Sciatica – Symptoms, Causes and Treatments

Sciatica is painful and can be debilitating.  Up to 40% of the population will experience sciatica at some point in their lives.  But, what is sciatica, really?  Is the cause always the same?  Do other conditions mimic sciatica’s symptoms?  Is there help?

We’ve all heard of it.  If you’ve ever experienced it, you don’t want it back.  Sciatica is painful and can be debilitating.  Up to 40% of the population will experience sciatica at some point in their lives.  But, what is sciatica, really?  Is the cause always the same?  Do other conditions mimic sciatica’s symptoms?  Is there help?

What is sciatica?

Sciatica is a term that describes symptoms of pain, numbness, and/or weakness that radiate along the sciatic nerve from the lower back to the buttocks and leg. The medical term is lumbar radiculopathy.

The vast majority of sciatica symptoms result from lower back disorders between the L4 and S1 levels that put pressure on or cause irritation to a lumbar nerve root.

Most commonly, sciatica is caused by a disc problem, such as a herniated disc that is pressing against a nerve root.

It can also occur when a disc degenerates, which releases inflammatory proteins that irritate the adjacent nerve. There are many additional causes of sciatica.

Causes of Sciatica

Lumbar radiculopathy is a separate disorder from piriformis syndrome, although the symptoms may be practically identical.  The most common cause of sciatica is a disc problem, such as a herniated disc pressing against a nerve root.

sciaticaOther causes include degenerative disc and/or joint disease; spinal stenosis (a narrowing of the spinal canal); sacroiliac joint dysfunction; spondylolisthesis – a medical condition characterized by the slipping of a vertebra forward over the vertebrae found below; ankylosing spondylitis – an uncommon type of arthritis that can affect the vertebral column and the pelvis in which the bones of the spine tend to fuse together leading to a rigid spine; muscle strain; piriformis syndrome; pregnancy; poor posture,  spine trauma in the past, as well as remaining in certain positions for many hours during the day while working are all predisposition factors for back problems, including sciatica.

Because the causes of sciatica are different in every patient, the treatment for this muscle straincondition will also be different.  Regardless of the cause, however, sciatica will affect the surrounding musculature, which can worsen the symptoms.

Treatments

Some cases of sciatica resolve themselves within about 18 months.  But, don’t wait to see if that will happen.  It’s important to know what the cause of your sciatica is – a herniated disc is much more likely to resolve, for instance, than spinal stenosis or spondylolisthesis.

Clinical tests for sciatica

Examples of clinical tests for sciatica may include:

  • Straight leg raise (SLR) test. This test includes the patient lying on his/her back and lifting one leg at a time with the other leg flat or bent at the knee. A pain encountered while lifting the affected leg usually indicates sciatica.
  • Slump test. This test includes the patient seated upright with hands behind the back. The patient bends (slumps) forward at the hip. The neck is bent down with the chin touching the chest and one knee is extended to a degree possible. If pain occurs in this position, sciatica may be present.

These tests, however, may be positive only when the sciatic nerve is mechanically compressed at any point along its origin, such as from a herniated disc. Other causes of sciatica such as inflammation or chemical irritation of the nerve may not cause pain in these tests, so it’s important not to self-diagnose the cause of your pain.

spondylolisthesis

Your doctor may recommend various invasive therapies, injections, physical therapy, even traction or surgery depending on the cause of your sciatica.  And, that may be the route you choose.

There are less invasive alternative therapies that may also help.  The National Institutes of Health state that acupuncture is significantly more effective than conventional medication in the treatment of sciatic pain.  Manual therapies can also help you heal.

In some cases, sciatica can be controlled in just a few sessions.  Other more severe causes may require ongoing treatment, or even multiple therapies.  Adding functional and corrective exercises will give you the techniques necessary to help you control your sciatic pain.

The most important consideration is to get you comfortable again, and that’s what I do best.  Regardless of whether you choose traditional massage or the advanced techniques of bodywork therapies, the goal is to get you back to living your best life!

When you’re over 40 and they say just put a BandAid where it hurts . . .

Just put a bandaid

I see it all the time.  The wait to get treated until the discomfort is more than that person wants to deal with.

By the time you feel that level of discomfort, your body is already at the point where its ability to compensate is being tested.  And, generally, the time it takes to treat that issue is more complicated, and the problem may no longer be local, so treatment takes longer.

