Sciatica and Piriformis Syndrome

One of the more common injuries seen in chiropractic offices around the country is sciatica. Those of us unlucky enough to have dealt with this injury in the past fully understand how painful it can be and how much havoc it can cause in your life. Sciatica has a lot of fancy names like sciatic neuralgia, sciatic neuritis, and lumbo-sacral radiculitis but no matter what you call it it is defined by pain in the buttock and leg. If you break down its fancy names you will see that it results from the inflammation of the sciatic nerve. This inflammation can be the result of direct trauma, compression, or decreased blood flow (ischemia) to the sciatic nerve. Compression of the sciatic nerve, the most common cause that I see in my office, generally occurs either at the spine where the nerve exits the spinal column or somewhere along the nerve as it descends the leg. Compression at the spine is usually the direct result of a disc herniation, bulging disc, foreign body, or the narrowing of the canal that it exits the spine through, which is called stenosis. Stenosis usually occurs because of arthritis, disc degeneration, bone spurs, or abnormal growth of ligament or bone called hyperplasia. It is also important to note that a very common cause of ischemia to the sciatic nerve is by direct compression by a bulky wallet in the back pocket of your pants so make sure to get that wallet out of there while driving or sitting for long periods. I cannot even count how many cases I have resolved by that simple change. Now, when it comes down to peripheral nerve entrapment, the most common structure to compress the sciatic nerve is the piriformis muscle. This small muscle that runs across the top of the buttock from the pelvis to the side of the hip can go into spasm and compress the sciatic nerve, causing sciatica. The sciatic nerve passes directly under the piriformis muscle and in 12% of the population it actually pierces through the middle of the muscle. This specific form of sciatica is called piriformis syndrome and in this article I will discuss its presentation, causes, and treatments.

Sciatic nerve neuritis caused by the contracture of the piriformis is one of the most common peripheral nerve entrapments in the body and is also one of the most misdiagnosed entrapments as well. Many doctors just assume that cases of sciatica are caused by disc bulges and herniation and order MRI's to diagnose the condition. These same doctors are confused when the MRI shows no sign of arthritis or disc displacement. EMG tests will have mixed results but for the most part the lower gluteal and lower limb muscles will be abnormal but the large paraspinal muscles in the lower back will be normal, as will the TFL. Piriformis syndrome will have many signs and symptoms in common with traditional sciatica including pain down the buttock and lateral leg, numbness, pain with forward bending, leg weakness, and decreased range of motion in the low back and leg. Both with have positive orthopedic tests like the Straight Leg Raise Test. Valsalva Test will be negative if there is no disc involvement but remember that piriformis syndrome can coexist with a disc injury. The piriformis muscle's normal action is to externally rotate the leg which means it opens the foot outward as if you were going to kick a soccer ball with the instep of your foot. With that in mind, signs that the piriformis muscle is contracted include one-sided toeing out when standing or walking, increased pain with internal rotation of the leg, and pain with stretching the piriformis muscle. The way to isolate and stretch the piriformis muscle is to sit in a chair, cross and flatten the leg (like a man crosses his leg), and lean forward and to the side towards the crossed foot.

There is a lot you can do at home for treatment before going into your doctor's office. Massage and trigger point work at the origin and insertion of the piriformis muscle is very effective. Ice therapy in the area of the upper buttock along with stretching can also calm down an inflamed case of sciatica. Stretching the piriformis muscle as described above in the seated position with the affected leg crossed can help to lengthen the contracted muscle. Other muscles that should be stretched include the hamstring muscle, TFL, and glut medius. Lifestyle changes include avoiding long periods of sitting, beginning a light walking routine, and drinking lots of water to keep your muscles from cramping. If the condition does not improve within 2 weeks it is recommended that you see a specialist. Chiropractors are trained to diagnose and treat these conditions and will typically incorporate myofascial release, post isometric relaxation stretching, therapeutic ultrasound, electric muscle stimulation, and chiropractic manipulations to complement the above mentioned home treatments. In more severe cases you may need to see a neurologist or orthopedist. It is important to remember that prolonged ischemia or compression to the sciatic nerve can cause major damage to the nerve so it is recommended that you seek medical help if the condition lasts longer than 2 weeks.

