There are those who believe chiropractic treatment helps any kind of back pain and there are others who believe it should be avoided altogether.  The truth is most likely somewhere down the middle.

There are several causes of sciatica pain that benefit from various kinds of chiropractic treatments, not during an acute flare up, but in the treatment of a chronic sciatica history.

Aside from spinal adjustments, the chiropractor has different ways to relieve sciatica pain and help you regain mobility and strength, as some chiropractors use physical therapy alongside the manipulations.  A chiropractor will also be able to teach you about exercise, proper body mechanics and ergonomics to prevent back pain from recurring.  Among the exercises there will most likely be stretching and strengthening exercises to relieve and retrain the various muscle groups that hold up the spine.

Once a chiropractor used spinal manipulation to bring you relief, massage therapy may be a excellent next step, since massages help loosening up tight muscles and stretching the muscles can help keeping the adjustment where it is supposed to be.  Oftentimes massage therapy is also used to prepare the patient’s tensed muscles for a spinal adjustment.

So what are some of the risks of chiropractic treatment for sciatica pain?  Not all causes of sciatica pain benefit from such treatment or are even considered unsafe, as for example advanced osteoarthritis of the spine.  Rotational adjustments to the neck have a minimal but serious risk (one to two in a million) of stroke.  If your pain is in the lower back you could question not to have your neck treated.  Claims have also been made that chiropractic treatment has really caused disks to herniate.  When adjustment are being performed too often and too forcefully hypermobility of the joints can be a result, as can microscopic tearing and consequently scarring in ligaments, both of which rather worsen your condition in the long run.

Is chiropractic treatment the solution for your sciatica pain?  It’s probably not the solution, but a valid part of it.  Are there risks?  Most certainly there are, but then there are risks in any kind of medical treatments.  Spinal injections aren’t risk free either, not the procedure, nor the side effects of the medication.  In the end you have to inform yourself about your options, weigh the risks, choose the right professionals and choose which kind of treatment you are comfortable with.

In my opinion, chiropractic treatment should never be seen as a total solution, since the adjustments and other procedures don’t remove the cause of the sciatica pain, but alleviate the pain and pressure.  Chiropractics need to be part of a treatment plot that has to have the strengthening and restoration of muscle strength and structure as a goal, as any serious chiropractor would point out him/herself, to bring your body to the point where it can take care of the spine itself through muscle tissue, ligaments and tendons strong enough to do the job right.

Millions of people each year are affected by sciatica. If you are one of them, it is vital that you relieve what is causing your pain and how to get the proper treatment. Treatment can be from doing various exercises to home remedies that only take a few minutes a day.  Below is why you might have sciatica pain in buttock and how you should treat it.

Sciatica pain in the buttocks is usually caused by a pinched sciatic nerve. This is caused by a disk complication that is pushing against your sciatic nerve and thus making it very painful. If it is hard for you to sit down and stand up, this could be the cause of your problems. Also, if you are not getting sleep because of the pain, it could be because of sciatica.

Many symptoms go along with sciatica including numbness, tingling feeling in the legs and lower back pain. If you have any of these symptoms along with your pain in the buttocks, it is vital that you get proper treatment.

With so many people living lives that are full of tasks and duties, it is hard to get time to do sciatica stretches and/or exercises. So, people are turning to the internet for help. 

A treatment plot that is very simple to follow and only takes a few minutes or your day is called Treat Sciatica Now, and it has helped thousands of people just like you relieve their sciatica. If you are interested in receiving a home remedy for sciatica, it is a fantastic book to pick up.

Sciatica is a condition that affects the sciatic nerve. In most cases it will become pinched and you will have pain in the lower back and leg. Here are some ways you know if you have sciatica.

Most of the time, sciatica has consistent pain running down the left or right leg. The first common cause of sciatica is called Lumbar Spinal Stenosis.  This can be caused by standing or walking for long periods of time. Due to sciatica hits, older people, it can be from years of doing your job, or not participating in physical activity. If you reckon you have symptoms of sciatica, it is vital that you get proper treatment.