Here are some examples of this:

Case study #1:  An older gentleman was referred to me for severe sciatica, interfering with his lifestyle.  He had suffered with back pain for over 40 years, but only sought help when the sciatica was so long-lasting and severe there was nerve damage resulting in loss of feeling and strength in one leg.  MRIs showed remodeling in the spinal vertebra  resulting in anterolisthesis – a condition where the upper vertebra slips forward onto the vertebra below.  This gentleman, at this point, was desperate for pain relief and sought no other opinions or alternative treatments, and underwent a spinal surgery known as laminectomy.  This surgery creates space by removing the lamina — the back part of a vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.

The surgery gave him temporary relief, but when the pain returned, it returned with a vengeance.  Had this gentleman taken advantage of alternative treatments, had he been educated in the self-care he needed to aide in his recovery, his outcome might have been much different,  But, this gentleman was looking for the “magic wand”, was not invested in doing exercises, was not willing to learn how to make his recovery successful.

He came to see me originally for relief from the sciatica.  That didn’t take long – a few visits.  I warned him the results would not last unless he was willing to correct some other musculoskeletal imbalances, or really put effort into strengthening his core, the muscles supporting the spine and correcting his very poor posture.  He needed to be on a regular treatment schedule.  But, whenever we achieved his goal for pain relief, he’d stop exercising, forget about the effect his postural distortions were having on the spinal column and leave off treatment.  Before long, he was again in severe pain and at that point, he’d go back to seeking medical advise: epidurals, physical therapy, etc.  He was looking for the “magic wand”.

This gentleman was any medical practitioner’s worst nightmare – Waiting to get help until it’s too late.

The moral here is don’t wait years before seeking treatment – while you’re “toughing it out,” the damage inside continues.

Case study #2:  Another older gentleman was referred to me for low back pain.  He had “thrown his back out” the week prior.  Assessment showed a tortioned pelvic girdle so severe, one leg was 1-1/2 inches shorter than his other leg.  One of his body’s compensations was to develop scoliosis (curvature of the spine).  After determining  the scoliosis was functional, muscle testing showed how to unravel the muscular imbalances that led to the pelvic torsion.  The first treatment saw much improvement, and his back pain was reduced by 60%.  I had him return within the week, when full correction was achieved and his pain was gone.

The moral here:  Even though this man’s musculoskeletal imbalances had been in place for many years, he sought help when he developed pain.  Don’t wait to seek treatment – while you’re “toughing it out”, the damage inside continues.

The best way to keep your body balanced and reduce your risk of developing long-term, musculoskeletal issues is to get on a regular schedule of self-care.  But, don’t expect that a monthly massage will do it all – You’ve got to do your part with exercise and eating right, too.

Waiting to get treated, delays recovery.

Call, e-mail or request your appointment online today!

 

 

Is Your Pain Due to Musculoskeletal Imbalances?

Another reason would be degeneration in the skeletal structure – as in degenerative disc disease.  The brain “stabilizes” the area by having the surrounding muscles brace the area.  This works really well short term; however, long term the results can be disastrous.

Once a muscle(s) becomes dysfunctional, other muscles take over to compensate.  Of course, it doesn’t take too long before those secondary muscles become overworked, since they are doing double duty, then a third group of muscles begins compensating for the first two groups – and that pattern mushrooms.  Soon, instead of a really tired upper trap, the dysfunction runs from the head to the pelvic girdle or into the chest and down the arm.

musculoskeletal imbalances

Another reason would be degeneration in the skeletal structure – as in degenerative disc disease.  The brain “stabilizes” the area by having the surrounding muscles brace the area.  This works really well short term; however, long term the results can be disastrous.

Another common reason would be poor postural habits.  Picture a person slouching with the shoulders and head rolled forward.  In this case the muscles in the front part of the neck and chest shorten while the muscles in the back that hold the neck and head in proper alignment get stretched out and weak.  Or a person who sits most of the time – in this case, the hip flexors will become weak and can cause groin, leg and hip pain.

Common areas where dysfunctional patterns emerge are the shoulders, hips to knees and the low back.  But dysfunctional patterns can emerge anywhere in the body from the head to the toes.  

Why doesn’t massage address these dysfunctional patterns?  Massage therapies are systems of structured palpation or movement of the soft tissue of the body.  Massage does not address the brain/nervous system/movement relationship. 

