Anyone have sciatica?

Patrick B · 09-23-2009, 01:58 PM

I had it for a while. Got one shot to reduce the swelling and worked on hamstring and back flexibilty - problem solved. I really believe stretching and strengthening the legs/back/core are great for dealing with this problem.

Blueface · 09-23-2009, 02:00 PM

Quote:

Originally Posted by Patrick B

I really believe stretching and strengthening the legs/back/core are great for dealing with this problem.

As you can see by my previous post, you are certainly not alone in this well held belief.
One of the most common cures for back ailments is leg and back strengthening. However, 300 lbs. plus is a big, big hurdle preventing that back strengthening from taking place.

Riff Raff · 09-23-2009, 02:36 PM

Quote:

Originally Posted by Blueface

As you can see by my previous post, you are certainly not alone in this well held belief.
One of the most common cures for back ailments is leg and back strengthening. However, 300 lbs. plus is a big, big hurdle preventing that back strengthening from taking place.

I couldn't agree more. As callous as that sounds, losing weight is your best CURE! The others only treat the symptoms. I know from experience. It is not the easy way out, but the best usually isn't.

Hopefully your MRI will shed more light for treatment options for the immediate pain. I feel for you brother! I have been there. Hang in there!

09-23-2009, 03:18 PM

Based on what you are telling me, it would likely be radiculopathy. Radicular impingements occur in regions where the neuron axons exist grouped into "nerve roots" as they leave the bulk of the spinal cord (spinal cord actual ends at the level of the lowest rib approx). These nerve roots exist as the the axon conduits until they further "bunch up" into proper nerves, outside of the vertebral column. Thus, inside the vertebral column=radiculopathy, outside the vertebral column (AKA passing through or between muscles) = peripheral neuropathy. In the case of the sciatic nerve = sciatica.

What is hard to understand unless specifically mentioned, is that not all of a nerve root will bunch into a proper nerve. Put another way, some axons in a nerve root will distribute into one nerve, while other axons, from the same root, may enter into another nerve.

How does one tell the difference? If its a radicular involvement, then the symptoms will "follow the dermatomes", striped nerve regions mapped to the surface of the body. If its a peripheral mononeuropathy, it will map to the respective nerve's distribution, which will seem like parts of multiple dermatomes, but not any one dermatome is completely represented by that nerve.

Thus, sciatica will demonstrate nerve symptoms to the posterior leg, pretty much completely across the posterior thigh, but not lower than the knee. Meanwhile, L5 will form a thin strip of symptoms all the way down the posterior lateral leg to ankle and foot.

So, what does this mean?

Well, if you have sciatica like symptoms, then the abnormality is in the region of the muscles/nerve, if its radicular in pattern, then its occuring inside the spine.

But this brings to us to an interesting point.....many studies exist that continue to re-inforce the fact that we really don't know where the abnormality is. Regardless of the pattern, we are just as likely to be right as to be wrong.

That colours the value of any therapies that might be considered:

Back surgeries show an average benefit of 2 months past recovery from surgery. Steroid injections also demonstrate a mean benefit timeframe of 2-6 months. By the way, 3 injections is a guideline and any specialist should be able to quote some study that shows this number to be fully arbitrary. And, the larger and more controlled the study, the less benefit chiropractic demonstrates (to the point of nothing greater than control group). Keep in mind, some people get permanent benefit from whatever treatment they get. They are few and far between, but they DO exist, and they are also the success stories we all want to talk about.

So, what seems to work. Well, if you are willing to do it, WEIGHT control is where the money is. Then strengthening is where to go next. You want a back so strong that it never fatigues, and supple enough that the muscles never get stretched beyond capacity. This requires focused strengthening and range of motion exercises FOR EVER. The medications' primary role is to create a window of opportunity to allow you to buy into the physiotherapy and weight control modalities.

Further, with weight control....expect the plan to be 2 years long once you find a method that works for you.

I was 255 lbs 1 year ago. 60 minutes of heart-rate>180 every day followed by 30 min strengthing/core exercises (well, 6 days a week) and I am down to 218. The rest of this year and I will be at my goal. Had lots of chronic pain before hand. Now, I am nearly pain free and loving it!

