Sciatica | Sciatic nerve pain | Piriformis syndrome | Sacroiliac Dysfunction | Illiopsoas Dysfunction | Lower cross syndrome | Spinal Nerve Entrapment

Living a happier life:

Understanding how to Overcome Sciatic Nerve and Lower Back Pain

 

 

Overview:

“Sciatica” is a term often used inaccurately to globally refer to pain felt in the lower back, hip, legs and sometimes feet. Not all lower back pain is created  equal, and the cause of pain can differ significantly. Because of this, treatments differ depending on the underlying cause of the problem not just the symptoms.

The good news:

In most circumstances symptoms understood as “Sciatica Pain” are completely treatable without surgery or other invasive options. If you are reading this article, you are probably experiencing pain, discomfort , weakness, and or numbness in your lower back, buttock region or legs, in some cases you may be suffering from headaches and in more severe cases be plagued by migraines and/or vertigo.

What you need to know:

The term “Sciatica”, through popular culture and misunderstanding, has become more of a layman’s term than an accurate description of a bodily dysfunction. Due to similarities in symptomatic pain patterns of the lower back, spine, hips and legs, most people lump together several conditions under the umbrella term of “Sciatica”. This inaccuracy leads most people away from the solutions within reach that could alleviate, and in many cases eliminate, their pain. Precipitating unnecessary discomfort and pain lack of understanding and misinformation create great confusion among most people and sadly lead to radical and often times unnecessary treatments such as surgery, or a life-time plagued by pain leading to a loss of lifestyle forfeiting happiness.

Luckily, not all “sciatica” pain and discomfort is created equal. Most diagnoses are completely unreliable either because of flawed self-diagnosis and/or in many cases due to a flawed interpretation of symptoms by a practitioner who failed to administer the proper tests to identify the actual cause of the dysfunction before rendering their diagnosis.

More often than not “Sciatica” can be non-permanent provided the cause of the discomfort is assessed correctly and treated accurately. There are several conditions that create very similar pain patterns, indistinguishable without the proper knowledge and testing, which once identified are treated completely differently.

WELCOME



NYC Healing and Massage
A holistic wellness practice specializing in chronic pain relief, trauma recovery and personal empowerment through massage, bodywork and custom tailored education.


Two Locations



Tribeca / Wall Street / South Sea Port
80 Nassau Street Suite #202, NY, NY, 10038


Midtown / Grand Central
274 Madison Avenue Suite #1205, NY, NY, 10016


Causes of Sciatic Nerve Dysfunction, Lower Back Pain and “Sciatica” 

 

• Stress

• Poor or collapsed posture

• Prolonged sitting, especially in environments that perpetuate hyper-lordosis of the lumbar spine (poorly made chairs and bad sitting posture)

• Hernia, or degeneration of vertebral discs leading to nerve entrapment

• Muscle imbalance causing the lower spine to collapse anteriorly or posteriorly

• Forward head posture often associated with prolonged computer usage or careers where leaning forward is constant (for example: Surgeons, Hair Stylists, Dentists, Desk Work, etc.). An imbalance in the Cervical Spine will eventually cause problems in the rest of the spine.

• Impact injuries often caused by sports, falls or vehicle accidents

• Improper lifting, especially when twisting from the hip (This activity can cause severe injury. Always lift correctly!)

• An overactive and shortened iliopsoas (aka. Hip Flexor). This is very common in runners, but also highly common in the 9-5 desk culture due to bad sitting posture. When this is the cause of Sciatic Pain the iliopsoas must be treated for relief to occur. (read more: treating the iliopsoas )

• Obesity

• Spinal Stenosis 

• Scoliosis

• Diabetes (source: MayoClinic )

Causes of Sciatic Nerve Dysfunction, Lower Back Pain and “Sciatica” 

 • Stress

• Poor or collapsed posture

• Prolonged sitting, especially in environments that perpetuate hyper-lordosis of the lumbar spine (poorly made chairs and bad sitting posture)

• Hernia, or degeneration of vertebral discs leading to nerve entrapment

• Muscle imbalance causing the lower spine to collapse anteriorly or posteriorly

• Forward head posture often associated with prolonged computer usage or careers where leaning forward is constant (for example: Surgeons, Hair Stylists, Dentists, Desk Work, etc.). An imbalance in the Cervical Spine will eventually cause problems in the rest of the spine.

• Impact injuries often caused by sports, falls or vehicle accidents

• Improper lifting, especially when twisting from the hip (This activity can cause severe injury. Always lift correctly!)