I find it sad that we are so in our heads these days, we don’t feel these patterns developing.  It’s understandable if the cause is trauma – there’s not much we can do to prevent a motor vehicle collision, for instance – but we tend to ignore the early signs of dis-ease.  I have one client that ignored his back pain for 40 years!  I wish that were the exception, but it’s not.

Another client was recently referred to me who treated his long term back pain with western medicine, until that didn’t work anymore.  When he came to see me, he was a mess, and looking for the “magic wand”.  I developed a treatment plan and after just 4 sessions, he was pain free!

Don’t ignore what’s happening in your body.  When you feel pain, address it.  Pain is a request for change.  Believe me, I understand the draw of reaching for the bottle of ibuprofen or tylenol and sometimes that is just fine.  But if the symptoms keep coming back, it’s time to get help.  

Don’t let that nagging pain in your neck go for a long time.  One of my clients had poor posture throughout his lifetime.  Because he ignored his pain for so long, the body stabilized areas of dysfunction with bracing, which contracted the spine and eventually caused vertebra to fuse.  

Think of it this way:  If you’re changing the oil in your car more often than getting massage or bodywork, you are definitely taking care of the wrong vehicle.  After all, if you don’t care of your body, where will you live?

Pain is a Request for Change

Few things are as distressing as chronic pain.  It saps your energy and takes an emotional toll.  Over time, a vicious pain cycle develops, one that seems to have a life of it’s own, often persisting even after the original cause is resolved.

chronic pain

Our bodies were created to be self-healing dynamos, given the right tools.  But, often, we’re so distracted by life that we’re not paying the attention to our bodies that they deserve, and we don’t provide the tools our bodies need to avoid postural distortion and developing pain syndromes.

Amazingly, though, making just a few simple changes in your life will set you up to once again live a pain-free life.

Pain often develops with injury or illness.  Chronic pain develops when the complex interplay between the Central Nervous System and the Peripheral Nervous System is upset.  Each element of pain – especially stress – can add to or even start the cycle.

The current medical model in this country advises that pain medications are considered the last line of defense in the increasingly common fight again chronic pain.  The most commonly prescribed medications for pain management are prescription grade anti-inflammatories, opioids and anti-seizure medications.  All have severe side effects, up to and including death, which often further degrade your quality of life. 

Manual therapies have been proven to be more effective tool in pain and stress management than medications.  It’s been in use since mankind’s beginning.  Haven’t you used mechanical pressure to relieve pain – stretching an aching back or rubbing an area that hurts?  Research shows that massage stimulates the release of natural pain-relievers such as endorphins and reduces the devastating grip of pain on your body.

When I first met George, he literally vibrated with tension and pain.  George suffered with a nerve entrapment causing pain that most days exceeded 10/10 and was nearly suicidal.  The traditional medical approach was to surgically sever the nerve (a short term answer at best as nerves regenerate over time) and physical therapy made his pain worse.  Working together and using a multi-dimensional approach, we were able to restore his life and lifestyle with pain levels which have maintained below 2/10 now for several years – a more than 80% reduction in pain!

Using the food you eat to support your body, instead of eating for dis-ease, will also help reduce pain levels by reducing inflammation.  Discover the foods you’re allergic or sensitive to, and correct the adverse affect those foods have on your system.  Eliminate the foods from your diet that contribute to dis-ease; eliminate and purge the effects of chemicals, heavy metals, pesticides and herbicides from your body.  Learn how to eat to balance your pH and to eat for health.

Christine’s case illustrates the dramatic effect diet can have on the body.  Christine suffers with arthritic degeneration of her spine, and came to me when her back pain ratcheted up to the 7-8/10 range and was interfering with her retirement lifestyle.  After a thorough assessment, it became clear that inflammation was a major contributor to her pain.  Just a few tweaks to her diet, and her inflammation was dramatically reduced, which brought her pain levels back to a manageable level (3/10 and below), allowing her preferred lifestyle to resume.

Our bodies were built to move, not sit behind a desk 40 hours a week, then behind the wheel of our car another 10 or more hours a week, sit to eat, sit to read, sit to watch television, sit to play games . . . The average American now sits 13 hours every day.  No wonder chronic pain is becoming epidemic!

I wish I could tell you that the simple solution is a certain number of hours at the gym 3 times per week, after all exercise is exercise, right?  I’m afraid not.  Once pain develops, you already have musculoskeletal imbalances, and it takes an expert to unravel the influences that contribute to those imbalances. 

