Currently viewing the category: "sciatica"

Another great stretch for the low back and hip regions is the twist stretch.  A bit different than your typical piriformis stretches, the twist stretch hits the piriformis, glutes and lumbar spine erector spinae (or paraspinals).  Because of this, the twist stretch is great for relieving low back pain, hip pain, piriformis syndrome, and can even help in some cases of sciatica.

Watch the video below to learn the best technique for doing the twist stretch.  The key that you must remember when doing this low back stretch is to keep your lower back straight, so sitting up straight before twisting is imperative.  If you fail to do this important step, you do risk the potential for injury.  I find this point so important because I observe many people at the gym doing a twist stretch with rounded backs.  Listen, if you want to come see me as a herniated disk patient, then twist with a rounded back.  But if you would rather fix your low back pain, then twist with a straight back–simple as that.  Have fun twisting.

Low back pain, hip pain, butt pain, sciatica–these are all conditions that can occur as a result of a tight piriformis muscle.  But it doesn’t stop there.  Gait abnormalities, hip bursitis and knee pain can also result as secondary disorders related to a tight piriformis muscle.

Stretching a tight piriformis is imperative to prevent these conditions from plaguing you.  And if you’ve already got some of these problems, after you see your friendly neighborhood sports chiropractor, you’ll probably need to stretch your piriformis to bring length to the muscle and help open your hips sufficiently.

In the video, I demonstrate three excellent stretches (really two, with one version having two variants).  Start with the first one–lying on your back–if you are very tight OR you could even do that same stretch while sitting in a chair (although I don’t demonstrate that version in the video).  You can try the other two variants if you have a little more flexibility.

Play with all three to see where you currently are, and then work at that level for two to three weeks.  Once you’ve mastered your current level, you can move on to the next.  Have fun and happy stretching.

Low back pain is the fifth most common reasons for physician visits in the U.S.  One third of them report persistent back pain of at least moderate intensity one year after an acute episode, and 1 in 5 report substantial limitations in activity.

Sciatica–a painful nerve irritation–can accompany low back pain and can sometimes be present on its own.  Sciatica and low back pain together very often result from disc herniation, predominantly in the lumbar spine.

Several treatment options exist, but which ones are most effective?  A 2010 study set out to determine the efficacy of two of these treatments–chiropractic adjustments or surgery.  Forty patients were chosen through elective referral by primary care physicians to spinal neurosurgeons.  Patients were chosen on the basis that they had already failed at least three months of nonoperative management including treatment with analgesics (pain killers), lifestyle modification, physiotherapy, massage therapy, and/or acupuncture.

The patients were randomly split into two groups: those to receive chiropractic adjustments and those to receive microdiscectomy (surgical removal of the herniated disc–cool video here).  Crossover to the alternate treatment was allowed after three months.

Researchers found significant improvement in both groups.  Hmmm…so, by this study, chiropractic and disc surgery were better than pain killers, lifestyle modification, PT, massage and acupuncture to relieve chronic, stubborn sciatica.  Okay, I’ll buy that (well, I am a chiropractor, you know?).  But which one is better?  We’ve gotta have a ‘better’, don’t we?

The results showed that the two treatments came out exactly the same for all outcome measures for the majority of subjects one year post-treatment.  However, eight patients did crossover from chiropractic to surgery, while three crossed over from surgery into chiropractic.  The three that did not benefit from surgery failed to benefit from chiropractic as well.  The eight chiropractic-didn’t-work-for-me crossovers, however, did benefit from the disc surgery…and get this…they did so to the same degree as their surgery-first counterparts.  Dang–now that’s a good study!

Here’s the take home: When dealing with chronic sciatica due to herniated disc, try chiropractic first, period (authors believe first line should be drugs, physical therapy and lifestyle modification…but I don’t).  If the chiropractic doesn’t work, go ahead and get the surgery (although I still think I would try chiropractic, rehab and orthotics [if foot dysfunction present] seriously for at least one year before making that decision).  If you do it this way, you won’t hurt yourself  (at least within three months) by waiting on the surgery–you will still likely benefit as if you went surgery right away–AND if chiropractic works for you (as it did for a majority in the study), you’ll be better off physically and financially, because remember, you’ll never be the same or better following a surgery, and microdiscectomies aren’t cheap (unless, of course, you are lucky enough to live where there’s socialized medicine, and then somebody else will pick up the tab).

Finally, if you decide to get the surgery and it doesn’t work for you (10-20% failure rate), understand that there’s no going back–chiropractic probably can’t help you then.  Get it?  Good.
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