The next cause of sciatica is a herniated disk.  This is the most common cause of sciatica. A herniated disc happens when the disc bulge or herniates, causing the disk to compress against the sciatic nerve.  This cause can lead to irritation in the lower back, and also make numbness, tingling feeling, and much more.

The last common cause of sciatica is Piriformis Syndrome.  This is due to a muscle hitting the sciatic nerve, thus irritating it.  When your muscle spasms, it can lead to compressing the scat nerve.  Not only is this serious, but it could lead to other complications if left untreated. 

As you can see, there are many different types of sciatica and how to obtain it. If you reckon you have any of these, you should see treatment before it is too late. Sciatica needs to be treated when it starts, or complications could increase as you age. 

Chronic sciatica is a torturous and hard to resolve back and leg pain syndrome.  Sciatica is not a diagnosis, but a symptom of an underlying causative condition.  Right sciatica is sourced by a spinal abnormality, while pseudo-sciatica can come about due to muscular, circulatory or even psychosomatic reasons.  No matter what the actual cause of sciatica, chronic symptoms can make life very hard for affected patients.

Chronic means long lasting or recurring.  For sciatica sufferers, there are a fantastic number of different chronic patterns associated with their symptomatic expressions.  Some patients endure the same pain everyday, while others endure a variable symptomology which can change hour to hour in some cases.  Many patients endure constant back and leg pain, while others suffer only at certain times of the day, or with certain activities or positions.  Some patients have a small or a lot of pain everyday, while others will have excellent days without pain and terrible days with hellish symptoms.  Finally, recurrent bouts of acute sciatica or “flare ups”, as they are often called, can be one of the most agonizing clinical profiles possible and can make a tremendous amount of anxiety in every sciatic nerve pain sufferer.

Statistically, the most common diagnostic conclusion used to clarify sciatic nerve symptoms is a herniated lumbar disc, typically at L4/L5 or L5/S1.  These are the levels which suffer the greatest and most universal degeneration in the human spine, so it is simple to see why herniations at these locations are common diagnostic scapegoats.   But, in order for these bulging discs to enact symptoms, they would have to affect surrounding neurological tissues through the processes of spinal stenosis or foraminal stenosis.  This is because the spinal discs themselves do not feel pain, as they do not have blood supply or nerve endings.

Foraminal stenosis is the usual diagnosis for herniated discs theorized to cause sciatica.  These “pinched nerves”, as they are often called, go on to form the sciatic nerve, so it is thought that compression of one or more nerve roots can enact sciatica pain.  Clinical research has decisively shown that actual compressed nerves stop signaling altogether, causing a condition of right objective numbness and weakness in the regions served by the affected nerve structure.  There would be no lasting pain or tingling, as well as no subjective numbness and weakness common to the vast majority of sciatica complaints.  This makes the pinched nerve theory lose tremendous credibility as a right source of sciatica.  Additionally, in order for a herniated disc to really have any effect on the nerve at all, the bulge would have to virtually completely close off the neuroforaminal space, which is a very rare scenario indeed.

Spinal stenosis as a source of sciatica is more complicated, since stenosis anywhere in the spine can make a variable pain pattern, along with the typical neurological symptoms in the legs.  Stenosis in the lower back can make sciatica, as can stenosis far up in the cervical spine.  This makes diagnosis very hard, when the causation is indeed structural.  Add to this fact that most stenosis is not symptomatic in anyway, even though anatomical alteration is evident upon diagnostic imaging, and you really have a hard time differentiating between potentially troublesome stenosis and innocent spinal canal narrowing.  Many herniated discs, for example, may impinge on the
thecal sac surrounding the spinal cord, but do not have any effect on the cord itself.  Even herniations which do press into the cord typically may displace the cord (making a frightening image on MRI films), but usually do not cause any pain or sciatica.  But, in some cases, spinal stenosis can be problematic and truly enact lower back, buttocks and leg pain syndromes.