A recent case study of mine really illustrates this truth:  Bob was referred to me when his back pain was so severe, he could no longer stand up straight or work.  Bob, a middle-aged “gym rat”, had unwittingly been continuing a work-out routine that was making his symptoms worse.  But, by using an approach of manual therapies combined with functional and corrective exercise, Bob could stand erect after just two sessions; after 8 sessions, he was balanced, pain free and back to work.  Before you hit the gym with pain, get properly diagnosed and have a plan to overcome the imbalances.

My clients know me as the go-to person when allopathic medicine fails.  When allopathic medical treatments fail, my clients come to me to help them devise a plan to address their complaints in a natural way, often without the need for medications or surgery.  It IS possible to unravel the unwanted influences on your body and regain your health.

Janet Lawlor is a holistic practitioner, Board Certified Bodywork Therapy, posture and pain specialist and a chronic pain survivor.  Janet is also a certified Yoga instructor and certified in Functional and Corrective Exercise.  She continues to train in techniques to help others overcome their chronic pain.  Her focus is on reducing pain, improving mobility and restoring quality of life.

The Symptoms and Risks of Hormonal Imbalance

It may feel as though you are simply tired or upset after an unusually stressful or busy week. With a hormonal imbalance, a person may suffer from anxiety, insomnia, loss of appetite, and poor concentration. Irritability and mood swings are also quite common. Hormonal balance is critical for our emotional well-being, so radical changes in the way we feel about ourselves and interact with others may indicate a problem.

Because hormones affect so many different aspects of how our bodies operate, the outward symptoms tend to be varied and nonspecific. It may feel as though you are simply tired or upset after an unusually stressful or busy week. With a hormonal imbalance, a person may suffer from anxiety, insomnia, loss of appetite, and poor concentration. Irritability and mood swings are also quite common. Hormonal balance is critical for our emotional well-being, so radical changes in the way we feel about ourselves and interact with others may indicate a problem.

Unknown

Some physical indicators of a possible hormonal imbalance include sudden weight gain, acne, hair loss, night sweats, and reduced libido. Women may experience intense premenstrual symptoms, vaginal dryness, yeast infections, and hot flashes. Some women also suffer from unusually heavy, irregular, or painful periods. Infertility may also be the result of a hormonal imbalance.

If a hormonal imbalance is suspected, blood, saliva, or urine tests can determine whether hormones are within a normal range.

Some of the risk factors associated with hormonal imbalance are emotional. Untreated hormonal imbalance can lead to intense anxiety, depression, and lethargy. Irritability, inability to concentrate, and mood swings may also take a significant emotional toll on both the patients and those around them.

There are also numerous physical risks associated with hormonal imbalance, the severity depending on which hormones are not at ideal levels and how long the imbalance is sustained. The dangers of insufficient insulin, for example, are well-documented in studies of diabetic patients. If insulin levels are not controlled, the blood sugar imbalance can lead to serious complications, including nerve damage, heart disease, stroke, kidney failure, and blindness.

The adrenal glands above the kidneys are divided into two structures that each produce different hormones, all involved in regulating essential body functions. The adrenal cortex synthesizes corticosteroid hormones, which help control metabolism, blood electrolyte levels, inflammation, stress response, and immune response. The other structure, the adrenal medulla, is the source of several hormones that communicate with the nervous system, including adrenaline, nor adrenaline, and dopamine. Adrenal hormone imbalance can result in depression, fatigue, dehydration, and susceptibility to infection.

In the case of hypothyroidism, where the thyroid is producing insufficient hormones, untreated patients may develop heart disease and high cholesterol. Pregnant women with hypothyroidism may have significant complications with their pregnancies, including premature labor, anemia, pre-eclampsia, and other conditions that may threaten the life of their baby.

As middle age approaches, women are at risk for hormonal imbalances associated with the onset of menopause. During this time, the ovaries cease to function, inducing an imbalance in estrogen and progesterone. Untreated, these imbalances put women at risk for osteoporosis, breast and uterine cancer, and heart disease.

Stress Kills

We’ve all heard it, it’s been all over the news lately, and the more science delves into the physiological reactions in our bodies, the more it’s realized that:  Stress does kill.

images

It’s not really stress itself that does so much damage, it’s our response to stress.   For that reason, it is vitally important that in tough times you keep up whatever stress reduction programs work best for you, whether it’s running, Yoga, kickboxing, or getting regular massage sessions.

