Sciatic pain relief: Keep hydrated

by Christina Abbott on July 13, 2010

When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is something you can do for pain relief every day from my checklist for corrective actions and treatments Part 2.

thmKeep hydrated. Water is essential to healthy muscles and joints. Every process in your body requires water. In my Neuromuscular Therapy center near Boston, I have seen patients recover from pain complaints with a few appointments to manually release muscle tension and Trigger Points and then simply an increase in their water intake.

To understand why, here are a few images. Think of a juice concentrate. It’s really strong tasting as a concentrate. The more water you add the less of the juice you taste. Now think of a strong acid. If you put it on your skin straight, it can “burn,” causing damage. If you dilute an acid, it can be safe, even edible. Now think of those acids inside your body bathing your nerves and muscles. Undiluted acids in the fluids of your body can be irritating. Drinking fluids dilutes those fluids.

Another image is a car engine. If it doesn’t have enough oil, the parts rub together creating friction and heat. Eventually the heat causes damage. In your body, water acts as a lubricant, preventing inflammation from tissues rubbing together. Inflammation equals heat. Heat causes pain. Water cools the heat.

Now think of a boat transporting essential products into a port. Water is the means of transport in the body, feeding the soft tissues of the body with the essentials for healthy tissue and removing waste products that cause pain. If it doesn’t dissolve in water, then it is carried by water.

Almost all of the chemical reactions in our bodies take place in the presence of water. Without it we cannot live. Metabolism, temperature control, elimination, blood volume and pressure, and the health of every cell depend on water. The muscles are 70-75% water, blood is 82% water, even your bones are 25% water and those figures are just a start in understanding it’s importance, especially in relieving pain. Chronic muscle aches and pains are one of the symptoms of a lack of water.

The formula I use for a general guideline is: Your weight divided by two equals the number of ounces of water you should consume each. Some factors like medications and alcohol increase that requirement. A passionate plea for the medical community to understand it’s curative powers is presented in The Body’s Many Cries for Water by Dr. Batmanghelidj. Some think it is an extreme view, but it will open your eyes.

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Sciatica pain relief: Keep moving

by Christina Abbott on July 12, 2010

When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is something you can do for pain relief every day from my checklist for corrective actions and treatments Part 2.

tai-chi-beach1Keep moving to keep the muscles limber and the blood and lymph flowing. Prolonged tension or inactivity can produce pain. Tai Chi is a gentle movement therapy to explore. I love the phrase “Rest is Rust.”

Remember when going to the hospital meant days of bed rest? Those days are over! They get you up and moving the same day as your surgery. That’s because your body heals better when you move.  The formula for injury recovery used to be RICE Rest, Ice, Compress, Elevate. It’s now MICE: Move Ice Compress Elevate .

When you move, your muscles work, and as they work they pump blood through those soft tissues, carrying precious nutrients, rebuilding cells and energy molecules: healthy tissue! The movement also pumps waste products out through the circulatory and lymphatic systems as well as through your breath and your skin, relieving pain by restoring a healthy environment. Movement also lines up the healing tissue in the direction it moves. If you don’t move, your body forms irregular scar tissue areas that prevent restoration of normal movement patterns.

Even random movements will help, so move whatever you can in any way you can and it will be good. Other gentle exercises you might consider are swimming and Tai Chi. When I say swimming, I don’t mean you have to swim laps, but moving about with the support of the water will be comfortable and should be pleasant. Tai Chi is an Asian exercise routine practiced by young and old. It is more of a movement therapy than exercise, getting your body and your energy (chi) moving to remove areas of “stagnation.” It shouldn’t take much looking to find a Tai Chi class somewhere nearby. Walking is another good way to keep moving. You don’t have to walk fast, just amble along if that’s all you can do. Moving is the important thing. Try moving your hips as you walk, or do a little dancing in your livingroom. Put on some good music and have some fun! Enjoying your exercise has been shown to increase it’s benefits.

I subscribe to a saying I heard years ago, “Don’t sit if you can stand. Don’t stand if you can walk. Don’t walk if you can run.” Keep moving!

…from my Neuromuscular Therapy center near Boston.

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Sciatica pain relief: Stretching

by Christina Abbott on July 11, 2010

When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is something you can do to relieve pain every day from my checklist for corrective actions and treatments Part 1.

stretchingStretching is a big key to pain relief of “sciatica” pains. Use the Active Isolated Stretching method: Actively stretch, assist at the end range for 2 seconds max and repeat 10x. Find out which muscles are tight and use specific stretches to lengthen them. (See my post on AIS protocol.)