Despite all this doom and gloom, there is some excellent news about sciatica.  Structural causations which are accurately diagnosed and truly do make symptoms most commonly respond very well to indicated medical and complementary treatment.  This means that most right anatomical issues responsible for enacting pain can be completely cured.  For patients with long term symptoms which have proven themselves to be unresponsive to various forms of treatment, the answer is simple.  In these cases, the condition is virtually always misdiagnosed, leading the sufferer on a wild goose chase using treatments which are all targeting mistakenly identified causes of pain.  No wonder the treatments fail…

In this article, Im going to add to my list of Stretching Don’ts and show another widely well loved stretching and warm up exercise that is based on nothing but nonsense, and should be eliminated from your program.

The scary thing is that because of the vast popularity of this exercises, it’s very likely that you’re practicing it or that it has been recommended to you by a chiropractor, physical therapist, yoga intructor or personal trainer.

As I have done in my previous stretching donts article, I’m going to provide you with a whole bunch of science and a solid rationale for why the stretching exercise listed below both fails to promote proper movement patterns, and, based on recent research, may really lead to dysfunction.

Stretching Don’t: The Lying Piriformis Stretch and/or Standing Leg Cradle

The leg cradle is used by many sports coaches to develop mobility in the hip rotators by mainly stretching the piriformis. It’s basically a standing variation of the traditional supine piriformis stretch.

This is another one of those movements that I haven’t used much because I’ve never really liked it. I feel that it’s a hard movement to coach and thought that it made unnecessary torque on the knee joint. Regardless, I kept giving the leg cradle a chance and used it on occasion. Finally, but, I chose to eliminate it entirely from our program while attending a physical therapy workshop. It was called Diagnosis of Mechanical Dysfunction and Stability Retraining of the Hip, and taught by Mark Comerford.

During the workshop, Comerford thoroughly clarified why stretching the piriformis from any position (standing, sitting, supine, etc.) with the hip externally rotated and abducted (as in the leg cradle) will really do more to stretch the posterior lateral hip capsule than the piriformis muscle.

According to Comerford, consistently stretching the hip capsule in most cases is a terrible thing because it can develop uncontrolled motion (i.e. instability). This type of instability can eventually lead to a number of hip dysfunctions such as hip impingement syndrome.

Hip impingement occurs when the head of the femur (thigh bone) butts up against the acetabulum (hip socket). In the process, the labrum (cartilage around the rim of the socket) gets pinched.

It was at that point that I realized something very vital. I realized that both the leg cradle and traditional supine piriformis stretch placed the hip in virtually the same position as when sitting cross-legged.

What Comerford was teaching us went along with what physical therapists have been saying for years about limiting cross legged sitting as it can lead to hip dysfunction. Until then I had just never made the connection. It was honestly obvious to me at that point that the leg cradle was a stretching Don’t. Just to place the final nail in the leg cradle’s coffin, I found a research article on hip impingement by Dr. John C. Clohisy that said something pretty incredible.

“Improved MRI technology has made it possible to study this problem more closely. As a result, we now know that many people who have no symptoms have femoroacetabular impingement.” (John Clohisy, Clinical Orthopedics and Related Research Journal September 2007. Vol. 462 Pp. 115-121.)

This is very vital to know because it means that someone can really have hip impingement and not even know it. What’s just as vital to know is that the first thing any qualified physical therapist instructs a patient with hip impingement to do is avoid cross-legged sitting because it enhances the problem.

So, by performing the leg cradle or the traditional piriformis stretch (which imposes the same forces as cross legged sitting) you could very well be promoting a dysfunction. It should be clear to you now that the leg cradle and the traditional supine piriformis stretch are both poorly designed movements that should be eliminated from your program.

The question now becomes, “Can I stretch the piriformis muscle without possibly causing hip dysfunction?” Lucky for you, I have the answer. Yes, you can, and I’m going to show you how it’s done.

To help you better appreciate the rationale behind the stretching protocol I’m about to show you, you need to know some basic biomechanics of the piriformis muscle.

