Sciatica?

Discussions related to Sciatica and Leg Pain

Sciatica?

Postby Kevin » Fri Aug 18, 2006 10:26 am

I have pain in both legs, the right heel and the left foot. It is of the tingling pins and needles kind. If I run a pen along the left foot it starts to hurt when I reach the front of the foot right before the toes. The right heel is painful when I walk but not debilitating. I made the donation for RYB and have been doing the exercises for about a week. All the pain actually went away except for the left hip and then I did something to aggravate it and it is now all back.

1. Is this reoccurrence normal and will it take some time for rehealing?

2. How can I be sure if it is sciatica or piriformis? They seem almost too alike to distinguish when you have pain down both legs and buttocks.

Even though I am still in pain, I sense that my back feels stronger than it ever has and I do moderate weight lifting.

I am really encouraged by this book.

Thanks,

Kevin
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Postby randolph » Fri Aug 18, 2006 4:27 pm

Hello Kevin

Glad to hear of your initial success with RYB!

Sciatica symptoms, like you've described, can be caused by different tissues unnaturally pressing on the sciatic nerve. Two common causes - the piriformis muscle or a damaged lower disc. An MRI would reveal what is happening in your case, but there are self-tests (similar to those a GP would perform on you during an exam) that you can do to narrow down probable causes. My nearby college library had a book of these self-tests; maybe yours does too?

Very familiar with the sciatica symptoms you've described! My symptoms have been slowly but surely lessening as I do the RYB (and other) exercises daily. Careful with that weight lifting! Be especially careful lifting a weight while flexing your spine forward (such as lifting a barbell onto your shoulders from the floor) - very important for recovery from sciatica to maintain a nuetral spine while lifting, and avoid bending over to lift ANYTHING until the damaged sciatic nerve does a lot of healing. If your sciatica symptoms are caused by a damaged sciatic nerve, we're talking years to fully heal. Nerves take longer to heal than any other tissue that does heal.

I've had one bad relapse (did something really stupid) since my initial injury 11 months ago. I've recovered faster from that relapse ... but best to err on the side of caution and not risk doing too much. The challenge is to do enough to maintain flexibility and strength in the back without placing too much stress on the lower back. You know you've done too much or flexed too far if it starts to hurt (not muscular aches or pains but the sciatica, "referred" pain, usually in the foot, leg or butt); sometimes it may take a few days of very light activity to recuperate after a day of doing too much ... but after a while you do learn your limits so you can increase your activity weekly without reinjury.

Good luck with the exercises!

Randolph
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Postby Kevin » Fri Aug 18, 2006 6:26 pm

Randolph,

Thanks so much for the reply. I was very encouraged with my first weeks results where after one week the pain retreated to the left lower back for two days until I relapsed. Actually, very stupid, took my kids on a jet ski............but am doing the basic exercises plus some of the piriformis excercises just in case........what do you think?

By the way, I think this website and the books and the people are excellent and have already referred it.............

Thanks again.........

Kevin

hope you are doing fine also.........
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Postby randolph » Fri Aug 18, 2006 8:11 pm

Hey Kevin

Yes, you're right, bouncing on a jet ski is the exact kind of compression on our lower backs we're trying to avoid for a while. Other activities to avoid for a while: parachuting, bunge jumping, tackle football (duh), (but here's a tough one for real), driving for more than an hour or two without a break. Fall in love with movements that decompress (or strrrrrrretch) the spine, like hanging from a chin-up bar by the hands, feet not touching the ground (my favorite). Helpful, too, are IDD therapy (I'd do it if I had the extra $$$) and the inversion table (Ken loves his).

I've found that Ken's and Dean's piriformis stretches are personally very helpful. Just stretch to the point I start to feel a bit of pain in the hip, then back off. They seem to be a good, relaxing stretch to do between the more vigorous exercises.

Please keep us posted, Kevin, on your progress!
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Sciatica

Postby Kevin » Sat Aug 19, 2006 7:22 am

Randolph,

Thanks again. The only thing I have to do is play golf Monday in our Mayor's First tournament. 16 years ago when the books and this web site were not around, I had severe sciatica and golf relieved it only to "die" later. I note in the RYB book where a twisting motion actually can relieve sciatica pain. I was later diagnosed with a broken disc that lodged near a nerve. It was acutally thought that it lodged years earlier when I had pain, relocated to a non-nerve area and then back. Ultimately had surgery and discovered two other bulging discs (which were left alone as the Doctor told me they do not do "preventive surgery". There were no problems until about a month ago. Kept doing the stretches I learned in PT. I find the exercises in the RYB book to be more of a strength and stretch whick I like.