Times are tough right now.   Stress from money concerns is one of the biggest of all stressors and affects your relationships with family, co-workers and friends.

It’s not possible to cut all stress out of your life, and we don’t need to.   Stress, of itself, is not the bad guy; it’s our response to stress that can be so deadly.   Let’s examine what occurs in your body when it’s stressed out:

How Stress Affects the Brain

Stress creates excessive levels of cortisol in the brain, leading to the destruction of neurons, decreased short term and contextual memory and poor regulation of the hormonal response to stress.

How Stress Affects the Immune System

Stress affects the immune system by increasing sympthetic activity and decreasing cellular immunity.   Immune cells migrate to different parts of the body and can worsen autoimmune and allergic conditions.   Over time, this suppresses the body’s ability to fight off infection.

How Stress Affects the Cardiovascular and Metabolic Systems

The effects of stress can create significant damage to the cardiovascular system by increasing the risk of coronary artery disease, elevating blood pressure, increasing artherosclerosis (fat deposits in blood vessel walls), increasing the risk of myocardial infarction (heart attack), increasing the risk of diabetes and increasing the likelihood of obesity.

The Physiological Response to Stress

Seventy-five to ninety percent of all doctors visits are due to stress-related ailments and disorders.   Chronic stress leads to an out of balance biochemistry with elevated cortisol and suppressed serotonin.   The biochemical markers of stress in turn lead to ill health.   Stress plays a major causative role in both physical and mental health.

Stress has been linked to:

  • Cancer
  • Diabetes
  • Breakdowns in the immune system
  • Alcohol and substance abuse
  • Cardiovascular disease

How Massage Helps

Some of the benefits of massage include

  • Stabilizing your nervous system
  • Decreasing pain
  • Reducing blood pressure
  • Decreasing anxiety and depression
  • Increasing your energy and endurance
  • Increasing your strength and resilience
  • Improving the functioning of your nervous system
  • Improving your body’s ability to detoxify
  • Improving sleep
  • Improving posture, range of motion and flexibility
  • Improving dexterity and fine motor skills
  • Improving balance
  • Improving attention span, concentration, memory, creativity and learning efficiency

Massage increases the oxygen levels in your brain, keeps your internal organs functioning their best and nurtures your skin, all of which helps to slow the aging process.

Stress sneaks up on all of us.  Before you know it, you’ve got tight muscles or reduced range of motion from muscle tension.  The most common reaction I get from my massage clients is “I feel like a new woman/man.  I had no idea all that was going on in my body.”  

Regular massage sessions will play a huge part  in how healthy you are, how healthy you’ll be and how youthful you’ll remain with each passing year.   Budgeting time and money for bodywork at consistent intervals is truly an investment in your health.  Massage is much more than feeling good for the moment.   The effects of massage are cumulative – the more often you receive massage, the more your health benefits.

Stress, Humor and Massage

Laugh

Have you ever noticed that when you lose your sense of humor, life becomes so much more difficult?  The element that most contributes to the loss of humor is stress.  Stress from relationships, stress from your job, stress from life.

In order to maintain balance in our lives and in our relationships, we need to maintain our humor.  My own first line of defense against loss of humor is a really good 90-minute stress-busting massage!

A healthy lifestyle is an essential companion to any stress reduction program.  You can enhance your general health and stress resistance by getting regular exercise, “eating the rainbow” and avoiding excessive alcohol, caffeine and tobacco.

Exercise in combination with stress management techniques is extremely important: as an effective distraction from stressful events, and by directly blunting the harmful effects of stress on blood pressure and protect the heart. 

Research shows that humor is a very effective mechanism for coping with acute stress.  Keeping a sense of humor during difficult situations is a common recommendation of stress management experts.  Laughter not only releases the tension of pent-up feelings and helps a person maintain perspective, but it also appears to have actual physical effects that reduce stress hormone levels.

Making a plan and do your best to execute it successfully.  But, when you feel your balance or sense of humor slipping, it’s time to get in for some table time.  If a stress-busting massage isn’t helping as much as you feel it should, it may be time to schedule a holistic health consultation where we’ll examine your diet, exercise, stress levels and stress management to create a plan to better serve you.