Common Injuries in Minor Motor Vehicle Accidents

For many years, the motor vehicle industry has been growing. But it hasn't been bread and butter- if the common crushes that have lead to deaths and injuries of road users are something to go by.

Should a driver use a cell phone while driving? Or, even have his snack in the middle of a steamy conversation with a passenger? In most cases, drivers cause accidents due to lack of proper road attention. Such occurrences of accidents can be prevented.

A reckless driver becomes sober the moment he comes face to face with peritraumatic dissociation and posttraumatic stress. They are the common injuries that drivers who do other things alongside driving could end up suffering from. Other accidents can also cause sleep disorders. One could find someone, a driver, deeply gripped by sleep in the wee hours of the morning, a time when things need to be done. Then psychological outcomes set in a year later. At this point, the driver may have memory problems and hallucinations.

Soft tissue injuries are also a common occurrence after vehicle injuries. Recurrent pain due to the damage of soft joint tissues in accidents may also happen; dislocating hip joint, shoulders which can be very painful and hinder driving.

Bone fractures could also result from accidents. These can be severe depending on the impact of the accident. Most motorcyclists use painkillers when they feel discomfort not knowing that medical treatment is the proper course of action, although one can also seek advice from pain management experts and physical therapists.

Minor accidents can damage the vertebrae. It is as a result of the jerking during an accident. This can cause disc bulge. Disc bulge is the main cause of the pain one experiences on their limbs soon after an accident. This can be bearable but if the condition persists and becomes unbearable, spinal surgery is the most probable solution; a process known as Laminectomy. This tends to re-establish the cushion between the vertebrae. Spinal fusion can be used in cases where laminectomy did not work. Here certain plates are capped around the injured area to make it stable. They can also be screwed.

Medical evaluation could also reveal brain trauma after an accident. Brain trauma has symptoms like dizziness and nausea, even amnesia.

The accident might have left you with scars that need quick attendance so as not to become permanent. It's the responsibility of one's lawyer to help one access necessary justice. Making the insurance claims can be donkeywork. Law firms can help one to access accident compensation claims. Motorcycle drivers for example have suffered because of the ignorance of motor vehicle drivers. The driver who has hit a rider can fail to settle the damages. It's advisable to pursue the claims with one's lawyer until the insurance company pays up. But one must ensure that he/she acquires medical validation to support the claim.

But what is the point? All these can still be prevented by adhering to road rules and being responsible road users.

Causes, Precaution & Cure For Back Pain

Nowwadays back pain is a most common problem & main causes of this problem are bad posture, strain or bruising of muscles; sprain or injury to ligaments; osteoporosis, arthritis, slipped disc, using back muscles in activities to which you are not used to, like lifting heavy weight, twisting while lifting, & regular use of high heels. Another reason of back pain is desk job i.e. sitting for hours before computers where you unconsciously slump into odd positions or twist your backs frequently while trying to reach for something behind or beside you, or stretch forward too far; too fast.

Tips for preventing back strain

· Do not bend to lift weight or any object from the floor & avoid twisting your body while lifting.

· Do not pull heavy objects; always push to move the objects.

· Do not sit long hours continuously at your desk or to drive any vehicle, always break up the time & stretch your body.

· Wear flat shoes or shoes with low heels.

· Exercise regularly. An inactive lifestyle contributes to lower back pain.

· Do not over exercise & lift heavy weight with jerk

Precautions while suffering from backache

• Always lift an object by bending your knees and squatting to pick up the object. Keep your back straight and hold theobject close to your body.


• Always sit in chairs with straight backs or low-back support while reading or working on computers. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on.


• Always turn by moving your whole body rather than by twisting at your waist while trying to reach or pick up anything.


• Always get out of your bed after moving sideways instead of getting up straight.


