How to Naturally Treat Your Sciatica Using Exercise and Supplements

When you have intense pain running from your lower back down your legs due to sciatica, you're looking for a source of pain relief that will curb your symptoms. Relief from sciatica pain comes in many different forms, such as pain killers, exercise, an anti-inflammatory and other non-surgical treatments, plus surgical treatments.

Not all sciatica cases require a radical form of treatment such as surgery. Most cases of sciatica are treated with pain killers. In very mild cases, ibuprofen, aspirin, or another over-the-counter medication will reduce the sufferer's pain. Many sciatica sufferers are also prescribed non-steroidal, anti-inflammatory drugs to reduce symptoms and pain with the sciatica and the lower back in general. If the pain does not subside, stronger pain killers such as codein may be prescribed, but medications such as this come with the risk of addiction, and therefore should not be taken lightly. Muscle relaxers should also not be taken lightly. Although they will help alleviate symptoms associated with sciatica, they can also make the user drowsy, putting them at risk when driving.

Exercise is the best way to reduce sciatica symptoms for the long term. With a proper exercise routine, you can train your muscles to become relaxed and strong, and therefore reduce the amount that these muscles are compressing on the sciatica nerve that runs through them. When other options have failed, a health care provider might opt to perform spinal surgery. When herniated discs are the cause of sciatica pain, your doctor might recommend doing a microdisectomy. It's a procedure to physically remove what is compressing the sciatic nerve.

Sometimes sciatica pain and symptoms results from a condition known as spinal stenosis. This condition causes nerve compression and can be alleviated with a surgical procedure called a lumbar laminectomy. A lumbar laminectomy involves giving more space to the nerve bundles within the spinal column by removing bones from the vertebra.

One of the oldest surgical procedures to reduce back pain is called a diskectomy. This procedure involves removing the disc that is causing the problem, or that is diseased, from the spine. Once the disc has been removed, the pressure on the nerve is relieved and sciatica pain and symptoms are reduced.

One of the last options for patients with sciatica and back pain is to undergo a spinal fusion. When a spinal fusion is done, the doctor joins two or more vertebrae together in order to relieve irritation and compression. However, this procedure is only done when the spine has undergone years of physical injury, or when osteoporosis has set in. The reason this option is left as a last resort is because once done, the patient is left with very little movement within the spine.

Although the advances in medicine have been great for sciatica sufferers, pain relief is different for everyone. What might work for one person may not work for someone else. Therefore, you should always seek medical advice when it comes to relieving sciatica pain.

Understanding Typical Terms Applied to Back Pain

This article discusses the following terms (listed in alphabetical order):

• Back Injury vs. Spasm


• Bulging Disc


• Degenerative Disc Disease


• Disc Tear or Torn Disc


• Facet Joint Syndrome


• Herniated ("slipped") Disc


• Radiculopathy


• Ruptured Disc


• Sciatica, Referred Pain (see Radiculopathy)


• Scoliosis


• Spinal Fusion


• Spinal Subluxations

Back Injury vs. Muscle Spasm

People commonly confuse spinal injuries with muscle spasms.

Spinal injuries involve changes in bone structure or soft-tissue consistency: fractured vertebrae, degenerating discs, torn or stretched ligaments, nerve damage. Spinal injuries require substantial healing time -- or may never heal.

Muscle spasms -- painful muscular contractions -- though painful, do not constitute an injury. Though symptoms of nerve impingement (tingling, burning, numbness, loss of muscular control) may accompany muscle spasms and mimic a spinal injury, these symptoms often disappear nearly instantly, once muscle spasms relax. Muscle spasms can often be induced to relax through somatic methods relatively quickly.

Muscle spasms often follow traumatic accidents, such as falls or motor vehicle mishaps, shocks to the nervous system that prompt the muscular system reflexively to tighten up. For that reason, muscle spasms may be confused with spinal (not "spinal cord") injuries. In persons with chronic muscular tension, muscle spasms may also occur when lifting heavy loads or even when bending forward, leading persons to speculate that they have injured their back.

Degenerative Disc Disease

Refers to breakdown of the intervertebral discs -- the fibrocartilage spacers between vertebrae.

The discs consist of two layers: a tough, fibrous outer ring or cylinder (annulus fibrosus) and a gelatinous core (nucleus pulposus).

