bilateral sciatic neuralgia - Damn, that pain in my a##! Here's what you need to know about
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Damn, that pain in my a##! Here's what you need to know about

If you're reading this article, it's a good bet that you have a radiating pain running down the back of your leg that just won't go away. If what I'm about to tell you sounds familiar, don't worry, help is on the way.


Dr Graeme Teague is an expert in the structural field, and has been in practice since 1991. His newly launched web site The Back Pain Advisor - http://www.back-pain-advisor.com - strives to give you valuable and expert advice, tips and information on your back pain issues.


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 As you can see, there is a trend here... in nearly every case, muscle imbalances are the primary cause of the pressure being placed on the sciatic nerve.

First, let me tell you why today's traditional treatment methods just flat out miss the boat. The medical community is so conditioned and focused on treating only the symptoms and trying to get in as many patients a day as possible, that many people are misdiagnosed and/or mistreated.

Can you actually imagine being free of sciatica? Do you really believe there is a cure, so you can enjoy all the activities you use to do? Wouldn't life be perfect again if that pesky sciatica disappeared once and for all!

The deeper layers of the nerve then cause the sharper, definite pain. The deepest levels will cause actual numbness and loss of muscle power, strength and endurance. If you experience symptoms of the deeper layer disturbances, then professional help is essential.

To learn more about muscle imbalances and how they affect your body, please read our article 'Aches, Pains, and Injuries' which you can find on our website here: http://www.losethebackpain.com/achesandpainsarticle.html

Let me give you some examples of what I mean: 1. If you sit on the edge of your chair with you legs separated and your feet pointing outward you are keeping your Piriformis muscle in a shortened position and that's how it gets tight and with extended sitting in that position, it gets weak form lack of use. Hence the imbalance.

In most cases, people go to physical therapy or minimize their physical activity to break the pain ' spasm cycle and in most cases your symptoms subside. However'the event will also set you up for a life time of sciatic pain if the Piriformis muscle does not recover 100% in both strength and flexibility.

Question 2... What type of sciatic pain to do you have? Knowing which type of pain you suffer helps to determine how severe your sciatica is. Most people with sciatica will experience pain, it may be a gnawing, and toothache feeling or it may throb or shoot down the leg. Others will have a numb feeling and some may experience the muscles not holding their strength. If you look at the type of pain, you can see how serious it is.

For true sciatica, most people will find relief through the basic McKenzie extension exercise (named for physical thearapist Robin McKenzie). This exercise is performed by lying face down on a firm surface and then propping yourself up on your elbows, creating an increase in the curve of the lower back. Getting into this position may be painful at first, but within about 30 seconds, most people will notice a decrease in the severity or the range of the sciatica, or both. A positive sign is when the symptoms furthest from the spine decrease.

To simply correct this type of sciatica, you need to know this! If your lower back pain travels down the leg to your foot or ankle, then obviously the sciatic nerve is irritated at a greater level. The further your sciatica travels, generally speaking, the worse the condition. In these situations professional advice and treatment is indicated.

So how do you get rid of your pain? Will learning one new stretch be enough? It very well may be. However depending on the severity of your condition you may need to change your activities of daily living to include new stretches, new exercises that include the use of the hip rotators like roller-blading, basketball, tennis, etc, and even better, specific corrective exercise specific to your situation... like those covered in our video. As always, learn as much as you can about your condition, so that you can ask the tough questions to your healthcare providers and get the best care possible.

Sciatica is often confused. It can be a serious condition or it may be an irritation that is easily corrected. How do you know? If know the answer to three questions, then you can decide whether you can correct your sciatica yourself or you need to seek help from a structural specialist.

When the symptoms have subsided, it is extremely important to learn what sciatica exercises you can do to prevent the symptoms from returning in the future. Don't be fooled! Just because the symptoms go away, it doesn't mean that everything is back to normal. All too often, sciatica sufferers go from one episode of pain to the next, with episodes becoming more severe and more frequent over time, because they fail to manage the problem correctly so you can avoid the common problem of developing chronic pain and disability.

