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Prince Loeffler
20th August 2003, 07:58
I recently have two student who are currently out due to sciatic nerve pinch. Both love to to train and can't stand the fact that they haven't train for over a month now.

Can anyone here who has suffered from this annoying pain in the butt have any good exercise routine and hopefully share how you recovered.

Thanks in advance.

EHurley
20th August 2003, 14:05
Hi Prince,

I have been recovering from sciatica myself and what will work depends upon what is causing the trouble.

It seems alot of times it is attributed to a bulging/herniated disk in the lumbar vertibrae, for which an MD may recommend a range of treatments from physical therapy to more invasive procedures.

Another possibility, which affects some runners and other atheletes, is piriformis syndrome: the piriformis is a triangular muscle deep in the butt which the sciatic nerve runs beneath. If this muscle gets tight or shortened, it can press on the nerve and cause sciatica.

In my case, I opted not to do anything invasive until it was a last resort. My original diagnosis was that I had a bulging disc, and originally the pain would shoot all the way down to my foot. As time went on the pain was more localized to the hip of the effected leg (more like piriformis). I saw a chiropractor for a while, which I feel helped me out greatly, and once my insurance ran out I began researching and trying different stretches to see what worked.

I have found that waking up early and going for a quick walk and then some hamstring stretches (being sure to keep the foot facing forward and to bend from the hips), stretches that work the psoas muscles in the trunk, and the following piriformis stretches:

http://www.healthrap.com/Articles/ExCentral/st13.htm
http://www.drbackman.com/piriformis_muscle_stretch.htm

You can use a tennis ball directly on the site of the pain to help release the muscle and break up trigger points:

http://jaxmed.com/massage/pirformis_stretches.htm
(bottom of page. Also has psoas stretch.)

I am not a doctor and this is not medical advice, this is just a set of exercises that has been working for me. I still have some pain from time to time, but nothing like the first several months.

I hope this is helpful.

Take care,

Ed Hurley

Joseph Svinth
21st August 2003, 02:20
Google keywords:

An MD is likely to call this condition "lumbar radiculopathy," while a chiropractor is likely to call it "lumbar subluxation." For sample discussions, see http://www.physsportsmed.com/cover.htm , http://www.spineuniverse.com/displayarticle.php/article1469.html , and http://uscneurosurgery.com/classroom/science/pathophysiology/topics/spine.htm .

Also consider podiatric consultation, as orthotics are sometimes helpful in resolving underlying foot and ankle problems that in turn contribute to back pain.

mach5_kel
21st August 2003, 22:52
For most people its not a subluxation (disk problem), unless there has been some sort of accident, or heaving lifting, etc.

It is more common in MA for it to be the piriformis syndrome.

You could also check the nerve charts for the spine to see the zones of where the nerves go in the legs/ butt, and compair it to the pain.

Usually sciatic pain is not due to true neritis (nerve inflammation), but usually an impingment on the nerve from the muscles (piriformis muscle).

Check here http://www.acuxo.com/ for some acupressure points.

Good luck,
Eric Vander Wal

Tripitaka of AA
23rd August 2003, 20:52
I suffered from pain in the lower back that went down my rigt leg to just above the knee whenever I leaned forward. I tried to relax, rest the joint and ease whatever tension I thought might be affecting the area. It just seemed to get worse.

I went to my GP (General Practitioner, the English Family Dotor). She put one finger on the small of my bak and asked me to bend over (like a polite Japanese greeting). She asked when the pain started and when it stopped.

She said "You've got Sciatia. Be more active."

I was.

It went away.


Sorry, not a lot of technical data. But that's how it went.

MarkF
24th August 2003, 14:24
She probably found the muscle spasm so wound up it was irritating the sciatic nerve or one of the branch nerves.

Joe has it right as to what it is called whether it is a minor strain or a major herniation of a disc (usually L-4,5) radiculopathy or Lumbar radiculitis, which really means an injury with pain radiating out from that area. Chiropractors call everything luxation or subluxation, or an injury due from that cause. A lot could ride on treatment. Be careful.

Invasive treatment not only should be of last resort, it should not be considered for at least one year from the date of injury. Non-invasive tests should be done before trying a chiropractor, as well. Manipulation can make it worse, even if it feels better. X-rays, CAT /MRI scans are more definitive, though an MRI can over-diagnose a bulging disc, too so have both types of scans if insurance allows it. It gives more conservative treatment a chance to work, and even if you have done everything everyone has thought of, you should probably try a chronic pain clinic before more radical procedures are done. Insurance usually allows six months of conservative treatment. I guess it is more expensive than the more immediate invasive treatment. You may want to start taking pills OTC of ground Valerian root, also. If your problem stems from a spasm only, that may help. Many times, it is the result of a minor strain which causes spasm which does encircle a nerve and does "pinch." Some invasive procedures involve only injections of a local anestheric such as Novocaine or Marcaine, but you must know the exact area or areas from where the pain starts. These are temporarily effective in some and are completely effective in others. For a ruptured/herniated disc, injections of papain has approximately the same degree of success as does major or microsurgery, so treatment plans should start low and go up from there giving everything a chance, if possible.

The good thing today is that even with the worst of injuries, such as a ruptured disc, microsurgery and perhap one night in the hospital followed by physical therapy is just as effective as open surgery, and requires far less cost and hospitalization today.