Disc breakdown may range from mild disc bulge, to more severe disc bulge (herniation), to rupture of the disc with extrusion of disc material, to conversion of the disc into bone (fusion). This phenomenon may occur anywhere in the spine, including the neck.

While defined as a disease, Degenerative Disc Disease is no more a disease than a blowout of an overloaded tire is a disease of the tire. The breakdown comes from mechanical causes -- overcompression.

Tight muscles of the back (the spinal extensors) pull neighboring vertebrae closer together, compressing the discs in between. Over time, the combination of overcompression and movement cause discs to break down, leading to the range of breakdown described above.

The breakdown process can be stopped by restoring normal pliancy to the spinal muscles and normal space between the vertebrae. Then, the healing process can restore disc integrity.

Added note: chronic dehydration due to insufficient water intake affects the discs adversely. As discs lose water, they lose plumpness and lose their ability to maintain space between neighboring vertebrae. Nerve entrapment, such as sciatica or tingling and numbness in the hands (including carpal tunnel syndrome), may result.

Disc Tear or Torn Disc

A consequence of violent injury, disc tear may appear symptomatically similar to a bulging disc but cannot be treated effectively by muscular retraining, traction, massage or other non-invasive techniques because the muscular contractions are protective in nature. The muscular contractions are stabilizing a length of spinal column that has lost its structural support.

A torn disc is a surgical situation.

While surgery may restore stability to the spine, it may leave residual muscular contractions that must be addressed for recovery (and alleviation of symptoms) to be complete. Somatic education addresses such unaddressed muscular contractions.

Facet Joint Syndrome

The facet joints are bony projections on vertebrae. Generally, these bony projections on neighboring vertebrae don't touch each other, but muscular contractions along the spine pull neighboring vertebrae together and may cause those facet joints to meet with undue pressure and friction.

Another type of face joint exists where ribs meet vertebrae. Excessive tension of the muscles that control rib movement may also cause a kind of facet joint syndrome.

The pain and inflammation that result are sometimes called "facet joint syndrome" and sometimes, "spinal arthritis."

Herniated (Bulging/"slipped") Disc

A sign of of disc overcompression, the condition commonly arises when overcontracted back muscles shorten the spine along its length and pull vertebrae too close together for too long. The resulting disc compression causes the pulpy center (nucleus pulposus) of the disc (or discs) between neighboring vertebrae to push against the containing outer cylinder of the disc (annulus fibrosus). This compression causes bulging, much as overpressure on an overloaded tire causes bulging at the tire's weakest point.

Over time, the annulus fibrosus may break down under the compression force and the bulge increases or ruptures, pressing on the neighboring nerve root and causing pain and loss of function.

Relaxation of the overcontracted back muscles relieves the overcompression stress on spinal discs and in time allows discs to heal and regain their integrity.

Radiculopathy

This is another term familiar to physical therapists. It refers to tingling and numbness in the extremities that result from nerve impingement (a pinched nerve). The term implies damage to a nerve root where it exits the spinal column.

Sometimes, no damage exists; a nerve impingement of muscular origin exists. The symptoms of radiculopathy often disappear as soon as tensions of the spinal musculature normalize. Somatic procedures are generally rapidly effective. If after one-to-three sessions, substantial improvement has not occurred, you should seek further medical tests.

Referred Pain

This term, familiar to physical therapists, has to do with pinched nerves (nerve impingement). The term refers to pain at a location other than at the location where the nerve pinch exists. The sensation created by impingement (pinch) of the nerve "refers" to the region of the body where the nerve ending is, so the sensation is there, rather than at the site of the nerve pinch, itself -- hence, "referred."

Sensory nerves end at brain connections corresponding to the body part they sense. A nerve that reports on the state of the foot ends in a brain connection that corresponds to the foot. That nerve "refers" to the foot.

If the nerve to the foot gets pinched, the brain interprets the nerve signal that results as a sensation of the foot. If the nerve that reports on the state of the buttock area gets pinched, the brain interprets the nerve signal as a sensation of the buttock.

Sciatica is an example of referred pain. The sciatic nerve branches down the back of the leg to the foot. A pinch or entrapment of the sciatic nerve at the waist or buttock (commonly caused by muscular tension) creates a signal that the brain interprets as trouble in the buttock, back of the leg or in the foot.

