Sciatica: What is the Source?

sciatica_legpainSciatica: What is the Source?

One of the most common things that I see in my office is Sciatica.  In fact, many patients come to their first visit and tell me straight away that they have sciatica.  Self diagnosis is common today as you can find anything you want on the internet.  However, what most people don’t understand is that sciatic symptoms can have multiple different causes.  This means that sciatica treatment can vary depending on the primary cause.  The real trick is to uncover the true source.  Is is stemming from poor soft tissue health in the low back?  Scar tissue build-up in the hips and glutes? Poor pelvis function?  Poor lumbar spine function?  A herniated disc in the lower back?  Poor postural position of the low back and pelvis?  Or more commonly, is it a combination of many of these?  Many times therapists take a cookie-cutter approach to sciatica.  Adjusting the lumbar spine and pelvis, stretches for the piriformis, and maybe some electrical stimulation to the area.  This can sometimes help overcome the pain and symptoms, but most of the times function is never addressed.  This is the real source of the problem.  Some dysfunction in postural positions or movement has taken place that led to the problem.  Unless this is addressed the problem is likely to return.

The other issue I see is that people many times have an MRI that is done because of nerve symptoms that are present.  While this is not a bad idea you always have to remember that the pain is not always caused by what is found in the MRI.  For example, if you take an MRI of someone’s low back, many times you are likely to find that is does not look perfect.  You may find some mild narrowing of spaces or even some mild disc bulging.  This does not mean that you can automatically assign these findings to the source of all the patient’s pain.  This is why many times surgery to the lumbar spine fails to resolve the patients complaints.  The surgeon did a great job at making the MRI look ‘normal’, but it may not have been the actual thing that was causing the symptoms in the first place.  In fact, in the vast majority of cases conservative care will be enough to take care of the symptoms and restore function without pain.  However, there needs to be a comprehensive approach to this care.  You must address the soft tissue health, the proper joint function, the nerve health, postural positions, strength capacity, AND movement patterns.  You cannot just pick one and roll the dice.  If you fail to correct postural and movement patterns then treatment will likely fail or the problem will shortly reoccur.  We see this many times in our office as patients come to us after numerous other practitioners have failed to resolve the problem.  This is not because they are bad at the services they provide, it is simply because they did not address all of the problems at the same time.

Understand the basic premise behind sciatica treatment is taking pressure off of the sciatic nerve, wherever the compression may be happening.  Whether this is caused by scar tissue, poor joint movement, or poor functional patterns, it doesn’t really matter.  All we have to do is uncover all the dysfunctions, restore normal function, and then let the body heal on its own.  If you are suffering from sciatica, just make sure that your sciatica treatment program is comprehensive and addressing all these areas to ensure you the best chance for success.

Top 5 Tips to Better Sleep

posted in: blog post, General Health | 0

sleep

Top 5 Tips to Better Sleep

Sleep is really an under-appreciated art.  Many people brag about how little sleep they can get away with and still function at high levels.  Sleeping 5 hours and night is seen as a milestone and many people are jealous of those that can pull it off.  This ‘achievement’ is only seen as a benefit because our work lives get more and more demanding every year.  However, all the most recent research is starting to show the real importance of sleep and how much it plays a role in overall health and longevity.  For instance, we now know that sleep is the only time that our brains gets to detoxify.  Without proper deep sleep this process cannot occur efficiently and toxins can build up in the brain.  And we do not want any toxins lingering in our brains for long.

Sleep is also the time when our hormones work to regenerate our bodies, recover from the day’s stressors, and repair any damage.  Limiting the hours of ‘shut-eye’ reduces the time that your body can grow, heal, and restore.  So, while it may seem counter-intuitive, the more you sleep, the more productive you may become.  While sleeping excessive hours can reduce brain performance, sleeping too little can also do the same.   However, I think that we can safely say that most people are not struggling from a problem of getting too much sleep.  Those instances are few and typically because of a chronic disease process that is occurring.  For the rest of us, sleeping more should only prove to improve health.  And it is not just hours spent in bed, but the quality and quantity of time that you are actually sleeping.  So, here are a few tips to help you achieve that goal.

  1. Get Rid of the Blues

Blue light is part of the spectrum of light, but is specifically important because it can directly affect the body’s circadian rhythms, or biological clock.  This is important because if too much blue light it detected by the eye at night then the body thinks that it is the day and time to fire on all cylinders.  This obviously is a bad idea for someone trying to sleep.  Problem is that most people are exposed to blue light just before bed as it is present in our phones, laptops, computers, TVs, etc.  So, get rid of the electronics at least 1 hour prior to bed to avoid this ‘blue-light confusion’.  Or, if you just can’t you’ll need to wear blue-light blocking glasses to avoid telling your body it is daytime.