Once you determine whether you have true sciatica or piriformis syndrome, or both, you can usually get considerable relief from just a single exercise for either condition (two exercises if you have both).

One last point, sciaitic pain is not caused by a lack of prescription medications so don't think that taking some anti-inflammatories or muscle relaxants will fix it... it won't! Also, many people are able to eliminate sciatic pain within days just by performing a few exercises and stretches... but not general exercise... the exact corrective exercises and stretches they need to do.

There are several self assessments you can perform to help identify which specific muscle imbalances you have and these are covered in our Lose the Back Pain Video along with step-by-step instructions on what to do to eliminate your imbalances and pain. You can learn more by visiting http://www.losethebackpain.com

Sciatica exercises come in many different forms, but the last thing you need when you're in pain is to have to learn a complicated exercise routine. But using exercise to alleviate sciatica doesn't have to be difficult. Getting relief can be as simple as doing just one exercise and doing it frequently until such time as the pain is gone or at least much improved.

If this is the path you have been down and you're tired of all the worthless treatments that just don't work, you must read this article! I guarantee you, it will likely be far different than what you have read or heard anywhere else!

If you have not had trauma, if your general health is generally okay, your sciatica will most likely respond to some simple self help techniques you can use at home. It can ease and disappear quickly... but as the saying goes - if pain persists see your doctor.

In most circumstances conservative sciatica treatment is tried for three to six months. When conservative sciatica treatment fails to alleviate your pain more aggressive sciatica treatment options are usually attempted. Epidural Steroid Injections: An injection of a corticosteroid medication to the affected area may be helpful in some instances. If taken in doses that exceed your natural levels, inflammation is suppressed relieving painful symptoms caused by the pressure of the inflammation. Most effective when used in conjunction with a sciatica treatment rehabilitation program. Because of the serious side effects that corticosteroid injections can cause, the number of injections you can receive in a year is usually limited to no more then three. Surgery: Surgery is most often a last resort and left until the compressed nerve causes significant weakness, loss of bowel or bladder control, or if the pain itself is progressing and conventional sciatica treatment is not working. Most often surgery is preformed as a sciatica treatment to remove a portion of a herniated disk that is pressing on a nerve. The goal is to preserve as mush of the normal anatomy as possible, leaving as much of the disk intact as possible.

Find out what's causing your sciatic pain and learn exactly which exercises and stretches you should be doing by watching our Lose the Back Pain Video. Order your copy now online at http://www.losethebackpain.com

Did you go see your primary care physician and get diagnosis of Sciatica only to have them refer you to an orthopedic specialist and than get a diagnosis of Piriformis Syndrome... and than be told to see a Physical Therapist and the PT tells you a little heat, ultra sound, electrical stimulation and some therapeutic exercises and we will have you good as new???

2. Pressure caused by spinal stenosis, which is a decrease in the space between the vertebrae. This is primarily caused by uneven pressure and compression due to muscle imbalances.

An easy method to help you determine what the problem is can be done by doing a couple of tests while sitting in a firm chair. In the sitting position, try straightening your knee on the painful side, so that your leg is parallel to the floor. If this increases your symptoms, chances are you have true sciatica related to a disc problem.

2. Another example is runners and bikers who actually work very hard tend to get sciatica because they fail to keep a strength vs. stretch balance in their workouts. Hence the imbalance creates a greater pull toward external rotation and the result is a tight Piriformis and an irritated sciatic nerve creating pain.

Sciatic pain comes about either due to a traumatic event, muscle imbalances, or a combination of both. The event scenario is most likely the catalyst for sudden onset of sciatic pain. So what happens' when there is undue stress on the Piriformis muscle that stress causes it to go into spasm and then you have pain due to the Piriformis muscle putting pressure on the sciatic nerve.

3. Pressure caused by Isthmic spondylolisthesis which is simply when a vertebrae slips or moves... this can sometimes pinch the sciatic nerve but often times people who have this condition don't have any pain, symptoms, or even know they have it!