Stretching serves at least two purposes. The first is that it lengthens and relaxes your muscles, allowing them to work more efficiently when you need them. Muscles contract in the middle (like Popeye) shortening the muscle length and forming an area where the tissue is thicker from the doubled-up muscle cells. As they contract in the middle, they shorten the muscle, pulling on the ends where they attach to bones. If the muscles can’t relax and form muscle contraction knots, they stay in that doubled-up state and can’t move well because they are shorter than normal. When they lengthen they can relax. Stretching lengthens and relaxes muscles when it is done correctly.

The second purpose is to get fresh blood pumped into the muscle to bring energy cells, nutrients and oxygen which are necessary for it’s health and ability to do work. Almost as important is that stretching increases lymph flow. The lymph is what is collected by lymph vessels from the fluids that surround all the tissues (interstitial fluids).  The content includes waste products of various kinds. When waste is allowed to accumulate and decompose, it forms acids that irritate the nerves and cause pain. Without the lymphatic system, we would die in 48 hours (reference Dr. Bruno Chickley). As the muscles work, contracting and relaxing, blood and lymph are pumped through. Active Isolated Stretching, as the name implies, is active rather than passive stretching. The activity does the pumping. Passive stretching with the stretch held for a long time does no pumping, in fact it reduces fluid flow by narrowing the blood and lymph vessels.

Stretching has also been found to help release Trigger Points (reference Travel and Simons), those areas of hyperactivity that work a muscle constantly and that refer pain. In my Neuromuscular Therapy center near Boston, I stress the use of AIS for patients with TrP activity. If you pull on a muscle that is actively contracting, it is counterproductive, even harmful. AIS prevents the protective action of the muscles to threatening activity and helps release those hyper muscles.

For sciatic symptoms there are specific AIS stretches that help the low back muscles, the glutes, piriformis and hamstring muscles. To see those stretches, buying Stretching for Everyone by Aaron Mattes is a sound investment of $15 . Go to our sidebar store or directly to his web site.

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When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is a tip for pain relief to investigate from my checklist for corrective actions and treatments Part 1.

Restore balance to muscles and joints with manual muscle therapy, appropriate daily stretching and a careful corrective exercise. Swimming is one of the best general exercises for back and hip problems. It takes away the effects of gravity.  Do everything you can do without pain to stimulate your body’s wellness response.

Your joints have nerves within their protective tissues that alert the nervous system when there is a condition that is threatening. Tension or imbalance in a joint that causes the bones to rub together will fire off those nerves. The rubbing causes friction, heat, inflammation and pain, in that order.

To relieve joint pain, release the tension on all the muscles that cross the joint to allow freedom of movement without friction. In the case of sciatica symptoms, the joints that need attention are the joints between the vertebrae in the small of your back (lumbar), between the lumbar spine and hip (iliolumbar), and between the bone at the base of your spine and it’s adjoining hip bone (sacroiliac).

Muscles work together in groups to produce fluid movement. If one muscle isn’t working well, it causes the body to compensate. Compensation causes muscle imbalance. Those muscles that are required to do more work get tight and tired causing greater compensation. Eventually the overworked muscles become painful. Additionally, the joint movement is altered when muscles are not balanced, which causes friction where the bones are pulled too closely together on one side and produce the condition I just described.

Manual therapy, especially a specific and deep one like Neuromuscular Therapy, will relieve muscle tension and Trigger Points that shorten a muscle and tighten the joints. Lengthening and relaxing the muscle allows greater blood flow to bring the essentials (energy, nutrients and oxygen) for healthy tissue, and it removes waste products that cause pain.

Appropriate stretching (see Active Isolated Stretching) helps to decrease muscle and joint tension every day and increases the gains achieved with good manual therapy. Additionally, using AIS stretching techniques increases blood and lymph flow by pumping healthy fluids in and unhealthy fluids out of the tissues.

Careful corrective exercise strengthens the muscles that cross the joints, allowing balanced and flowing movement and good support. Increasing exercise gradually will help the muscles rebuild and prevent stressing the joints. Making sure that the muscles are working equally and together prevents the joint tension and imbalance that leads to pain. For low back and sciatica symptoms, exercise that takes the effects of gravity off the low back and butt are preferable.

Your body has what is called a “wellness response.” If you act as if you are well, your body will respond in kind. Try to focus on the parts of your body that feel good rather than on the parts that hurt.

Sciatic pains are one of the most common complaints that I treat in my Neuromuscular Therapy center near Boston.

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Sciatica pain relief: Treat Trigger Points

by Christina Abbott on July 9, 2010

When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is something you can do from my checklist for corrective actions and treatments Part 1.

Treat Trigger Points in affected muscles with neuromuscular techniques.

This is my favorite subject as a Neuromuscular Therapist.

Trigger Points are specific hyperactive and hypersensitive places in your body’s soft tissue that refer symptoms to another place from that spot. Because they are working 24/7, they never get a rest. Consequently, they use up all the nutrients and oxygen necessary for work which causes muscle spasms (and pain), and they give off waste products that accumulate, decompose and irritate the nerves (more pain). Trigger Points must be deactivated using Neuromuscular Techniques to reduce the local and referred pain.