• If you have to stand long hours than always keep one foot higher than the other & change your foot after every 15-20 minutes to relieve pressure on your lower back. You should also maintain good posture by keeping your shoulders & hips in straight line with your head up & stomach pulled in.

Exercises & asanas to relieve from back pain

Asanas & exercises are very effective for all types of back pain (lower back or upper back pain) but before starting exercises or yoga you should understand structure of human spine & possible causes of back pain. Human body depends on the spinal column for structural stability and mobility. Spine provides the necessary support to bend, twist or move around. The spinal column is has 24 vertebrae which are placed one on another from the skull to the pelvis. The spinal column is tightly wrapped by muscles and ligaments. Any type of injury in these muscles or ligaments can result in pain.

Exercises/asanas for back pain are safe & free from side effects & are effective if pain is caused by an improper posture or sudden movements, jerks or is accompanied by bowel or bladder control problems. Ardh Pawan mukt asan, Shalabh asana, Tada asan, Markat asan, Bhujang asan & Makar asan are very effective in curing back pain.

In case of pain due to injury or any other medical reason advice of doctor & proper treatment should be taken.

Sources Of That Pain In The Buttocks

The sciatic nerve is the longest and largest nerve in the body and pain in the buttocks area may occur when the nerve is pressed or impinged. The nerve descends from the lumbar area of the spine into two branches down to each buttock, back of the leg and to the foot.

There are many causes of pain in the buttocks including anal and rectal medical conditions. Osteoarthiritis or wear-and-tear hip arthritis is a degenerative joint disease wearing away the cartilage of the joint that may also be causing buttocks pain. Another cause for pain in the buttocks is claudification caused by obstruction of the aorta or the common iliac artery. There are also incidences of sacroiliac joint inflammation called sacroilitis which maybe caused by arthritis, traumatic injury or a blow to the buttock or pelvic region causing injury to the joint connecting the spine to the pelvis and lower skeletons. Spondyloarthropaties on the other hand, are inflammatory conditions usually found in the vertebral column sometimes involving the sacroiliac joint and affect the ligaments and tendons attached to the bone in the knee, foot or hip. Inflammation from these and other types of inflammation causes the pain in the buttocks symptoms

A very serious condition that requires long courses of antibiotic treatment is Pott's disease or the TB infection of the spine. Brucellosis is another bacterial infection that may affect the sacroiliac joints that have discovered to be transmitted from goat's milk. Another infection characterized by local inflammation caused by pyogenic bacteria is called pyogenic infection causing common disease processes and pain in buttocks. And there are of course the primary tumor and the secondary tumor of the pelvic bone which causes considerable pain in the area of the buttocks. In elderly persons specially, a pelvis fracture involving the pelvis, hip bone, coccyx and sacrum will bring pain in the buttocks.

Paget's disease happens when the bones grow abnormally larger and weaker and may cause bones in the spine, skull, legs and pelvis to break easily. Another inflammatory disorder involving the hip and shoulder area is called polymyalgia rheumatica which can occur in people over 50 years old. Ankylosing spondylitis is another term which causes inflammation of the joints between the spine and pelvis eventually causing the affected bones to join together.

Trochanteric bursitis is also known as the greater trochanteric pain syndrome or GTPS, another inflammation of the bursa, the shock absorber adjacent to the femur. When the inflammation is in the hip area, the pain in the buttocks is often felt radiating down to the thigh.

Also a probable cause of buttocks pain is Leriche's syndrome which may involve the abdominal aorta and may also be occurring in one or both of the iliac arteries. The syndrome's symptoms may consist of the atrophy of the leg muscles, impotence and paralysis of the nerve and claudification of the thighs and buttocks. Physical trauma, accidents, inflicted wounds or accidental wounds are other causes of the pain in the buttocks and thigh areas. Pregnancy should never be removed from the list of probable causes, as the growing baby causes pressure on muscles and nerves of the soon-to-be mother.

