch

the hip flexor is, and by the way before Ishow you that, all the stretches I am showing you are standing stretches. For those of youwho struggle getting up and down off the floor the beauty of these four stretches is youcan do them all in a standing position. I am going to show you in another tutorial thatis going to show you how to stretch those same four muscles but in a more of a lyingposition. So, this is good for those of you who again, struggle with getting up and downoff the floor. So the way we stretch the hip flexor is when we load the front leg likethis, I am basically in a lunge position. So I am putting my weight on the forward leg,my left heel stays down, my right heel comes

up off of the floor. It is very importantI am going to tilt my pelvis, called a posterior pelvic tilt. My pelvis is going from hereto here. So if I tilt the front of the pelvis, I am going to lengthen or stretch those hipflexor muscles right there. I am also squeezing my right glute which helps assist in the stretchas well. So if you notice I am next to a sturdy frame here. You can use a chair at home ifyou like whatever is sturdy to help you with your balance. Because sometimes balance canbe tricky on this stretch. This is very beneficial because again to stretch this muscle. I amholding it for thirty seconds on one side. Then thirty seconds on the other. Again, Iam loading the forward leg, I've got the

front of the pelvis out. I am squeezing theleft glute. My belly button is braced toward the spine. Again, I am holding on if I needto for balance. That is called the hip flexors. Thirty seconds to a minute on each side. Nextone is the hamstring complex. Hamstring muscles align right on the back of the thigh. Theway we are stretching that is we prop one foot up, I have one hand on top of the other,I have nice long posture, I am reaching forward so that I feel a stretch right through there.I do not need to round forward like this because it is putting me in a bad posture. I can stillget an effective stretch by staying right here. My shoulder blades are together, I havenice, tall posture and I am still getting

a good stretch back through here. You do notwant the bench to be too high because if it is too high you are more likely to lose yourbalance. Also if it is too high you might get some tension up here in your hips. Wekeep the bench fairly low for the purposes of this stretch. Thirty seconds on one side,then of course thirty seconds on the other side. And if you do struggle with balancea lot, you can hold on to something and stretch to your side like this so you can get a goodstretch. That is ok if you need to modify it. Thirty seconds to a minute on each side.Next one is a muscle called the piriformis is in your gluteal region. Any of you whohave had sciatic issues in the past, then

this muscle is likely tight. A lot of us havetight piriformis muscles. The way I am going to stretch this is in a seated position here.I'm going to place my right ankle across my left thigh like this, take my knee andpull it to the opposite shoulder like this. I am pulling this knee diagonally toward thisshoulder. Nice, tall posture and I am holding this for again, thirty seconds to a minute.I don't want my left foot to turn out of this this is a compensation. You want to keepyour left foot straight ahead as you can see. Again, nice tall posture. Thirty seconds here.And then I switch it again everything aligned, ankle, knee, hip in alignment. And then Igot thirty seconds on this side as well. I

Sacroiliac SI Joint Fusion for pain treatment

Borgess happens to be one of the premiereinstitutions in sacroiliac joint fusion. The SI joint, or the sacroiliac joint, is thejoint between the sacrum bone and the ilium, which is a part of the pelvis, and the sacroiliacjoint can become inflamed or unstable or degenerated in some patients, resulting in pain. There are nonsurgical treatments for sacroiliac joint pain that can work in a certain subset of patients. That includes physical therapy, chiropractor treatment, injections, or painshots in the joint, but for those patients who don't get relief those treatments, theyare a good candidate for a sacroiliac joint fusion. We make an incision, an approximatelytwo centimeter incision, on the lateral aspect

of the patient's buttock. Through that incisionusing Xray guidance, we place three guide wires, and then we place screws over thoseguide wires to stabilize and fuse the joint. The three screws that we place in the sacroiliacjoints have slots in the center of them, and we pack those with bone such that the slottedareas span the sacroiliac joint, and we can actually get bone growth or bony fusion across the joint through those screws. The typical sacroiliac joint procedure that I am doingtakes approximately 45 minutes to an hour. Patients usually spend a night in the after surgery. They have restrictions for the first 12 weeks or so after surgery, bending and lifting restrictions.

I can't even describe in words how great it is to see people improve after this surgery and other surgeries that we do in neurosurgery for pain. We actually do have patients coming from other states at times to have their sacroiliac joints fused. To anyone who is out there who has not gotten relief with their treatments, I would suggest that you talk to your family physician or your primary care physician and request areferral to the Borgess Brain and Spine Institute so that we can assess you and see if we canhelp you with your pain.

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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