Saturday, May 21, 2005

Sciatic Pain Does Not Have To Be Debilitating

By Richard Lauro

Sciatic pain or sciatica is a commonly used term for pain originating from the back. Sciatic pain is felt along one of several nerve distributions in the leg, ankle or foot, buttock, hip, thigh.

Sciatica involves compression or irritation of one or more nerves, which exist in the lower spine making up the sciatic nerve.

The sciatic symptoms are often combined with low back pain. The appearance of symptoms may vary; sometimes the back pain comes before the sciatica, and sometimes it will follow.

Any person experiencing sciatic pain should make caring for sciatica an integral part of their daily life, not just something to add to the routine at the end of the day.

It is recommended that everyone suffering from sciatic pain should consult a physician or Muscle Activation therapist before beginning any exercise program. There are many sciatica exercises, which are suggested for different conditions.

To be effective the exercises should be done regularly and close attention should be paid to posture and body mechanics.

There are four major types of sciatic pain which include:

Sciatic pain from a herniated disc
Sciatic pain from spinal stenosis
Sciatic pain from degenerative disc disease
Sciatic pain from isthmic spondylolisthesis
Herniated discs commonly involve disk material protruding backwards and irritating or compressing a nerve root. Specialists prescribe exercises to treat the condition according to the situation, which will cause the symptoms to move up the lower extremity and into the low back.

For many patients, this is done by getting into a backwards-bending position. The low back is gently placed into extension by lying on the stomach (prone position) and propping the upper body up on the elbows, keeping hips on the floor. This should be started slowly, since some patients cannot tolerate this position initially.

This position is typically held from five to 30 seconds per repetition, for 10 repetitions. A similar exercise can be done standing by arching backward slowly with hands on hips if the patient is unable to lie flat. However, the prone position is usually preferred.

Spinal stenosis can also cause nerve root irritation or impingement through a narrowing of the nerve's passageway. When treating stenosis, the spine specialist may encourage flexion exercises. Flexing the lower spine increases the size of these passageways and allows the irritation or impingement to resolve.

This is accomplished by stretching the muscles of the back that hold the spine in extension (backwards bending) and strengthening the muscles that bring the spine into flexion (forward bending). Stretches for the low back extensors are typically held lightly for 30 seconds.

Lie on the back and gently pull the knees to the chest until a comfortable stretch is felt. From all fours, sit back on the heels with the chest down and arms outstretched.

The exercise normally suggested for treating disc degeneration is a dynamic lumbar stabilization program. This includes finding the most comfortable position for the lumbar spine and pelvis and training the body to maintain this position during activities.

In doing this correctly, one can improve the proprioception (sense of movement) of the lumbar spine and reduce the excess motion at the spinal segments. This will in turn reduce the amount of irritation at these segments.

These exercises often require specific hands-on instruction because they offer much less benefit if done incorrectly, and tend to be much more difficult than they appear. This type of program is progressive, starting with the easier exercises and advancing to the more difficult exercises.

The most important aspect is sensing and controlling motion in the spine. Once learned, the body can eventually take over and do this without the level of concentration it takes early on.

Isthmic spondylolisthesis is typically treated with a program that is a hybrid of the flexion-based exercises (as in stenosis) and the stabilization program (as in degenerative disk disease).

The goal of this method is to teach the lumbar spine to remain stable in a flexed position. Therefore, the exercises are a combination of both programs.

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Sports Injury
Originally Posted on 5/21/2005 8:48:49 AM


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