“In the neutral hip position the force vectors of piriformis action contribute to hip abduction, extension and lateral (external) rotation. It might be assumed that the hip must flex, adduct and medially rotate to stretch piriformis, but this isn’t the case. As the hip flexes, the rotation moment of piriformis changes such that by full hip flexion it becomes a medial (internal) rotator.” (Travell & Simons, 1992)

“The transition point for this change in action is considered to occur at about 60 degrees of hip flexion.” (Kapandji 1970, Lee 1989)

Because the piriformis, like all muscles, functions in all three planes of motion, it must be stretched in all three planes of motion in order to be lengthened effectively. If we look at the leg cradle we can clearly see that the hip being stretched is in flexion, external rotation, and abduction.

As clarified above, the piriformis contributes to hip abduction and therefore is shortened in that position. This is the reason why the leg cradle does not stretch the piriformis effectively.

In order to effectively stretch the piriformis as an internal rotator (above 60 degrees of hip flexion) we need to place the hip into flexion, external rotation and adduction. You will see this occur in the protocol below.

Note: the below sequence displays how to stretch the right hip. Reverse for the left hip.

Step 1: Assume a quadrupedal (all fours) position with your right ankle crossed over the back of your left knee.

Step 2: Place your right hand out to the side.

Step 3: Shift your hips and shoulders toward the right until you feel the stretch.

<a onClick=”javascript:pageTracker._trackPageview(‘/outgoing/article_exit_link’);” href=” http://www.performanceu.net/article02.html”>Click here</a> to see pictures of this stretch

Be sure to go your pelvis and shoulders together in rhythm while avoiding any lateral flexion or rotation at the pelvis and/or trunk. This helps you prevent any substitution patterns (such as lumbar flexion which is commonly seen in the supine version) and build some awareness of spinal stability.

This stretch can be performed dynamically by moving the hips back and forth every one or two seconds, or it can become a static stretch by holding the position for 20 to 60 seconds or more.

We use this hip stretch as a level one progression in which we have developed two other, more advanced variations. In my Warm Up Progressions DVD series, we show the entire progression spectrum for this stretch and give you many thoughts for safer, more functional alternatives to the Warm up and stretching don’ts listed in this and my other articles.

Conclusion

I’m going to close by sharing something I’ve been pondering about this whole piriformis thing:

Given that the piriformis changes its function from an internal rotator to and external rotator relative to the degree of hip flexion, is it possible that in order to better improve its function, we might need to stretch it in two different ways using two different hip positions? It’s certainly something to reckon about. And like I said, I’m the thinking man’s coach.

Very often the muscles most affected with trigger points are the postural muscles. The trigger point model states that most unexplained pain radiates from these points of local tenderness, suggesting that treatment should be addressed to the relevant trigger points. But before I carry on to further explaining the Trigger Point Theory let’s go back in time first to see where this concept comes from.

HISTORY

An American doctor, Janet G. Travell, was responsible for the most detailed and vital work. Her work treating US President John F. Kennedyback pain was so successful that she was questioned to be the first female Personal Doctor to the President. She published more than 40 papers between 1942 and 1990 and in 1983 the first volume of The Trigger Point Manual appeared.

This was followed by the second volume in 1992. In her later years Travell collaborated extensively with her colleague David Simons. A third edition is soon to be published by Simons and his wife, both of whom have survived Travell.

Today, much treatment of trigger points and their pain complexes are handled by Physiotherapist who are trained and experienced in Trigger Point Therapy, Myofascial Trigger Point Therapists and some other Therapists who are trained in this field. The trigger point concept remains unknown to most doctors and is not generally taught in medical school curricula.

THE TRIGGER POINT THEORY

Trigger points have a number of qualities. They may be classified as active/latent and also as key/satellites and primary/secondary. I will just go on to clarify the active and latent concept to avoid making it too technical.

An active trigger point is one that actively refers pain either locally or to another location (most trigger points refer pain elsewhere in the body along nerve pathways). A latent trigger point is one that exists, but does not yet refer pain actively, but may do so when pressure or strain is applied to the myo-skeletal structure containing the trigger point.