And, of course, if need be, we do have other potent drugs to nullify all your pain forever, but at the cost of your soul. Just kidding, but many people hate the side effects, fear the drugs, and I personally consider them a "last resort".

Well, that's about as much as I can type now....Time to go home. Will expound on this if you want, when I get home.

Cheers

John

09-23-2009, 01:58 PM	#1
Patrick B Feeling at Home Join Date: Sep 2009 Location: Cincinnati OH Posts: 713 Trading: (6)	Re: Anyone have sciatica? I had it for a while. Got one shot to reduce the swelling and worked on hamstring and back flexibilty - problem solved. I really believe stretching and strengthening the legs/back/core are great for dealing with this problem.

09-23-2009, 03:18 PM	#4
Cyanide Guest Posts: n/a	Re: Anyone have sciatica? Based on what you are telling me, it would likely be radiculopathy. Radicular impingements occur in regions where the neuron axons exist grouped into "nerve roots" as they leave the bulk of the spinal cord (spinal cord actual ends at the level of the lowest rib approx). These nerve roots exist as the the axon conduits until they further "bunch up" into proper nerves, outside of the vertebral column. Thus, inside the vertebral column=radiculopathy, outside the vertebral column (AKA passing through or between muscles) = peripheral neuropathy. In the case of the sciatic nerve = sciatica. What is hard to understand unless specifically mentioned, is that not all of a nerve root will bunch into a proper nerve. Put another way, some axons in a nerve root will distribute into one nerve, while other axons, from the same root, may enter into another nerve. How does one tell the difference? If its a radicular involvement, then the symptoms will "follow the dermatomes", striped nerve regions mapped to the surface of the body. If its a peripheral mononeuropathy, it will map to the respective nerve's distribution, which will seem like parts of multiple dermatomes, but not any one dermatome is completely represented by that nerve. Thus, sciatica will demonstrate nerve symptoms to the posterior leg, pretty much completely across the posterior thigh, but not lower than the knee. Meanwhile, L5 will form a thin strip of symptoms all the way down the posterior lateral leg to ankle and foot. So, what does this mean? Well, if you have sciatica like symptoms, then the abnormality is in the region of the muscles/nerve, if its radicular in pattern, then its occuring inside the spine. But this brings to us to an interesting point.....many studies exist that continue to re-inforce the fact that we really don't know where the abnormality is. Regardless of the pattern, we are just as likely to be right as to be wrong. That colours the value of any therapies that might be considered: Back surgeries show an average benefit of 2 months past recovery from surgery. Steroid injections also demonstrate a mean benefit timeframe of 2-6 months. By the way, 3 injections is a guideline and any specialist should be able to quote some study that shows this number to be fully arbitrary. And, the larger and more controlled the study, the less benefit chiropractic demonstrates (to the point of nothing greater than control group). Keep in mind, some people get permanent benefit from whatever treatment they get. They are few and far between, but they DO exist, and they are also the success stories we all want to talk about. So, what seems to work. Well, if you are willing to do it, WEIGHT control is where the money is. Then strengthening is where to go next. You want a back so strong that it never fatigues, and supple enough that the muscles never get stretched beyond capacity. This requires focused strengthening and range of motion exercises FOR EVER. The medications' primary role is to create a window of opportunity to allow you to buy into the physiotherapy and weight control modalities. Further, with weight control....expect the plan to be 2 years long once you find a method that works for you. I was 255 lbs 1 year ago. 60 minutes of heart-rate>180 every day followed by 30 min strengthing/core exercises (well, 6 days a week) and I am down to 218. The rest of this year and I will be at my goal. Had lots of chronic pain before hand. Now, I am nearly pain free and loving it! And, of course, if need be, we do have other potent drugs to nullify all your pain forever, but at the cost of your soul. Just kidding, but many people hate the side effects, fear the drugs, and I personally consider them a "last resort". Well, that's about as much as I can type now....Time to go home. Will expound on this if you want, when I get home. Cheers John