  1. Stay in Rhythm

Your body’s circadian rhythms are very important to regulating many functions within your body.  Many hormones fluctuate based on these rhythms so allowing your body to maintain a ‘normal’ is important not only for getting the right amount of sleep, but also so that you don’t set up an environment for dysfunction hormones.  We are naturally geared to use light and dark as our body’s signals.  However, given our current lifestyles we can stay in bright environments whenever we want.  For best health try and keep the same sleep/wake cycle every night.  This means having a set bedtime and a set wake time.  While this may vary slightly, trying to stay on a normal rhythm will help you get better sleep.

  1. Be Cool

Research shows that sleeping in a cool environment is more conducive to quality sleep.  Our body is wired to cool internally close to bedtime so that it is easier for us to sleep and achieve deep sleep.  Too much heat and it disturbs our ‘shut-off’ process.  This doesn’t mean that you have to feel cold, but the room should be a cool.  A temperature of 65 degrees in the room is shown to have best results, but having it as low at 60 degrees can also be beneficial is you sleep with excessive amounts of sheets.

  1. Come to the Dark Side

This means the darker the better.  Even ambient amounts of light can be enough to rouse our brains and prevent full, deep REM sleep.  While this sounds obvious most people’s bedrooms are littered with light from their clocks, TVs, DVD players, fans, phones, etc.  These lights can be sensed by our bodies and can disrupt sleep.  So try to eliminate all artificial light in the bedroom and get blackout curtains if you live an area that has lots of neighborhood light.  This ensures that your brain and body know it is bedtime and can get the appropriate rest.

  1. Keep Caffeine as a Morning Treat

Caffeine consumption does have an affect on sleep.  Whether or not you can fall asleep it can disrupt your ability to get quality, deep sleep.  Remember it’s not all about how many hours your eyes are shut, but the quality of sleep that you get.  Caffeine stays in your body longer than you’d think.  Avoiding caffeine after lunch can help your sleep quality improve and maybe just get rid of some of your fatigue that is causing you to drink so much caffeine in the first place!

 

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Recovery: The Missing Link

recovery_nutrition_for_runnersRecovery:  The Missing Link

When someone is training, whether it be for an event or just to get in better shape, many hours are spent not only planning each days’ activities, but also in working towards a goal.  Most athletes spend most of their time making sure that they get enough training hours into each week.  A smaller number of athletes spend adequate time ensuring that their nutrition supports their training efforts (which is as equally important as the training itself).  However, very few athletes give enough attention and respect to one of the most important parts of training: Recovery.  Recovery is the glue that holds everything together.  Without this glue, areas in the body will gradually become dysfunctional and begin to fall apart.  Physical training, in any form, pushes the body to its limits.  This causes the body to breakdown as limits are surpassed and the athlete tries to make improvements; as muscles and other soft tissues are stressed, as in training, they essentially breakdown and cause micro-tears in the muscle fibers. After training, the body responds by building that tissue up stronger than before to support such efforts the next time.  This is how muscles become larger and performance is increased.  Now, what happens if you put your body through the same physical stress before it has had time to recover?  Essentially, you will be breaking down tissue that began the day at 90% instead of 100%.  This means that by the time you are done training you will have once again broken down the muscle tissue, but this time to a greater extent since you were not 100% at the start of training.  Now, the body is a remarkable machine that can adapt to many situations and learn to cope with many stresses.  By no means does this mean that you have to be 100% rested and fresh before each day of training.  However, if this scenario is repeated numerous times you can see how eventually the tissue will not be able to withstand the same levels of training.  Soon the tissue will be starting the days’ training at 20% and little work can be done before the tissue fails and injury occurs.  Recovery is a complex puzzle that requires more than just a little time off.  Understanding the importance of recovery and how to implement it correctly into your training plan will not only boost performance, but it will keep you active and injury free.  In my many years of clinical practice I have seen numerous athletes competing in a wide variety of recreational and professional sports.   Those who pay attention to the various parts of recovery almost always do better in competition.  There is a simple reason for this: improved recovery = an increased ability to train harder = better results!  In my opinion, the success rates of training programs hinge on the things done when you are not actually training!