Back pain is like a headache. Studies are slow and underfunded because they are not considered serious, but when you look at the cost of a missed week of work, several times over a years or so, you'd think they would study them with a little bit of urgency, if only to save money. While availability is much better today than in the 1970s, many of the tests and treatment modalities today were available twenty or more years ago, they just weren't being done to any extent. In a way, those who are young and have back problems now, are lucky as the choice of treatment is out there. OTOH, back pain can be a life long chase for relief. Don't hurry back to the mat. Give it time and be nice to it.

Exercises really are those which stretch and relax muscles. I wouldn't recommend specific exercises as this is especially personal as to what works and what doesn't. Ultimately, you may have to hurt yourself a little to get a lot of results.


Mark

hjnorris
26th August 2003, 02:47
On January 6th, I woke up with shooting pain up and down my left leg. An MRI showed I had a textbook herniated lumbar disc at L5-S1.

The NSAID's helped masked the pain. Heat and Ice made things feel better for a while. But honestly, for three months I was in hell trying to find an escape from the pain. I was told by my Doctor that surgery was my only option.

What cured the pain ( deliberate choice of words there) was a pair of physical therapists who showed me Robin McKenzie's groundbreaking excercises for lower back pain.

After three days, 95% of the shooting blaze of pain was gone.

I have some occasional back stiffness and sciatica, but it is usually taken care of with a few minutes of stretches.

If you suffer from back or neck pain, check out his books, Treat Your Own Back and Treat Your Own Neck. They cost less than $15 on Amazon, and they work. If your doctor or physical therapist does not recommend (or know of) them, hire a lawyer and sue their quack ass off.

BTW, This experience changed my karate practice greatly. I dropped JKA (shotokan) karate for Shitoryu when I found that shotokan (vibration/rotation/counter rotation) hurt and shitoryu made my back feel better. Go figure. Thanks to a steady diet of kihon involving shikodachi and nekoashidachi, I was able to train with great frequency and it felt great.

Yours,

Henry Norris
Raleigh, NC USA

TommyK
26th August 2003, 04:00
Greetings,

When I was testing for shodan, I was diagnosed with a Mild case of this afficltion. A mild case was enought to bring tears to my eyes when doing forms or acting as uke. It was terrible.

In our school you are observed, offically, for several months before the actual test and do receive intense instruction, modification, and correction on forms in addition to free fighting, Judo randori and Aiki related self-defense. After 5 months of suffering from the affliction, it started around the time of my notice to test; I continued going to class 3 nights a week, never mentioning it (the affliction) to the instructors as anything more than a muscle pull,thankfully it eventually disappeared.

The relief was amazing! I managed to test with the nagging mild case, and passed on the 2nd try, then a month or so later it just went away. While I suffered form it, I tried every exercise, and all that helped was gentle rolling motions on my back with my knees tucked in.

Best of luck to those with this problem and thank goodness I only had a 'mild' case.

Regards,
TommyK

MarkF
26th August 2003, 18:37
It doesn't mean the doctors are wrong when you have a bonafied, textbook case of a herniated disk. In their way, they see laminous material, leaked from the open disk, calcified (this happens very quickly), and putting pressure on the sciative nerve.

BTW: Henry, I woke one day with nearly identical symptoms which only got worse. Luckily or not, the doctors and other medical personnel were very conservative in suggesting treatment. Still, I did end up having surgery. My disc was the Lumbar 4-5 disc, the most common, yours was right there as the second most common but not by much. On top of things, electro-myographs showed I had nerve interference in Sacral-2 without S-1 which was thought to be very unusual, but the thought was that it would be relieved by taking pressure off by removing the free lamina, cleaning out the disk, and closing. It didn't. The recovery time in the hospital at that time, was one week, and the pain was exquisitely unbearable during healing, morphine sulfate being my only friend for three or four days.

That was after trying nearly everything, but I don't think the books you mention were available in the 1970s. I would have tried them, believe me. I have others, one written by a man who started the first clinic strictly devoted to relief of chronic pain called "Free Yourself from Pain (I can't remember the name, but he wrote a book which was used to get the funding necessary for his clinic)." He was a Ph.D. in Anesthesiology and on staff at UCLA Medical School. Most of the MDs were also anesthesiologists, two were CMDs who spoke no English, it was small but it outgrew the basement offices in Franz Hall fairly quickly. Headache and pain relief clinics are today very common offering everthing from standard treatment, to accupuncture with moxa, to (at that time) bio-feedback, etc. I tried them all including Imaging classes.

I since have had two more herniations of discs in my back, and I have refused follow up surgery recommended back in 1978. I just do not believe it is to my advantage, especially with a recent diagnosis of "an arthritic back, but you don't need surgery" from a neurosurgeon.

People can have herniations in any disc of the spine, know it instantly, overnight, after ten years, or never. I've learned to live with it, I eventually got back on the mat and continued my pursuit of success on the shiai mat. It actually made me a better player because I had to adjust my nage-waza downward to tuning up a smaller number of tokui-waza, so I worked on those, in particular during randori. I still live with pain and numbness in both legs (originally it was my right leg, but now my left leg seems to be more affected than it did originally), but I'm used to it. If I can't sleep or relax I do some relaxation exercises. If that doesn't work, well, narcotics are a reach away, but I don't recommend it. NSAIDs, like any other pain killer can mask some of it, but opiates mask almost all of it, so it is a type of "breakthrough" pain relief I need only occasionally. Pain tells us something is wrong, the poppy seemingly makes it all right, at least for the short term. I don't pretend I don't need it when I do. I have too many years with this and know my limits.

Tom, you're a lucky SOB, mild was rarely in my vocabulary, but I can't post those that were.;)


Mark