I have question. If a disc bulges out the back, will the cobra moves actually pinch it?

Also, at the gym, I do a leg machine where you lie down with feet near chest and push the weight up. I would not think this is good either....any thoughts?

What is IDD therapy?

Randolph, thanks again. Will keep you posted.

Kevin

Thanks again for responding.
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Postby randolph » Sat Aug 19, 2006 11:17 am

Hey Kevin

Most disc herniations/bulges are like ours: bulging out the side or back of the vertebrae (thus the relative noninvasive nature of a microdiscectomy - just a small incision necessary; conversely, some back surgery requires coming from the front, literally pushing aside innards - ouch). Seems plausible that doing the cobra would compress the disc (and there is one position where I twist and bend a certain way that zings me good)... yet the cobra seems a very effective exercise for pain relief and rebuilding. Absolutely my favorite exercise ... but it did take a couple months of healing before I could get up off my elbows and bend enough, without pain, to get up on my hands. How about you?

Dr McGill recommends free weights over machines, but he's OK with the leg machine with this recommendation: push up with one leg only, the other leg extended out, making sure your pelvis maintains contact with the back pad, and of course maintaining neutral spine. He claims this reduces the compression on the lower back, so important during the early stages of our rebuilding. I assume with healing and strengthening, using both legs to push the weight up would be OK. My own favorites for strengthening the quads are single leg lunges and the classic squat without weights.

IDD (intervertebral disc decompression) is a relatively new technology for relieving pain due to damaged discs (tho the idea has been around as long as chiropractic). The jury is still out on cost benefit ratio - usually requires daily sessions for several weeks at a specialist who has the high tech gizmo, to, basically, get stretched out on their traction machine. My GP recommended trying this before surgery if I have another relapse. (cost about $5K and 80% effective in relieving pain significantly) Laying on your back in the machine, your shoulders are immobilized, then the machine pulls your hips away from your shoulders, basically stretching your spine. The inversion table, and simply hanging by your hands from a chin-up bar are lower tech approachs to the same idea. I've gotten some help from a bar I've rigged up on my truck - hanging for just 15-30 seconds every few hours, VERY relaxing now. Like any other exercise, start doing just a little and gradually build up time you stretch out.

How long ago did you have your back operated on, and what operation was it? A microdiscectomy?

Randolph
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Hey Randolph

Postby Kevin » Sat Aug 19, 2006 4:45 pm

Randolph,

Thanks for the advice. I too like the cobra and hip shrugs are neat also. When I drove on vacation I did the pelvic and hip shrug maneuvers when I started feeling it and tried to concentrate on relaxing my back when I thought of it.......seemed to work pretty well. I am going to stay away from weights for a couple of more weeks.

I had my back operation 16 years ago. It was a full blown surgery where they pulled out a piece of broken disk and then carved out 80% of the rest of the disc to let it fill in with scar tissue. While there they found two other bulging discs which I assume I still have. Doc said they don't do preventive surgery. I don't even know if microdisc was around back then. I have pretty much kept up with the stretching exercises they gave me 16 years ago but I truly like the ones RYB has.

The theory behind the 80% disc removal is that years ago they used to take 20% of the disc and found that 80% of the people came back for another operation. By taking 80% they found that only 20% came back. Go figure. But in my case I was extremely fortunate to only feel a minor stiffness all these years with no sciatica (One two week minor occurrence in 16 years) and really not limited from doing anything except jogging which I never was a big jogger anyway.

Anyways, I am sticking with the RYB basics for now with a couple of piriformis stretches. I feel a little better but notice the sciatica a little worse if I over do the yard chores.

I chganged my cardio from stationary biking to treadmill and incorporated that back machine both of which I never used to do and am wondering if that contributed.

Hope I did not ramble on too much........sounds like you are well versed in this stuff and I appreciate your expertise..........

Keep in touch...............

Thanks again..........Kevin
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Postby randolph » Sat Aug 19, 2006 8:33 pm

Thank you, Kevin, for the details on your relevant medical history. It will be interesting to see how you respond to the RYB exercises.

I also found the pelvic and hip shrug movements especially helpful while I'm driving for many hours on the road. (And with the cruise control on, doing stretches while driving ... or maybe I shouldn't be mentioning that?)