• An overactive and shortened iliopsoas (aka. Hip Flexor). This is very common in runners, but also highly common in the 9-5 desk culture due to bad sitting posture. When this is the cause of Sciatic Pain the iliopsoas must be treated for relief to occur. (read more: treating the iliopsoas )

• Obesity

• Spinal Stenosis 

• Scoliosis

• Diabetes (source: MayoClinic )

Common symptoms often referred to as “Sciatica”

 

Localized Symptoms and Pain:

· Dull aching or stabbing pain in the lower back, deep hip and/or buttock

· Numbness, burning or a sensation of cold in the lower back, deep hip, buttock, leg and/or groin

· Loss of strength and mobility in the lower back, hip, leg, knee, ankle and foot

· Crunching, grinding or popping in the hip

· Loss of balance and dysfunctional gate issues

 

Satelite / referral (distal) Pain:

· Dull aching or stabbing pain in the lower back, hamstring and in many cases the lower leg and foot

· Middle and Upper Back pain including shoulder discomfort

· Migraines and Headaches

· GI track problems, loss of bowel control, pelvic floor dysfunction

 

*Not all symptoms need be present to indicate dysfunction.

 

Anatomy of the Sciatic Nerve and Lumbar Plexus

Overview of Sciatic Nerve Pain:

As shown in the images above, the Sciatic Nerve originates in the spine at the lower Lumbar Vertebrae (aka: the curve found in the small of your back) specifically L4, L5 and the Sacral Foramens (aka: the tail bone) located at S1, S2, & S3.

 

What does this mean and how does it apply to me?

Understanding the difference between the potential causes of your pain can be the determining factor of whether or not you will find the appropriate help you need to feel better, recover, and live with improved quality of life and in many cases live relatively pain-free.

Perhaps equally important is knowing what your condition is not so that you can eliminate treatments that are either unnecessary (like surgery in many cases) or ineffective because they are the wrong course of actions for your specific needs.

If you wouldn’t treat an open wound like you would a bee sting…

…why would you believe all pain is treated identically when it comes to muscle and spinal conditions?

 

Example:

BAD: If you have iliopsoas dysfunction (see below) and you treat it as if you have piriformis syndrome by wrongly strengthening the abdominal muscles (specifically those strengthened in sit-ups, which are not the correct core muscles to be strengthening for iliopsoas dysfunction because these actually enhance postural imbalance) you will actually further tighten the muscle you need to be loosening causing greater compression of the lower vertebrae and thus worsening your condition by impacting the nerves at the spine further causing damage and pain over time.

GOOD: By contrast, had you worked with someone who knows how to release the iliopsoas through massage, trigger point therapy, PNF stretching, myofascial release and/or other modalities you would begin to heal. Alongside direct soft-tissue release (achieved through massage therapy), utilizing the correct stretches at home in order to lengthen the dysfunctional muscles along with following a strength training program that targets the correct muscles groups of the core, back and hips the likelihood that you would begin to feel better quickly and the condition would lessen even more and heal over time is highly probable.

The Hidden Truth

Similar Symptoms: Totally Different Conditions

 

“Sciatica” is often used in laymen’s terms to inaccurately describe a dysfunction by a set of symptoms belonging to multiple other conditions, which exhibit similar discomfort to one another. Therefore, these conditions created similar pain and discomfort, however, they are not the same.

 

Let’s take a deeper look:

Meditation Classes Guided Meditation Reiki

Spinal Nerve Entrapment

Impacted Spinal Nerves due to joint dysfunction. 

TFL and IT Band Dysfunction

TFL and IT Band Dysfunction

Common in runners, causing knee instability, pain & weakness in hip. 

Massage Back Pain Relief

Piriformis Syndrome

Compression of the Sciatic Nerve in the deep hip by the external rotator.

Private Yoga Instruction Yogic Massage

Illiopsoas Dysfunction

Chronic tightness in the “hip flexor” causing Lumbar Vertebrae compression.

Meditation Classes Guided Meditation Reiki

Sacroilliac Dysfunction

Misalignment of hips at the Sacro-Iliac Joint. 

Private Yoga Instruction Yogic Massage

Lower Cross Syndrome

Pattern of weakness and over-tight muscle groups due to postural imbalance.

*While the dysfunctions above do not illustrate all possible conditions of the lower back, these were chosen because of their common nature and generally treatable potential.

Spinal Nerve Entrapment

  Most often caused by the Sciatic Nerve being impacted between vertebrae often due to degeneration, rupture, or hernia of the intervertebral disc(s) and can be caused by genetic malformation, trauma, or postural dysfunction, among other attributing factors, therefore resulting in the vertebrae compressing the nerves between the bones. This results in chronic conditions that are often debilitating painful and difficult to remedy.

Sciatica is a nerve condition where the sciatic nerve is either impinged or damaged due to trauma, chronic improper use, or genetic malformation causing pain, weakness and neuropathy down the leg and into the foot. In many cases Sciatica can become debilitatingly painful and can even lead to different levels of paralysis. Without surgical intervention sciatica is generally permanent and can not be repaired, though the pain can often times be reduced through holistic means and even abated. While true sciatica is generally accepted as a chronic disease, there are methods of non-surgical chronic pain treatments that can ease the chronic pain if the condition has not advanced too far.

Massage therapy and other wellness practices such as pilates, yoga, diet, and exercise have been noted to assist with lessening the chronic pain of some people that suffer from sciatica. If you are suffering from genuine sciatica you may experience increased and often debilitating levels of pain when attempting to use the effected limb.