With “sciatica” symptoms, I look at three muscles.

ksThe first, the quadratus lumborum, is often the original problem. “Quadratus” means four-sided in Latin and “lumborum” indicates that the muscle in located in the lumbar region of the spine, at your waist between your ribs and your hip bone. The QL refers pain into the buttock from the sacroiliac (SI) joint across to the lower butt and down into the upper part of the back of the thigh. It also refers into the hip joint and above that into the top side of the hip. Sometimes it even refers into the abdomen, groin and down the front of the thigh. The part of the muscle closest to the spine is actually a ligament (iliolumbar), but it has the same referrals.

glut-medmin-groupThe second muscle I check is the scallop shaped gluteus minimus located in the side of your hip above the hip joint. It has been nicknamed the “pseudosciatica” muscle because it’s Trigger Points exactly mimic sciatica symptoms. One set of TrPs refers into the lower buttock and down the back of the thigh to the calf. The other set refers to the side of the butt and down the side of the thigh, knee and lower leg to the ankle. The muscle is underneath it’s partner gluteus medius and requires deep sustained pressure to release it.

piri-glutmaxgrpThe third major cause is the piriformis muscle. Doctors are paying more attention to it lately. It is a little muscle located deep to the much bigger and thicker gluteus maximus. TrPs refer from the SI joint across the buttock and hip and down the back of the thigh almost to the knee. Just as important is the fact that when it’s tight it can press on the sciatic nerve and cause big problems that include weakness and loss of function. The overlying gluteus maximus will be treated along with the piriformis. It causes mostly buttock pain.

While these muscles are being examined and treated, it is advisable for a therapist to check the hamstrings in the back of the thigh since all of the above muscles refer there and can irritate them.

After twenty years in practice, I find this complaint to be one of the most common. Consequently I treat these muscles every week in my Neuromuscular Therapy center near Boston.

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Sciatica pain relief: Spinal adjustment

by Christina Abbott on July 8, 2010

When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is something to consider from my checklist for corrective actions and treatments Part 1.

86481146Use osteopathic or chiropractic correction of skeletal and joint misalignment up to 6 consecutive treatments. A chiropractor I respect told me if it takes more than that to correct a problem, you should probably be doing something else for treatment.

If nerves are being compressed or compromised at the spine or at the sacroiliac (SI) joint, it will effect the signals going to the muscles, increasing frequency or distorting them. When they are irritated at the nerve root, they can cause pain.

Spinal adjustments by an osteopathic physician (D.O. and fully qualified medically), or a good chiropractor (not registered medically) can correct a misalignment.

Be careful of two things.

First is that if the muscles are too tight around the joint in question, it can prevent a good adjustment or may just pull it back out after the adjustment has been made. Look for a practitioner who provides some kind of muscle treatment before the adjustment, or get a licensed massage therapist to treat you before you go in for your appointment.

Second is that continuous adjustments can cause “ligamentous laxity.” That means that the ligments that hold the bones together can get stretched by being adjusted too often. The result is that your muscles have to take up the slack and can get overworked trying to do the job of the ligaments. As I mentioned above, it shouldn’t take more than six adjustments to correct a problem.

If your spine is really misaligned, it is important to get straight!

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Sciatica pain and structural asymmetries

by Christina Abbott on June 24, 2010

When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is something to think about from my checklist for corrective actions and treatments Part 1.
Correct structural asymmetries with a heel lift, butt lift, foot orthotics, and make changes in misfitting furniture. This is more important than you would think.

When your skeleton is uneven, your body will constantly work to balance it, potentially causing overuse symptoms. Muscles burn metabolic fuel for energy and use up essential nutrients and oxygen in the process. When any fuel is burned it produces waste products. When a muscle is tight, the blood can’t circulate efficiently to take them away so they can build up and cause pain locally. If left untreated, overactive muscles become tight and tender and can develop Trigger Points that refer pain down into the butt and leg, causing sciatica symptoms.

Structural asymmetries are often genetic and run in families. Usually more than one asymmetry is present if you have one. Legs that are a different length can cause sciatica symptoms. Correction is easy and inexpensive. Add a heel lift to your shoe on the shorter side. Not everyone with a Lower Limb Length Inequality (LLLI) develops symptoms, but once a Trigger Point forms, the imbalance can be a perpetuating factor.

Another strutural factor is a hemipelvic asymmetry, or uneven pelvis. When the hips are different sizes, the pelvis tips whenever you are sitting. Correction is a “butt lift,” like a paperback book or foam pad under the smaller side.