Piriformis syndrome causes pain in the buttocks because the muscles press down on the nerve bringing about inflammation of the sacroiliac joint at the base of the spine, resulting in sprain of the iliolumbar ligament, or brings about referred pain from the lower back problems.

The buttocks are thick muscular areas that are seemingly impenetrable. But pain in the buttocks and lower thighs are usually from disorders and diseases in the spinal and lumbar areas that should not be taken lightly. A thorough examination by your doctor will keep you healthy and prevent further degeneration and damage to your most vital body parts.

Do You Have Sciatica Or is the Pain in Your Hip and Leg Caused by Your Piriformis Muscle?

Do you really have sciatica or is something else causing your sciatic pain?

There are far fewer back surgeries performed today than there used to be. Why? The reason is because so many times after surgery patients still had the same pain. It didn't go away.

It is possible to have surgical treatment for "sciatica" and still have the same symptoms afterward.

This happens when the diagnosis for the cause of the pain is incorrect. Muscles are the most common cause for this type of pain and they are also the most commonly overlooked or ignored cause.

Sometimes a person truly does need surgery. But surgery should always be a last resort. Once a body part is removed or fused or altered it's changed forever. And if it doesn't cure your problem it makes it harder for natural methods to succeed. Maybe not impossible, just harder.

Probably the biggest problem with surgery for sciatica is that it's only addressing the immediate symptom. It's not addressing the muscle imbalances that probably caused the problem in the first place.

When your muscles are "out of balance" you get into pain. That's why you didn't have pain when you were an active child; you were using ALL of your muscles then. And that's why you have pain now; you aren't using them all anymore. You might not move much these days, right?

Maybe you're thinking, "Of course, I don't move much: I have pain!" On the other hand, it is very possible that the reason you have pain is because--just maybe--perhaps--you weren't moving very much to begin with.

You see, when your muscles are out of balance (some overused, some underused) they pull your spine out of the position it is supposed to be in. This includes your leg muscles. Your bones can press on your sciatic nerve.

Did you realize that just about everything that happens in your body has a cause? If you fall, you get a cut or bruise or broken bone. The reason was because you fell. Cause and effect.

Get rid of the cause and you can change the effect or symptom.

So if you really want to get lasting relief from sciatica, the very first thing you must do is figure out which muscles are out of balance and causing your pain. Muscles cause sciatic-type pain more than bones do. And the second thing to do is to treat those muscles and get them back to a balanced, neutral position.

I remember years ago when I was a new massage therapist. An elderly woman came in complaining of "sciatica." As soon as I placed my hand on the gluteal (buttock) muscles on the side she complained about, I could feel the very hard piriformis muscle. It was tight!

She had sciatic pain for almost 20 years. She didn't have it anymore when she left.

It was her piriformis muscle pressing on the sciatic nerve. No one had ever helped her before. And it was only muscles. They just didn't know.

When the piriformis muscle in the buttock presses on the sciatic nerve, it is called "piriformis syndrome" or "pseudosciatica" or "false sciatica."

Treating the muscle to cause it to relax took the pressure off the nerve. So logical. Bodies are logical.

When your muscles get back to normal and neutral, your pain can go away. But you have to keep your muscles that way. If you fall back into the same postures or habits that caused your pain in the first place...well, you will probably get it again.

Are you going to have to do some work to get rid of your pain? Yes. But what's the option? I'd rather see you have natural relief of your sciatica or piriformis syndrome. You, too, right?

Can a Chiropractor Fix a Bulging Disc?

Many people are intimidated by chiropractors because they don't really know very well what chiropractic specialists do and if they can actually fix their bulging disc. Chiropractic care was basically invented to help you eliminate or diminish back pain. But will a chiropractic specialist be able to really fix a bulging disc?

The short answer is yes, a chiropractor can help fix a bulging disc, if additional treatments are employed. The big bonus that chiropractors come with is that they completely focus on your back only. A chiropractor understands nearly anything there is to comprehend concerning the back discs, the spinal cord, the nervous system structure as well as the biochemical processes going on in the back. That is actually the key motivation why many people consider chiropractic specialists not alone to obtain assistance but also for a diagnosis.