Latent trigger points can influence muscle activation patterns, which can result in poorer muscle coordination and balance. Activation of trigger points may be caused by a number of factors, including acute or chronic muscle overload, injury to the area, muscle imbalances and some other less common reasons.

Trigger points can appear in many myofascial structures includingmuscles, tendons, ligaments, skin, joint capsule, periost (bone fascia) and scar tissue. When present in muscles there is often pain and weakness in the associated structures.

Trigger Points are often the cause for the development of muscle imbalances, which in return cause spinal and joint mal-alignment. As structures become uneven or excessively stressed a condition of the spine or joint will develop!

TREATMENT

Prior to treatment commencement, the therapist should be sure that the pain patterns they are treating lend themselves to Trigger Point Therapy. If the patient presents with swelling, discoloration, or neurological symptoms, it is always advisable to refer to another health/medical care provider regarding further examination and/or investigation.

Treatment of trigger points may be by Physiotherapists trained in Trigger Point Treatment, Myofascial Trigger Point Therapist and other Therapists trained in this field. If your back pain, sciatica or any other pain treatment has been unsuccessful then it is very likely that the Trigger Point Treatment has been the missing link of your treatment. You are best to find a Health Professional experienced in the Trigger Point treatment concept.

THE TRIGGER POINT SELF-TREATMENT SYSTEM

The Trigger Point Self-Treatment System was developed by an Americanneurological chiropractor who once suffered from low back pain and shoulder/arm pain himself. This system allows you to treat your trigger points in the comfort of your own home, as often as necessary. People who can’t afford to see a Health Professional Privately or just don’t have the time to regularly make visits to a Professional can treat their pain at the comfort opf their own home.

The program’s unique, simple to use design helps you completely relax your muscles while you apply only the amount of deep therapeutic pressure needed, to your comfort level. The Trigger Point Self-Treatment System allows you to be in complete control. With the treatment platform design you can simply use your body weight, and completely relax whilst effortlessly melting your pain away.

With just ten minutes a day, you can find blessed relief you probably have not known for a long time. All the trigger points around the body can be pressure massaged away. Nothing could be simpler!

For the majority Living With Sciatic Pain often means:

A life of pain relievers – anti-inflammatory medications, over the counter pain medications and prescription pain medications are not meant to be taken on a continuous basis and often cause more harm than excellent. Ulcer, IBS and other complications can arise from too many pain relievers.

Modified behaviors – you can’t do the things you used to do and you just have to live with it. Not such a nice way to live is it? When you used to run, walk the dog or swing from a trapeze now you can only sit on the couch and knit and even that helps.

Dealing with the pain – this is the course of action that most people choose to take. “I’ll just deal with it.” When the alternatives are surgery and stretching exercises which don’t really seem to work, and in fact make the pain worse sometimes, it doesn’t leave a person living with sciatic pain with much hope.

Variations of sciatic pain

Living with sciatic pain may be fine if you have mild symptoms like occasional tingling or a dull ache down one leg but if you have more severe symptoms like:

- Shooting pain in your low back or hip
- Numbness in your leg, hip or buttocks
- Burning sensation in your leg, hip or buttocks

Then living with sciatic pain isn’t an option. It can keep you up at night and forget sitting still at a movie theater or enjoying a meal at the table with your family. Often not moving makes the pain worse so people suffering from sciatic pain are constantly needing to get up and go around.

If pain relievers aren’t an option, surgery, steroids, and basic stretches aren’t an option and just don’t seem to work anyway, what is a sciatica sufferer supposed to do?

Rather than live with sciatic pain, consider seeking a therapist which can diagnose the cause of your sciatica and treat your whole body rather than the symptom. A well balanced and structured muscle system will provide your body the support it needs. Balanced muscles mean your body has the ability to compensate when you push it hard, make an unusual movement or are injured.

If you or someone you know has been living with sciatic pain, stop. Take action. You don’t have to rely on doctors and therapists who only know to treat the symptoms. Find balance and stop your sciatica pain today. Start with simple sciatica stretch and continue to learn more about the condition and how to treat it