A Morton’s Foot Structure, where the second toe is longer than the great toe, causes faulty foot mechanics. If you have a callous under the middle toe, bunions, or callouses on the outside of the great toe or little toe, you may need corrective orthotics to allow your foot to track correctly from your heel to your great toe and prevent pronation (a fallen arch). A faulty gait can cause muscle imbalance from compensatory muscle actions.

If your upper arms are short in proportion to the length of your spine, you may be leaning to the side to rest on your chair arms or leaning forward onto your desk or table to rest your back muscles. Correcting misfitting furniture can relax your low back and reduce sciatica symptoms.

A scoliosis also causes muscle imbalance and compensation. Supportive furniture, core and back strengthening exercises and postural corrective instruction can help (try Alexander Technique).

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When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is a guide, a checklist for suggested corrective actions and treatments. (Synthesized from my 19 years as a Neuromuscular Therapist in the Boston area and from the medical text by  Drs.Travell and Simons, Myofacial Pain and Dysfunction: The Trigger Point Manual, Vols I and II.)

12) Self-treat your muscles with pressure and massage, ice or heat (ice for pain and muscle spasm 1-5 minutes, moist heat for achiness and stiffness 1-5 minutes. (See my post on Ice or Heat)
13) Treat medical conditions and disease as your doctor prescribes.
14) Try Physical Therapy procedures including “boot camp” for the back. If these make your symptoms consistently worse, you probably have hyperactive Trigger Points that need to be released before too much exercise is imposed. (Too much exercise overloads muscles that are working 24/7 due to Trigger Point activity.) Modalities like ultrasound can help as can myofascial and positional release techniques and craniosacral therapy.
15) Reduce stress! It’s a huge factor in back pain. Pay attention to the mind-body connection. Breathe, do visualizing, talk to your back side :-) . John Sarno, MD has two short books about this subject called Healing Back Pain and Mind Over Back Pain.

16) Massage Therapy and Deep Tissue Work are great for increasing circulation, reducing stress and eliminating pain-causing waste products.
17) Have surgery only when absolutely nothing else will work. There are plenty of failed back surgeries as well as those that are successful. You can have a herniated disc and not have pain. Bulging discs rarely cause pain.

The posts that follow in this series will expand on this checklist.

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When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is a guide, a checklist for suggested corrective actions and treatments. (Synthesized from my 19 years as a Neuromuscular Therapist in the Boston area and from the medical text by  Drs.Travell and Simons, Myofacial Pain and Dysfunction: The Trigger Point Manual, Vols I and II.)

6) Keep moving to keep the muscles limber and the blood and lymph flowing. Prolonged tension or inactivity can produce pain. Tai Chi is a gentle movement therapy to explore. I love the phrase “Rest is Rust.”
7) Keep hydrated. Water is essential to healthy muscles and joints. Every process in your body requires water.
8) Check for systemic conditions, vitamin and mineral inadequacies, food sensitivities, allergies, anemia, infections and parasites, yeast infections, toxic blood conditions, thyroid hypoactivity, circulatory disorders, acidic pH level. Limit intake of carbohydrates and other muscle stimulants like caffeine.
9) Have Trigger Point injections when appropriate (see a physiatrist usually, also medical pain specialists, neurologists and anethesiologists) Dry needling is a good option that doesn’t use an anesthetic.
10) Nerve blocks, radiofrequency treatments, facet blocks etc. can be performed in out-patient pain clinics.
11) Make physical changes in posture, repetitive tasks involving affected muscles, sleeping position, irritating activities. Alexander Technique and Feldenkreis are two reliable corrective therapies.

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When sciatica type symptoms get the better of you and nothing you do seems to make it better, here is a guide, a checklist for suggested corrective actions and treatments. (Synthesized from my 19 years as a Neuromuscular Therapist in the Boston area and from the medical text by  Drs.Travell and Simons, Myofacial Pain and Dysfunction: The Trigger Point Manual, Vols I and II.)


1) Correct structural asymmetries
with a heel lift, butt lift, foot orthotics, and changes in misfitting furniture. This is more important than you would think.
2) Treat Trigger Points in affected muscles with neuromuscular techniques.
3) Use osteopathic or chiropractic correction of skeletal and joint misalignment up to 6 consecutive treatments. A chiropractor I respect told me if it takes more than that to correct a problem, you should probably be doing something else for treatment.
4) Restore balance to muscles and joints with massage therapy and deep tissue treatments, appropriate daily stretching and a careful corrective exercise. Swimming is one of the best general exercises for back and hip problems. It takes away the effects of gravity.  Do everything you can do without pain to stimulate your body’s wellness response.

5) Stretching is a big key. Use the Active Isolated Method: Actively stretch, assist at the end range for 2 seconds max and repeat 10x. Find out which muscles are tight and use specific stretches for them. (See my post on AIS protocol.)

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