Another important detail would be that chiropractors don't use any kind of medications plus they never perform any surgical procedures. They will aim to solve the condition in non invasive approaches and whenever they may discover that the ways that they employed didn't work, a good chiropractor is going to send you to someone else who they think are more suitable to fix your back problems.

Most people are introduced to chiropractors because they have been involved in some kind of injury, generally a vehicle accident. More often than not a car accident that has hurt the back may bring about a painful bulging disc, and soreness in the muscles and joints that are connected to the spinal column. A chiropractor in many cases can take care of it through focusing on the right places around the spinal column. An excellent chiropractor will also continue working on your back for an extended period of time and maintain the alignment of the vertebrae so that you can keep your life quality.

Despite the fact that chiropractic specialists are completely accepted as health specialists by all health care institutes and physicians it is still part of what has become known as alternative treatment and usually employed in cases where the standard medication couldn't help. You will find that numerous medical practitioners might send you to the chiropractor after they detect the condition you have and realize that the standard medications will fail to benefit. Oftentimes the hospital will have its very own chiropractor staff members who can provide you with help even at the clinic itself.

Chiropractic treatment can help fix bulging discs, but it should always be utilized in addition to further effective treatment options for disc dysfunctions. Seeing that each back condition is different, this mix of therapies has to be fitted to the specific disorder of the affected individual. Alternative therapy possibilities like acupuncture, massage therapy, and physical exercise are extremely good solutions to make use of in combination with chiropractic care.

Relief For Spinal Stenosis With Spinal Decompression

Spinal stenosis is a condition associated with advancing age. As people grow older, if they do not take care of their spine and are not leading an active and healthy lifestyle, their bones can begin to deteriorate and problems such as spinal stenosis can begin to show up. Spinal stenosis is a narrowing of the inter-vertebral spaces in the spinal cord, which puts pressure on the nerves that branch outward from the spine and causes pain.

One of the major causes of this condition is advancing age. It is more common in men and women who are over the age of 50. Older people are also more likely to develop arthritis, which is a degenerative disease that wears away joints and cartilage. It can cause bone spurs and is a contributing factor to spinal stenosis.

What is spinal decompression?

Spinal decompression is a non-invasive, non-surgical treatment that gently stretches taking pressure off the compressed nerves and areas affected by spinal stenosis. The patient is strapped in and the straps are attached to a computer-guided machine that gently and precisely stretches out the bones in the spine to decompress the vertebrae. This pulling and separating of the bones in the spine allows oxygen and nutrients to flood into the once-compressed area, allowing it to begin the healing process.

What are the symptoms of spinal stenosis?

Symptoms sometimes appear slowly and worsen over time. They can include:

• Back or neck pain


• Numbness, weakness or pain in the arms and legs


• Shooting pain down the leg


• Foot pain

What are the treatment options?

Non-surgical treatment options include:

• Anti-inflammatory medications


• Pain relievers


• Rest


• Physical Therapy


• Back brace to stabilize and protect the lower back


• Acupuncture


• Chiropractic treatments including spinal decompression


• Exercise

What can be done to prevent further chiropractic issues?

Leading a more active, healthy lifestyle that includes a balanced, nutrient-rich diet, lots of water and consistent exercise can help prevent many back problems.

Certain exercises, such as Yoga and Pilates, focus on strengthening the body's core strength and are good for keeping the spine limber and flexible. Moving and stretching keeps the spine mobile and helps prevent arthritis and spinal stenosis from developing. Swimming, bicycle riding, vigorous walking with swinging arms and moderate weight training will protect the spine by building up the muscles and supporting structures of the spine.

After a series of spinal decompression sessions, your Chiropractor may give you a series of exercises to do at home so that your back will continue to heal. You will want to maintain a consistent exercise routine to keep your back and the rest of your body in the best shape possible. Before you find a Chiropractor in Springfield, VA, do your research. Don't be afraid to ask for patient references or the amount of experience the chiropractor has.