Very good that you're learning when you are overdoing on chores like yard work. We're coming up to leaf-raking season, and that's one of those activities to really watch yourself - bending over and using a tool with arms outstretched - high stress on the lower back, even with a light rake.

The change in your cardio activities and additon of the back machine could be a factor in the onset of your sciatica symptoms, depending on how vigorously you began doing those new activities. Dr McGill sez in any physical activity, insure you're warmed up and begin gradually; and when doing something new, gradually build up the amount of time and level of intensity doing it. Endurance for doing an activity is built up gradually; in other words, don't try to run a 3 hr marathon a month after beginning a running program. And after a session, rest adequately; tissues apparently break down easier with lower levels of activity if not sufficiently rested. To build strength and endurance, we certainly need to stretch our personal envelopes a bit, but we also need to rest adequately to recover from the stress. You'll have to judge, if, for instance, you did too much too fast ... a typical guy thing to do. (My wife had it right on this one after watching me overdo it for years. When I told my wife about this "new" approach [for me] to exercising, she responded: "Duh????" Pretty simple ... except for some of us.)

Continued good luck! Randolph
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Hey Randolph

Postby Kevin » Sun Aug 20, 2006 6:50 am

Cruise control stretching.........would make the wife and kids nervous if I did that one.........


Who is Dr. McGill? You seem to reference him alot. Is he a good resource I can tap into? Any books out?

Thanks Randolph............

Kevin
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Postby randolph » Sun Aug 20, 2006 8:34 am

Dr Stuart McGill has been doing really good scientific research the last 25 years in Canada on lower back disorders, especially on what exercises/treatments do and don't help with sciatica. He's written 2 books for mass consumption summarizing the results of his research. Just google his name. His first book is specifically on LBD's; his second applies his research to preventing back injury in athletic activity. The books are expensive ($40); I found copies at my local college library.

I'm pretty high on him because he bases his recommendations on scientific observation of how each exercise affects particular muscles and related stress on the spine. Reading his first book made it clear to me why Dean's RYB recommendations work for back rebuilding in general, and also clarified, in particular, the special challenges that sciatic nerve damage from disc herniation adds to the mix.

Randolph
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Dr McGill

Postby Kevin » Sun Aug 20, 2006 2:53 pm

Hey Randolph,

Thanks, I will definitely look him up and get his books. It appears that the research is growing in this area and is interesting especially to those of us who need it.............take care,

Kevin

keep in touch
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Re: Dr McGill

Postby Rupert » Mon Aug 21, 2006 4:42 pm

Kevin,
I agree with Randoplhon approach to exercising. Watching your body and how it reacts to exercises, cut out the inciting factor and keep the helping exercises.
I have similar symptoms like yours that i have the sciatica in both legs. My MRI revealed a broad based herniation of the l5-s1 disc. It has been about 3 months i hae been slowly and steadily improving but it seems whenever i go into the gym and do the machines that my PT recommends and with small weights evenm I see a spike in the nerve symptoms. But otherwise my general quality of life has improved a lot compared to a month ago.
Like Randolph says I need to add the gym routing slowly in bits and pieces. Now I am doing twice a week gym routine which is, walking on a treadmill at 2.5 mph, rowing machine, ab crunch machine, shoulder pull down machine, back machine, nautilus push machine. Will wait and see for couple of weeks before adding the required 3 strenghthening iterations a week.
Nerve symptoms cause concern I know how you feel, but my friend what can we do? Just watch the body and exercise that seems to be my motto.

It gives me hope that you had surgery and then were fine for 16 years, sure this gives hope.
Keep posting.

Best Wishes,
Rupert,PA
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Rupert

Postby Kevin » Tue Aug 22, 2006 7:37 pm

Thanks Rupert. I am staying out of the gym completely for now. Long day at the office sitting am my legs are hurting. My back sees relatively pain free but the pain concentration is mainly in the upper back and front legs with less below the knee. I am hoping this is some kind of improvement.

Thanks again, and Randolph if you are out there, hi, and jump in any time.

Take care guys, talk to you soon. I think if I don't see significant improvement in a week and I going to al least try to get officially diagnosed.

Rupert, were you diagnosed with an MRI? Or x-ray...
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Rupert

Postby Kevin » Tue Aug 22, 2006 7:39 pm

Sorry about the MRI question.......it is in your email.................thanks....Kevin
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