See Free of Back Pain or Outgrowing the Myth of Aging, two self-help programs that normalize muscular tensions that cause sciatica.

Ruptured Disc

A common end-point of disc herniation left untreated, a disc rupture extrudes the pulpy center of the disc (nucleus pulposus) out of the disc into the surrounding space outside the disc, like toothpaste out of a tube. The extruded disc material may then press upon nerve roots, causing referred pain.

A ruptured disc is generally a surgical situation. (Think "getting toothpaste back into the tube".) One minimally-invasive surgical procedure involves aspirating (sucking up) the extruded disc material.

While the procedure may relieve pressure on nerve roots, it leaves the muscular contractions underlying the problem unaddressed. Somatic education deals with such unaddressed muscular contractions.

Scoliosis

Abnormal curvature of the spine. While a normal spine exhibits curves and the natural curvability that allow flexibility, some people exhibit spinal curvatures that interfere with normal movement and distort posture.

Scoliosis has been classified into several categories that describe type of curvature and degree of severity. Without going into detail about the varieties of scoliosis, it can be said in general that scoliosis can be classified into "structural" and "functional" types. Structural scoliosis involves distortions of bone growth. While not correctible by non-surgical means, some procedures can improve comfort and mobility within the limits of the scoliosis. Functional scoliosis arises from muscular pulls that may arise from injury and subsequent casting of an extremity. It is often correctible by non-surgical means (see below).

Common medical treatments for scoliosis involves casting, the wearing of a brace, insertion of metal rods along the spine, or spinal fusion surgery.

In some cases, less drastic, non-medical means are equally effective without inflicting the trauma or lifelong limitations that medical procedures impose. Somatic training can sometimes correct even complex scolioses by correcting the imbalances of muscular pulls. At other times, more may be needed, particularly if the supportive connective tissue is displaced from its normal position and span. Then, a combination of myofascial integration (soft-tissue manipulation) techniques (such as Rolfing簧 or Hellerwork簧) plus somatic training (such as Hanna Somatic Education簧) is needed. Interestingly, with the combination of soft-tissue manipulation techniques and muscular retraining, the body's own soft-tissue and muscular system provide the support otherwise provided by casting or bracing.

Spinal Fusion

A surgical procedure, spinal fusion is a man-made way of recreating a natural end-process of disc breakdown: the growth of bone to replace degenerated discs. In the procedure, the ridges (spinous processes) and rear wall (laminae) of vertebrae are surgically removed (laminectomy), the disc or discs removed, bony material (generally the size and shape of matchsticks) placed to grow over the surgical wound, and the patient placed in a torso cast. The result is a rigid spine incapable of its normal flexibility, but stabilized to prevent nerve impingement. Pain sometimes remains due to reflexive muscular contractions at the surgical site.

Spinal fusion is considered a last-measure procedure employed in "emergency" cases, as determined by symptomology and radiological examination, generally with patients for whom physical therapy has failed or who have had traumatic injury. In some cases, it is unavoidable; in other cases (scoliosis), less aggressive surgical means combined with somatic education can produce a satisfactory outcome.

Spinal Subluxations

The term, "subluxation," originally coined by D.D. Palmer, refers to a blockage of light ("lux") through the length of the spinal cord by misalignments of neighboring vertebrae. Such misalignments adversely affect posture, movement, and organ function by affecting nerve signal transmission. The original meaning of the term is no longer used in public discourse about chiropractic.

Bones go where muscles pull them. Abnormal (habituated) tensions in the spinal muscles pull vertebrae out of alignment. As muscular functioning normalizes, spinal alignment usually normalizes spontaneously.

Without normalization of muscular functioning, spinal misalignments tend to return; with normalization of muscular functioning, chiropractic adjustments, if needed, tend to be long-lasting and are needed less often, if ever.

Learn Three Secrets to Strengthen Your Lower Back and Avoid Pain

Our lower back is perhaps one of the most vulnerable parts of our body, and one that we should take particular care of as we get older. This is especially true if there has been an earlier problem affecting your lower spine. If it is not looked after and cared for the incidence of the problem recurring rises dramatically. Slipped disc, damaged vertebrate, whatever the problem was, it will tend to happen again with increased frequency if not cared for.

None of us want to endure the accompanying pain and disability any more than is necessary, so it is wise and good practice to get into the habit of a few simple exercises in a proactive way to pre-empt these painful disabilities.