Nerves, when irritated, exhibit definite pain patterns. The outer fibers of the nerve create what is called paraesthesia - which mean altered sensation. You may experience tingling, the gnawing feeling and a sensation of numbness. The numbness is a sensation not a reality. You can check this by pinching the area or using a pin prick. If you still feel pain with these then you have paraesthesia not true numbness.

Are you one of the thousands you have sciatica. Do you have that nagging back pain that now travels down your leg... making you feel tired, frustrated and grumpy?

 
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Sciatic pain is simply caused by pressure being placed on the sciatic nerve and there are primarily four things that can create this... you may have one or more of the following:

However, from a technical stand point the process really describes the development of the muscle imbalance in your hip. The Piriformis muscle is responsible for external rotation (moving your leg so your feet point outward). So over time that muscle gets tight from the positions you put your self in and weakens from lack of use.

About the Author:

Dr. George Best has been treating patients with sciatica and piriformis syndrome in his San Antonio, Texas practice since 1992. To access his free E-book and his free video course on understanding and treating sciatica, go to http://www.sciaticaselfcare.com.

When you have an injury to a muscle, both strength and flexibility are compromised, and if your recovery ends before strength and flexibility return, you will never be 100% and will likely struggle with the problem forever.

If you know the right answers to the 3 important Sciatica questions, sciatica can disappear quickly. If you fit the criteria of caution, then be cautious and seek professional intervention. Don't let sciatica "lay you up"... learn to get rid of sciatica once and for all.

The other way sciatic pain creeps into your life is due to your lifestyle and habits, and that is what we like to call the process. The process can be described as a prolonged onset of symptoms based on your everyday activities...

Question 3... What caused your sciatica? If you have had a fall or injury then sciatica needs attention. Sciatica at times is caused by disc injuries and spinal conditions that relate to joint instability. These need to be assessed and treated accordingly. Although the majority of sciatic nerve irritation comes after situations that appear completely normal. Your normal daily activity should not cause sciatica, however a build up of tension can lead to sciatic nerve problems.

The second test is to bend your leg to pull the knee toward your chest. Begin by first bringing the knee on the painful side toward the shoulder on the same side. Then release the leg slightly and pull the knee toward the opposite shoulder. If pulling the knee toward the opposite shoulder increases the pain significantly more than pulling it toward the same side shoulder, chance are you have piriformis syndrome. It should be noted that it is possible to have both true sciatica and piriformis syndrome at the same time.

4. Pressure caused by a herniated or bulging disc. A herniation is when a disc protrudes out from between the vertebrae and this can either be caused by an event like a car accident, or, by months or years of uneven pressure due to muscle imbalances. It is also important to note that many people with herniated discs don't even experience pain or symptoms, and many don't know they have the condition.

Recovery Tip: In severe cases, the sciatic pain can run from the top of the hip to the bottom of the foot. It is very important to recognize that changes and shifting of pain is often times a sign of improvement. Further more as a way of gauging recovery, take note of how far down the leg the pain goes. If the pain goes to the foot one day and then only makes it to the calf and then to the knee and then it can only make it to the hamstring that is a sign of improvement. You should feel good about those noticeable improvements and this should give you encouragement to keep working toward a full remission of pain.

For piriformis syndrome, you can do a simple stretch of the piriformis muscle. I recommend you do this by lying on your back, pulling your knee on the painful side toward the same side shoulder for a few seconds, then partially releasing the leg and then pulling your knee toward the opposite shoulder. Hold this stretch for about 10 seconds at a time, then carefully release your leg for a a few seconds before repeating the stretch.

1. Pressure caused by shortening and tightening of the piriformis muscle. This is almost always due to months or years of muscle imbalances in the hip rotator muscles.

