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If you are suffering from what you think is a flare up in your Sciatica this may not be the case.
Many people come into the office with their “self-diagnosis” already in hand. They have pain in the low back, often longstanding, and now some pain radiating into the gluteal region and back of the leg. We’ve all heard so much about disc herniations and sciatica that immediately we fear the worst. But in many cases these symptoms are NOT representing a TRUE sciatica (caused by disc herniation, stenosis of the spinal canal, spondylolisthesis etc) and, although the pain can be very severe, the patients prognosis is for an easier and faster recovery.
It’s important to understand that when a muscle stays contracted for long periods of time it isn’t receiving a proper irrigation of blood. All the fibers are hyper tense and many of the small arterioles are not able to supply the muscles cells. So we end up with muscle cells that are not receiving as much nutrients and oxygen and, more importantly, are building up waste product (like lactic acid) which, in excess quantity, is toxic for the cell.
As most of you know, lactic acid buildup is the cause of the burning fatigue we feel after heavy exertion (marathons, weight training etc) and in focal concentrations will cause the famous “trigger points” that good massage therapists seem to find immediately when you lay down on the table. This pain CAN and DOES radiate into the buttock and lateral thigh and many times is misinterpreted as True Sciatica.
Usually these trigger points and chronic muscle contraction are found either in the Quadratus Lumborum (low back) muscle or in the Gluteals (butt muscles, and the strongest extensor of our legs.) Since these are POSTURAL muscles they are usually working all day long and most of us never take the time to conscientiously stretch/relax them. To get an idea why these muscles seem to end up causing mankind such misery examine the following scenario:
 Imagine making a tight fist, squeezing as hard as you can, and maintaining that contraction for 5 minutes!!? The forearm muscles eventually begin to “burn.” Now imagine holding that for 5 hours! 5 days! At 5 weeks I think you’d agree that those muscle cells are NOT healthy, have begun to actually change their morphology (becoming more fibrotic like a cheap cut of meat) and are PRIME candidates for an uncontrollable muscle spasm the next time you ask it to perform a job. Of course, the forearm muscles are mostly made up of “fast twitch” fibers which differ from the postural muscles in terms of endurance. However this is a decent analogy to help explain why someone who was just “picking up a pencil from the floor in the morning” felt a painful twinge in their back and ended up in bed for a week in terrible pain (often radiating down into the upper leg.)
Now take into consideration the fact that these chronically, hyper tense muscles are not permitting the vertebra of the spine to move as they should. This is called altered biomechanics. Each individual pair of vertebra is not able to rotate, laterally flex, flex and extend as it should. This situation is known as a SUBLUXATION and is the functional lesion that chiropractors and osteopaths treat with our specific spinal adjusting. Subluxations cause further irritation to the delicate spinal nerves where they exit the spine which in turn usually leads to MORE muscle spasm and altered biomechanics, setting us up in a terrible vicious circle.
Anybody who is experiencing this sort of pain with radiation into the leg NEEDS to be evaluated by a professional. Unless you like the idea of just covering up the pain with meds until it subsides, and then forgetting about it, you’ll probably need to find a good chiropractor, osteopath or physiotherapist. We can perform some pretty simple orthopedic and neurological tests in our offices to determine whether your pain is TRUE sciatic pain that would warrant further studies, or if its pseudo sciatica caused by a more benign muscular origin.
The next article will focus on some of the most effective stretching regimens that we prescribe to combat these chronic postural muscle contractions.
Author: Dr. Joseph Will, 1997 Graduate of New York Chiropractic University and has been working 6 years in a multi-doctor clinic in Cancun (phone #8870028). He is also available to patients of Playa del Carmen in the easily accessible clinic of alternative medicine in the community of Nicte-Ha located just north of the “Colosio” with a direct entrance from the highway. The number to make an appointment there is: 984-859-2625 or email:
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The new and remodeled SANAR clinic in Playa is right behind Walmart...the local number is 984 8032039.
Toggle atlas!
dr josefo