Ouch! Some days are worse than others. What gives?

Pain and inflammation in the body are affected by many things ranging from diet, lack of sleep, stress, humidity, worry and grief, not to mention repetitive use and poor body maintainance.

Sciatic Pain Syndrome, Piriformis Syndrome, Sciatica… What’s the difference?

Question: Why work with a sciatic pain relief specialist?


Answer: Different names for very similar symptoms – the main difference being Nerve Entrapment vs. Nerve 
Impingement

  The two most dramatic differentiating factors between these two conditions are:
    1) impingement of sciatic nerve at it’s roots from the spine (ref: sacral plexus) , as in the cases of “herniated discs” or “spinal stenosis” (sciatica), vs.
    2) muscular conditions causing nerve compression, or nerve compression due to poor posture (sciatic pain syndrome).

Sciatic Pain Syndrome aka. Piriformis Syndrome is highly treatable with non-surgical intervention in most cases.

Sciatic Pain Syndrome is generally caused by muscular conditions which compress the sciatic nerve thus mimicking the symptoms of sciatic nerve entrapment (true Sciatica). Sciatic Pain Syndrome is most often caused by inflammation and aggravation of the sciatic nerve due to spastic muscles conditions (very often the Piriformis Muscle), poor posture, injury due to impact and or chronic use injuries and hip displacement. 

Sciatic Pain Syndrome is almost always treatable and commonly completely curable without surgery. Massage Therapy, specifically through a combination of trigger point therapy, myofascial release, and PNF stretching, properly applied by a specialist, or a team of specialists, can provide profound healing results. Relief is possible and within reach for you.

Spinal Nerve Impingement in the deep hip and buttock region aka: Piriformis Syndrome

A completely different condition that can exist both acutely and chronically, and is often misdiagnosed as the above (See: Spinal Nerve Entrapment below). Commonly, impingement of the sciatic nerve is completely curable as it is caused by soft tissue dysfunction, either through being compressed by the Piriformis Muscle as is the case in the condition known as Piriformis Syndrome, or other similar conditions like Iliopsoas Dysfunction, which causes the lower spine (the Lumbar Vertebrae) to over extend causing a condition known as hyperlordosis. The latter would be an example of impingement of the Sciatic Nerve through a mechanical imbalance that mimics the nerve entrapment described above but that can be alleviated through a rebalancing of the connective tissue and lengthening of the Iliopsoas muscle while strengthening the decompensated and thus weakened muscles meant to support healthy spinal posture and function. The former, Piriformis Syndrome, is often treated easily through myofascial release, trigger point therapy, P.N.F. stretching and some strength and stretch training you can do at home.

 

Pain is relative to each person’s tolerance but should not be ignored.

All of the conditions above range from uncomfortable to incredibly painful regardless of which underlying condition you actually have. Often times the primary condition can cause secondary conditions to follow. Like a line of dominos, once the first falls, the rest are soon to follow. Unlike dominos, heal the primary injury and the rest of the body can return to balance. There are tests that can be done that have a high level or accuracy in determining which condition you are actually suffering from so that you can be properly treated.

While new research in pain has found that some pain that is felt is completely arbitrary due to malfunctions in our nervous system, this is not the case with most discomfort we feel. More of than not, pain is our body’s way of telling us we need to address something before it’s too late. Using chemicals, such as pain killers, to numb chronic pain without taking the necessary actions to fix the underlying problem does not heal the cause of the pain, but instead masks your discomfort giving you a false sense of wellbeing by deadening your body’s alarm system. Thousands of years of evolution has resulted in an incredibly thorough and accurate self-maintenance and repair system to protect us from further injuring ourselves as long as we head-the-call.

Pain is good, as long as we listen to what it is telling us, so that we don’t cause greater injury and eventually breakdown. Just like the “check engine” light in a car, ignoring pain and medicating instead of addressing and fixing the issue can lead to greater discomfort easily avoidable, and in some cases, complete system failure. Learn to heal yourself to today so that you don’t need to take more drastic measures later.

 

Treatments

More often than not, the person who wishes to overcome any of these conditions permanently needs a mixture of direct manual manipulation of the soft tissue through massage, trigger point therapy, PNF stretching and myofascial release in addition to implementing self-healing techniques on a regular basis. We can teach you the techniques and give you the knowledge so that you can start feeling better immediately. Knowledge is power and learning the proper techniques that you can do at home or in the office is generally quite easy providing you learn the right skills. Once the underlying condition is being treated, the symptoms naturally dissipate leading to the dysfunction being healed and the pain disappearing.  

 

WELCOME



NYC Healing and Massage
A holistic wellness practice specializing in chronic pain relief, trauma recovery and personal empowerment through massage, bodywork and custom tailored education.


Two Locations



Tribeca / Wall Street / South Sea Port
80 Nassau Street Suite #202, NY, NY, 10038


Midtown / Grand Central
274 Madison Avenue Suite #1205, NY, NY, 10016


Ready to Feel Better?

The difference is in how you’ll feel.