Why does Sciatica treatment fail?

Why does Sciatica treatment fail?

Why Does Sciatica Treatment Fail?      

Sciatica is a painful condition that can affect the way we move and limit our ability to participate in our favorite activities. Sciatica pain can be difficult to treat because the nerve is often easily irritated. Treatment for sciatica often fails because several areas were not addressed. In order to get lasting pain relief the way we move around and sit during the day needs to be changed. Watch the video below to find out more.

Top Signs of a Bulging/Herniated Disc

Top Signs of a Bulging/Herniated Disc

Top Signs of a Bulging Disc in the Low Back      

A bulging or herniated disc is a common cause of low back pain and sciatica. It can often interfere with your ability to sit comfortably, reach down to pick up items and to carry objects. Watch this video below to determine whether or not your back pain may be caused by a disc problem.

Top 3 Signs of a Herniated Disc and What You Can Do About It

Top 3 Signs of a Herniated Disc and What You Can Do About It

Top 3 Signs of Herniated Disc and What You Can Do About It          

        Top 3 Signs of a Herniated Disc and What You Can Do About It        

Chances are that if you have back pain your doctor, or maybe even a friend, has told you that you may have a herniated disc. An MRI can confirm this, but this expensive imaging technique may not be necessary as herniated discs can be diagnosed quite easily with a comprehensive history taking and physical exam. I am not talking about a short 5-10 minute visit with a doctor or neurosurgeon in which you are given a label of “herniated disc”, “stenosis”, or “disc disease”. Typically an hour-long examination is necessary to either rule-in or rule-out other potential causes of your back pain. 5-10 minutes just won’t cut it, and often can leave you wondering what’s next. Below I will talk about the top 3 signs that you may have a herniated disc.

1. Your pain is usually worse when you are sitting.          

When we sit for long periods of time more pressure is placed on our discs than when you stand. If a disc has already been herniated or has been predisposed to a herniation this pressure can often cause an increase in pain in our low back. Often times, as sitting time increases the pain gets more intense and can often refer into the buttock/hip area. Many times this type of pain affects us at work and during social outings such as going to the movie theater. If you suffer with this type of pain you will want to avoid “slouching” when sitting and instead sit with a backward bend, or slight arch, in your low back. If you find this difficult to do you may want to consider placing a rolled up towel or foam roller (about 6—8 inches in diameter) and place it behind your back while you sit in order to keep you upright.

2. Bending forward often causes an increase in pain              

Bending forward or flexing your spine will be one of the more provocative positions for you if you have a herniated disc. Back to the same concept of placing “pressure on the disc”.  Each time you bend forward you increase the pressure on the back end of your disc (think of a balloon that you squeeze on one end and the opposite end bulges getting bigger). Now bending forward isn’t necessarily bad in general, but if you have a herniated disc then bending forward too much can delay your recovery. People with this type of pain usually have a hard time picking up small children/grandchildren and find it difficult to reach down for low objects. To avoid putting pressure when bending forward, perform the “hip hinge” technique. You can do this by keeping your spine straight and only bending at your hips when you reach down. This can also be performed when you go to stand up from a chair as well.

3. You often get numbness, tingling, or pain down your leg.

Herniated discs are the number #1 cause of sciatica. Chances are if you have sciatica it is likely related to your disc problem. If your pain is severe enough, your sciatic pain most likely can be set off by the above-mentioned postures/movements as well. Sciatic pain/numbness/tingling can be caused by irritation by the herniated disc.  This sciatic pain is often described as a “burning” that can make exercise and social outings very uncomfortable. The key to keeping your sciatic pain under control is to know what movement/postures turn the pain on. From there you can do the “opposite” of those irritating movements to help reduce the pain. For instance, many people find relief if they get up and walk while stretching tall. Lying on your tummy can also help reduce your sciatic pain (although this may increase your low back pain slightly, that is okay). These are the hallmark signs of a herniated disc.  Can a herniated disc be healed? Yes, it can! Often times it can be done without expensive surgery (medications and injections just mask the pain and do not fix the true source). Physical therapy is a natural and low cost proven line of defense against herniated discs. You will be given exercises and taught how to move throughout the day to prevent those painful ”flare-ups”.  The key to recovery is getting help FAST before the situation gets worse. If a herniated disc is left untreated it likely will progress to more intense sciatic pain. Do not delay treatment thinking your symptoms will get better. Find a good Physical Therapist that can get to the root of your pain and help you get back to the activities that you love.   

How Can You Understand Your Pain?

How Can You Understand Your Pain?

                          Are you having trouble describing your pain?                      

Can you rate your pain on a scale of 1-10? We all dread that question when we go to see the doctor. What does it even mean? As a Physical Therapist, I do not enjoy asking that question (in fact I avoid it as much as possible) because most of the time people feel that they have to be EXACT and maybe their pain isn’t so exact as a number. It can be frustrating to pick a number that represents our pain because pain is more than just a number; it affects our lives, our ability to exercise, perform our jobs, and enjoy time with family and friends.             

I myself have dealt with pain involving back and sciatic pain.  What I found through my rehab process is that it was more beneficial to focus on what I could do and how I did it, as opposed to my levels of pain. The more I focused on my “pain” the negative thoughts that came with it would creep into my head. I worried about if there was any end in sight. It made all the difference when I switched my view from focusing on “pain” to focusing on what I could do. When the focus was placed on my pain the thoughts would creep into my head…. ‘Will I need surgery?’ ‘How much longer will this last?’  Even as a Physical Therapist I questioned whether I would get better.        Understand Your Pain   

What Is Causing Your Pain?              