If the muscles around your lower back area are built up and kept strong, this will greatly reduce the chance of damage and injury. Here are three simple exercises, that if practiced regularly will go a long way toward keeping your lower back strong and healthy. We shall begin with the easiest.

Lay flat on your back on a hard floor. With your palms flat on the floor alongside, draw up your knees to a natural position. You can feel your lower spine arched away from the floor a little and in fact you can probably slip one hand into the space to check. Remove your hand and then ever so slowly push your spine down so that it eventually comes in contact with the floor. Push down until you feel it is hard on the floor and then try to slip a hand under - there should not now be space to do this - your lower spine should be flat on the floor. You will feel the tension in your muscles down there and this is good.

Hold your spine pressed against the floor momentarily and then release slowly back to original position. Repeat for a set of ten, each time just as slowly as you can. You will feel the tension in those muscles as you proceed. They will strengthen up in no time at all and add support to your spine in that area. Whilst it is best on a hard floor you can also carry out this exercise in bed when you first wake in the morning.

This next exercise takes a little longer to master the technique, but once you have, it will change the way you walk and change your life. When walking, most people first strike the ground with their heels. Over many years this may cause injury to your spine from the results of impact and jarring - remember, that when we were designed there was no asphalt or concrete around! To overcome this, try moving your weight a little forward so that when your foot impacts with the ground surface it is more flat so your weight is more evenly distributed. Roll your foot forward so you tend to rise (spring) upward. Lengthen your stride just a little as you do this and consciously stretch the long muscles up the backs of your calves and thighs -you can feel this quite distinctly as you spring/glide into your next step.

Now, as all of this is going on, arch your lower spine ever so slightly so you can feel the muscle tension right in that lower back area - once you have got it you will certainly feel the tension - as you walk every step will feel quite different from anything you have felt before, will energise your walking and you will wonder why you have never thought of it before. The muscles in your lower back area will be exercised constantly as you walk, be strengthened, and once again assist in supporting your lower spinal area. You can read a more detailed description of this change in walking pattern in my article 'Spring, Love and Health'.

Finally, we have a simple exercise that will help to keep your lower spine flexible and strengthen the muscles in that area at the same time. Lack of use tends to stiffen up this area of our body so it needs a regular loosening up. Every time you get into your car to reverse out of your garage place your hand on the side of the steering wheel, sit up straight, and as you turn around to look, really twist your shoulders and pulling your spine as far as you can comfortably go, and then twist a little further. At the same time twist your head around even further until you are more or less looking 180 degrees behind you. You will feel your spine clicking as you go and all the muscles stretching. Hold your position momentarily and then return to facing the front.

Place your other hand on the wheel and repeat, but this time twisting in the opposite direction. At the beginning you will find everything quite stiff, but as you go further into the process and you can twist around a little further each time, you will surprise yourself as to just how far you can see behind you. This exercise has the triple benefits of loosening up your lower spine and keeping it flexible, strengthening those lower muscles and also giving you much better vision comfortably when reversing. You can also do it in a sitting position on a chair by hooking your hand over your knees and twisting left and right against yourself, fighting the opposing pull.

As most of us drive regularly it is a simple action to carry out every time we get into our vehicle. After a week or two of this you will find that because of the delicious feeling you get from this exercise, your spine will cry out for you to do it every time you enter your car.

Remember, all of these exercises are designed to improve your body, not to damage it, so only do them incrementally so you do not hurt yourself - the writer accepts no responsibility.

Get into the habit of doing these exercises regularly and you will be pleasantly surprised at the difference it makes to your mobility and daily life.

Laser Spine Surgery Vs Spinal Fusion: Differences In Treating Back Pain

It's estimated that 80% of people will experience back pain at some point in their lives. In most cases, symptoms will disappear in 6-8 weeks regardless of whether or not the person seeks professional help. However, 80% of those individuals will experience a recurrence of debilitating pain. Just by looking at those statistics, it's clear that back pain is a serious problem.

Effective treatment is important because it helps return these people back to the workforce and more importantly, restores their quality of life. Spinal fusion and laser spine surgery are two of the most commonly recommended treatments for moderate to severe back pain. Read on to learn more about the differences in the two procedures.