In most people, self care measures is usually recommended a sciatica treatment as this usually responds well. Continuing with your usual activities but avoiding the original factor that aggravated your sciatica pain in the first place will help you to heal more quickly. Even though it seems like a few days of bed rest may provide some relief, any more then this is not a good idea. Inactivity will make your symptoms worse over time. In addition to self care sciatica treatment, try some of the following: Cold Packs: Cold packs help to reduce inflammation and relieve some of the discomfort. In a clean towel, wrap an ice pack or a bag of frozen peas and apply to the affected areas for fifteen to twenty minutes four times per day. Hot Packs: After 48 hours have passed, apply heat to the affected areas. Warm packs or a heating pad on the lowest setting should help to alleviate some of the pain. Try to alternate warm and cold packs if you continue to have pain. Stretching: When stretching initially after your sciatica flare up, stick to passive stretching and avoid jerking motions including bouncing or twisting. Over The Counter Medication: There are two categories of pain killers. The first one only relieves pain. The second type of pain killer relieves pain as well as treats inflammation. These are called Nonsteroidal anti-inflammatory drugs. Products such as aspirin, ibuprofen and acetaminophen products such as Tylenol can help to relieve sciatica pain. These can provide real pain relief but there is a limit to how much pain can be controlled. This is known as the ceiling effect - exceeding the recommended dosage wont provide better results. Worse though is that these NSAIDS are known to cause side effects in some people such as nausea, stomach bleeding or ulcers. Acetaminophen has been known to cause liver problems if taken in excess. If you use these medications on a regular basis talk to you health care professional so that you can be monitored for problems associated with prolonged usage. If you are exercising, stretching or following another sciatica treatment program you should periodically re-evaluate if you still require these NSAIDS for pain management. Prescription Drugs: A muscle relaxant along with anti-inflammatory medications may be prescribed by your health care professional. In some cases of chronic pain anticonvulsant and tricyclic antidepressant drugs may also be prescribed. By blocking the pain messages being sent to your brain or enhancing the bodies production of endorphins, pain symptoms can sometimes be handled this way. Your bodies natural painkillers are called endorphins. Physical Therapy: Physical therapy can play an important part in your recovery from a herniated disk. When your condition improves your physical therapist can work with you to help design a rehabilitation program that will help you prevent the same injury in the future. Regular Exercise: When you injure yourself you think that movement or exercise would be counterproductive and all you want to do is just lay down and rest until the pain goes away. The truth is that regular exercise is the best way to combat many ailments, including chronic discomfort. When you exercise your body releases endorphins. Endorphins are the chemical that prevent pain signals from reaching your brain and can also help to fight against anxiety and depression. Your pain may be more difficult to control if you suffer from either depression or anxiety.

To figure out what exercise will be of most benefit, it is important to try to distinguish whether you have sciatica from a lumbar disc bulge /herniation, or whether you have a condition called "piriformis syndrome", which produces symptoms very similar to disc-related sciatica but is caused by contraction of the piriformis muscle in the buttock area.

Sciatica and Piriformis Syndrome are the same condition... it is just that the medical community is starting to call the condition by the muscle (Piriformis) that is involved and getting away from calling it by the name of the nerve that is involved (sciatic) nothing more than semantics.

Question 1... How far does your sciatica travel? The sciatic nerve can be irritated in the lower back, pelvis and as a result of muscular tightness in the buttock. If you have lower back pain and pain travels out to the buttock, this can still be sciatica. It is just a lesser form and easily corrected with various lower back stretches, exercises and joint techniques.

To have this goal is admirable... but you need to know 3 very important facts first. Or your sciatica may not disappear and you may suffer for a long time yet. Something you do not want... or need.

These are just two examples of how muscle imbalances can affect the Piriformis muscle and cause Sciatic pain. You may not be a runner or cyclist but I'll bet you have muscle imbalances that are causing your sciatic pain!

As long as the symptoms are decreasing furthest from the spine, the exercise described is beneficial, even if the symptoms closer to the spine seem to increase at first (they'll usually improve with repetition of the exercise over time). I suggest you remain in this position for a couple of minutes and then take a break by either just lying flat, or by getting up and walking for at least a few minutes in between the exercise repetitions in order to avoid developing a lot of tightness in the low back muscles.

For more information on Sciatica issues just visit Sciatica - http://www.back-pain-advisor.com/sciatica.html

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