What’s more important than rating our pain on a scale of 1-10 is to know what “causes” our pain. Whether it be sitting, standing too long, running, or exercising, this information can give us good intel into how to handle our pain. From there we are able to determine what can help alleviate our pain, which may include moving more often, performing a certain stretch, or resting from exercise.  All of this information is key to finding out the solution on how to fix the problem.           

Many people have a fear of explaining or discussing their pain because it’s so hard to describe that they may not think its believable. I find that using common descriptions can be helpful in this situation. I’ve often heard patients tell me “it feels like an ice pick” or ” it feels like there is a block that won’t let me move further”.  These analogies can give good insight into whether the pain is coming from a muscle, joint, or nerve.

Pain can often be complex, we all may have experienced it at some point in our lives, but each of us experiences it differently. It may be time that we shift our focus from the “number” of the pain and more towards our pain experience. From there we can assess what areas of our lives it affects and how we can go about changing it. Once you find a health care provider who listens and understands your pain, it can make all the difference in the world in helping you return to the activities you love.

Is It Ok To Feel Pain When Exercising?

Is It Ok To Feel Pain When Exercising?

Is Pain Ok During Exercise When Rehabbing An Injury?

Is It Ok To Feel Pain When Exercising? When enough is enough and how to tell when.So you’ve had back pain for quite some time and aren’t sure what to do. You’ve been dealing with it for months, or maybe even years, and it has kept you from enjoying the activities you love. You may have tried several treatments to improve your condition, but at times it seems difficult to understand your body and know if what you are doing is safe and good for you. Your doctor may have said you need more exercise, but exercise hurts and you aren’t sure where to start. Many people will begin an exercise program but stop short of completing it due to the increase in pain they feel either during or after it. There are several approaches to managing our pain, but first, we must understand what our body is telling us before we get any relief. Knowledge is important to reduce pain and fear.

“No Pain No Gain”

Often times people will begin an exercise regiment with the concept of  “no pain no gain”, thinking that if they push through the pain that it will go away. In reality what they find out is that their body cannot tolerate the amount of stress and load they are placing on it. In this approach, the person will push through the pain barrier. This pain barrier is present to protect our bodies. With multiple tries at this approach to make their pain go away, they will become overwhelmed with the failure and give up on exercise altogether because “it didn’t work”.  This will lead to further avoidance of activity. Example: You begin a walking program in hopes to improve blood flow and decrease stress. However, you walk too long to begin with (depending on your tolerance it could be 5 minutes or 20 minutes).  You then experience immense pain when you come home and cannot do any of your regular household chores. To no avail, you try again but with the same result, each time flaring up your condition with no improvement.

“If It Hurts Don’t Do It”

This approach will do more harm than good and can be characterized by avoiding any meaningful activity or exercise that can be beneficial to the body. It is often accompanied by fear, anxiety, and uncertainty about what might happen if “too much” activity occurs. You will become hypersensitive about any movements you perform and in turn, avoid the very movements that can help reduce your pain. Tolerance to activity and movements will decrease, limiting exercise and movement. But the key is that the body and tissues need to be stressed a little so they can adapt over time, which will allow for high tolerance for certain activities. Example: Having experienced pain during walking you decide that this exercise is bad for you and you may be fearful that it will continue to harm you.  However, this will not improve your body’s ability to perform certain activities and will decondition it further.

“Tease It, Touch It, Nudge It”

What does this entail you might ask? This approach is the happy medium between the prior two approaches. “No pain no gain” is too aggressive and “If it hurts don’t do it” is too passive. “Tease it, touch it, nudge it” lies in the middle of the prior approaches. It entails performing a specific exercise or certain tasks into a little discomfort. There will be some soreness and maybe an ache here or there, but this is necessary for the body to adapt to new thresholds of activity. Over time, as the task or exercise is performed, the body adapts to new activity levels. This will allow you to perform the exercise for longer periods of time or at heavier loads. You have successfully gradually improved your ability to perform tasks with less pain and at longer durations. Example: You decide to begin a walking regiment. Your first walk can last 6 minutes or whenever you start to feel some aching/soreness in your low back. You decide to not push through into further pain. That afternoon you have a noticeable soreness in your back as if “you have definitely worked it a little bit” but it doesn’t keep you from carrying on your chores and work for the day. This soreness or slight increase in pain would be a normal response to an appropriate amount of exercise. So do not fret if this is what you feel. You progressively add a minute to your walk and slowly build up your activity tolerance so that you can now walk 15 minutes without any pain. When dealing with pain it can be difficult to know what will benefit you and what will keep you in a state of persistent pain. Some important ideas to remember include: “hurt does not always equal harm” and “soreness is ok”.  In other words, you want to exercise, but not in the “no pain no gain” range and not in the “if it hurts don’t do it” range. Instead, your body will need a certain dosing of exercise all the while respecting the body and your pain. This will allow for you to begin tolerating other activities in your life that are normally painful. So the next time someone tells you “You just need to exercise”, they better have a good suggestion on what type of exercise will benefit you most!