Treating back pain with spinal fusion

The most conventional kind of back operation is called spinal fusion. It involves removing a small section of bone from the spinal column to stabilize the affected nerves. A stainless steel cage or wire mesh is then inserted, and the patient's bone can then fuse to the new hardware, creating a structure that provides more support.

This approach is viewed by the medical community as fairly invasive because the surgeon will need to create deep incisions within the skin and muscle tissue to be able to perform the actual procedure.

Recovery time following a surgery like this can be as long as one year, and requires lengthy hospital stays. Besides being traumatic for the individual who has the procedure, it is not always effective. In fact, as many as thirty percent of these types of back surgeries are unsuccessful. In some cases, individuals cannot undergo the same intrusive surgery more than once because of an increased risk of complications.

Treating back pain with laser spine surgery

Unlike spinal fusion, laser spine surgery is considered a minimally invasive procedure because the incisions are routinely smaller than a quarter of an inch. This operation does not involve removing section of bone. Instead, the surgeon uses micro-surgery techniques to address the root cause of pain. Patients are normally are provided a local anesthetic agent, and some can expect to regain mobility in a matter of days. When a hospital stay is needed, it is generally less than twenty four hours.

The smaller incision site offers several advantages to the patient. For example, the surrounding skin and muscle tissue is preserved. This leads to faster recovery, more mobility, and fewer post-surgery complications like infection. Also, because there is no fusion, the patient can undergo additional surgeries if necessary. Later, if fusion is recommended the patient can still opt for it.

The success rate for minimally invasive laser surgery is high. On average, 75% of patients describe their outcomes as good or excellent. Another advantage to this type of spine therapy is the expense. On average, it costs 50% less than other conventional kinds of surgical treatment.

Who is an appropriate candidate?

Surgery is ideal for those who have already undergone unsuccessful surgeries, experience recurrent bouts of back pain symptoms, are diagnosed with narrowing blood vessels, as well as certain joint diseases like rheumatoid arthritis.

An experienced surgeon can help individuals determine if they are appropriate candidates for surgery through a combination of magnetic resonance imaging (MRI) scans and personalized consultations.

The choice to undergo a minimally invasive procedure is a highly personalized decision. Only an experienced surgeon can help an individual determine if they are appropriate candidates for surgery through a combination of MRI scans and personalized consultations.

For Back Pain Relief, Three Devices That Give Amazing Results

Back problems can ruin anybody's day, yet many people live with back pain for most of their life. There are ways to relieve this pain that does not require an expensive visit to a chiropractor. Following, are three Back Pain Relief Devices to realign the spine and relieve the pain. Reports have shown that just after using these devices the pain is relieved almost immediately.

The Spine-Worx is a device used to realign the back. It is a rectangle shape with two parallel rails in the centre of the device. These rails are where the spine with be realigned naturally with the help of gravity. A person using the device would lie back resting the spine in between the two rails. Reports made by users state just after one use they noticed a difference in pain relief. Some even reported hearing cracking sounds while their spine was being realigned by the Spine-Work.

When discussing Back Pain Relief Devices the Back Bubble Back Pain Relief Device cannot be left out. Because of its simple design, many may mistakenly feel that this odd looking device would not relieve back pain as promised. Surprisingly enough it does work and many people are pleasantly surprised at the results on the very first try. The spine is stretched while the body is suspended in an air filled bubble that is wrapped around the body that allows the feet to dangle. Thanks to gravity the spine is stretched causing a realignment of the spine naturally.

If gravity Back Pain Relief Devices aren't enough then a Trans-cutaneous Electrical Nerve Stimulator might be a better option. Better known as TENS, this device uses tiny pulses of electricity to relieve back problems. These electrical pulses are administered by way of electrodes that are attached to various locations on the back. Control of intensity is entirely in the hands of the user by adjusting a button. Depending on where the back pain is, assistance placing the electrodes may be needed.

This agony no longer needs to effect millions with devices like these around to relieve the pain. Whether it be with the help of gravity or tiny pulses of electrical massages, it is now possible for back pain to be a distant memory for many.

Back Brace For a Compression Fracture - Which Braces Are Best? Find Professionals Near You

How is your back doing?

Do you currently have a compression fracture that needs attention?

1.) The Nature of a Compression Fracture

Compression fractures are unfortunately common and found within the spine. They are caused by axial load and flexion of the spine to the point where the anterior aspect of the vertebrae compresses and fractures under the stress.

Unfortunately, many people can have compression fractures and not realize it, thinking it is just back pain from growing older and having "arthritis". They may keep pain medication close by and if the fracture does not heal, the individual can become more depressed as the pain lingers on. - Increased breathing problems and compromised posture can result from these kinds of fractures.

2.) Two Groups of People Who Suffer Most From Compression Fractures

Typically, there are 2 general types of situations when someone sustains a compression fracture:

A.) Individuals that have osteoporosis, which has caused bone-weaking.
B.) People that suffer from cancer that has now reached the bones of their spine (vertebrae).

3.) Back Braces For Support vs Other Treatment Options

People have choices when it comes to treating a fracture. You could do nothing and see what happens (not recommended). A person could also go in for a surgery, or the same individual could use a back brace as a useful conservative treatment option to help them heal their spinal fracture.

4.) Stopping Flexion of the Spine - Why This Can Be Important!

There are many types of back braces available, some are prefabricated and others are custom made. Depending on where your fracture exists will partially dictate what kind of brace you will need to get. - Often times, compression fractures are located in the thoracolumbar junction (in the middle of your back). Fractures in the spine do not always happen at this thoracolumbar junction and can actually occur anywhere.

Essentially, when a person uses a back brace to help promote healing in this scenario, they are preventing flexion at the fracture site. Preventing recurrent flexion on the vertebra that is fractured is beneficial and promotes healing. When you stop flexion, you allow your body a chance to heal because you are not constantly aggravating the issue at hand.

5.) Finding A Brace Provider (Licensed Orthotist ) Near You

It is important to work with a licensed brace specialist near you for best result. These individuals are known as orthotists. - It is important to work with these specialists for many reasons. For example, they have to earn their credentials in orthotics, pass exams on bracing, and take continuing education in order to keep their licenses. These individuals know which brace to fit you with due to your body type and size. They will evaluate you in conjunction with your doctors request to help you get the brace you need.

When it comes to the health of your spine and bracing, would you want to work with a specialist, or would anybody be ok? - We pose this question to you.

Note: This is not medical advice. This is health information. Every person's medical situation is different so it is important that you speak with your local, licensed orthotist regarding your orthotic treatment.

5 Joint Actions of the Thoracic Spine: Anatomy of Movement in the Flow of Qi

Anatomy of Movement in the Flow of Qi is a comprehensive, fundamental course of both classical and cutting edge study of the Essential Fundamentals of Kinesiology and Movement Behavior Analysis Protocol. This information is beneficial for those in the healing and healthcare profession and can be used as curriculum for those studying to provide healing and care taking services.

This article will cover just one particular topic of interest: Five joint actions of the thoracic spine. The thoracic spine has 12 vertebrae. Each vertebrae is considered a sliding joint. This is to provide support for the rib cage, not allowing the ribs to flare out too far during the action of hyperextension, thus injuring the supporting muscles or making the organs encased in the rib cage vulnerable to injury. This also restricts the movement of rotation in the thoracic spine, again for the purpose of creating a stable and protective container for the lungs and heart, the two most important organs for our immediate survival.

The muscles required for each type of movement are listed below. Please refer to anatomy text to visually see each muscle and perceive the logic of what bones will be moved when it contracts.

Notice the combination's of muscles and how they create specific directions of movement when used together, and conversely how they cannot create that movement when contracting alone. Some are for stability and alignment in the groups, and some are the main movers creating the specific joint action.

1. Flexion-The rectus adbominis, external obliques (both sides), internal obliques (both sides) create flexion. The upper body lowers toward the pelvis and legs, or the pelvis and legs come toward the chest.

2. Extension- The erector spinae leans backward, shortening the distance between the upper back and the lower back.

3. Rotation to opposite side - The external obliques (one side), semispinalis thoracis, and deep posterior spinal muscles contract to rotate the spine either to the right or to the left.

4. Rotation to the same side- Theinternal oblique (one side) and erector spinae (thoracic and lumbar portions) contract to rotate the spine toward themselves.

5. Lateral Flexion --The external obliques, (singularly to opposite side), Internal obliques (singularly to same side), erector spinae, (thoracic and lumbar portions) and quadratus lumborum, (same side) all contract to bend the spine sideways bringing the chest toward the pelvis either to the right or to the left.