What is sciatica?

Sciatica is pain which is referred to the back and outside of a leg due to a compression of the Sciatic nerve. The nerve is located in the lower back known as the lumbar and sacral region of the spine. It is made of L4, L5, S1, S2 and S3 nerve roots. The term sciatica can also be used interchangeably with other terms such as lumbosacral radicular syndrome, ischia, nerve root pain and nerve root entrapment.

What are the symptoms of sciatica?

Main symptoms of sciatica is pain which can feel sharp or achy radiating down a leg. Symptoms usually affect one leg, but in severe occasions can be present in both. However, it may also be accompanied with other symptoms such as:

• Tingling
• Pins and needles
• Lower back ache
• Loss of muscle strength (usually not very prominent)
• Loss of sensation in the area of pain (usually not very prominent)

What causes sciatica?

There are several conditions that can cause sciatica:

• Disc bulge – bulging disc can compress the nerve root causing sciatic symptoms. Most of the time disc bulge affects one side, however, if the bulge is central, it might compress the spinal cord and cause symptoms to radiate in both legs.
• Foraminal stenosis – is narrowing of the foramen due to arthritic changes. Foramen is the space on each side of the vertebra where nerve roots are coming out. Symptoms usually affect one leg.
• Piriformis syndrome – is the tightening or a spasm of piriformis muscle which is located under the glutei which are located at your buttocks. Piriformis spans the sciatic nerve, hence, when in spasm, can produce sciatic symptoms. It usually affects one side.
• Lumbar stenosis – is narrowing of the spinal canal where the spinal cord is located. Narrowing of the spinal canal will compress on the spinal cord and most likely result in symptoms in both legs.
• Spondylolisthesis – is a condition where one of the lumbar vertebra slips forward compromising the space of the spinal canal. This may result in sciatic symptoms being felt in both legs.
• Tumours/malignancies – sciatica can also be caused by an abnormal tissue growth in the spine area. It might affect one or both legs.

How can I treat sciatica pain?

First, treatment depends on the cause of your sciatic pain. For the majority of cases where only one side is affected conservative, a non-operative approach is recommended such as physiotherapy, osteopathy, massage, acupuncture and more. Most of the time it produces very good outcomes, however, in cases where symptoms radiate in both legs or when conservative treatment is unsuccessful, minimally invasive operation is needed.

In other words, according to the cause and the severity of your pain your therapist will tailor the best treatment for you.

What operation is available for sciatica?

There are two most common operations performed to treat sciatica:

• Diskectomy – is the procedure where a surgeon removes a portion of the intervertebral disk which is pressing onto the sciatic nerve causing symptoms. Operation is usually performed under a general anaesthetic. Recovery time after the surgery usually varies between 1 – 4n weeks.
• Laminectomy –is the procedure where a surgeon removes/shaves off the back of the vertebrae to increase space of the spinal canal and remove the nerve compression. Operation is usually performed under a general anaesthetic and recovery time varies from few days to several weeks.

How long does it take for sciatica to go away?

Symptoms usually affect one leg, but in severe occasions can be present in both.

Healing time very much depends on the cause of the sciatica. If you have symptoms radiating in one leg and they are not caused due to a serious condition, it is likely that your symptoms will improve significantly within 4 – 6 weeks. If your sciatica is caused due to a more serious condition, it might take several months for full recovery.

What to avoid if I have sciatica?

Try to avoid anything that exacerbates the symptoms. You might still be able to do some form of exercises, but the exercises must be prescribed by a qualified healthcare professional such as an osteopath, sports therapist or physiotherapist. The list of activities to avoid can include:

• Heavy lifting.
• Excessive bending of the lower back.
• Bed rest.
• Certain exercises.
• Being sat for long periods of time.
• Sudden twisting and turning.

Keep in mind…

Click here to stretch your sciatic nerve. It will help you to keep pain away!

We hope this information is useful. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always glad to help. If you like this blog, please share!

We are always happy to help!

 References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895638/pdf/bmj-334-7607-cr-01313.pdf 

https://my.clevelandclinic.org/health/diseases/12792-sciatica

https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435#:~:text=Sciatica%20pain%20can%20be%20almost,a%20jolt%20or%20electric%20shock

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Common Gluteal Injuries: Pain or numbness in your bottom when running?

Injuries involving the glutes are less common than those that affect the knees and lower leg. But when they do happen, they can be seriously debilitating and uncomfortable. What is more, injured, tired or fatigued glute muscles can cause associated pain in the lower back or legs, and lead to poor balance.

Anatomy of the Glutes 

Deep Gluteal Syndrome is a pain or numbness in your bottom, that can sometimes go down the back of your leg. This pain can be caused by muscles or blood vessels pressing in the nerve. Commonly known complaints such as “sciatica” and “painful piriformis” are part of the group of injuries known as, and more recently labelled as, Deep Gluteal Syndrome.

Symptoms:

The pain is usually just on one side (but in some instances can manifest bilaterally). Pain will intensify when you are sitting, or when you try to sit. You’ll likely feel a tender and aching sensation in the buttock. The numbness often radiates down the back of the leg.

Causes:

The condition is triggered by irritated muscles that put pressure on the sciatic nerve. Sitting for long periods of time or exercising for extended periods are both possible causes. And the combination of hours spent at a desk followed by long periods of running (especially on hard surfaces) can create a potent mix. A Physio or Osteo will often be able to help determine the precise movement or posture that is triggering the complaint.

Prevention:

If you start to feel a pain in the buttock area, ease off or stop running for a short period of time. In many cases the sensation will go away within two to three days, but if not, consult your doctor.

Treatment:

On the initial stages, you should:

• Ice the area.
• Hot/cold treatment works in some cases.
• Stretch glutes.
• Use ibuprofen gels for temporary relief.

Failure to address the problem in a timely manner can increase pain perception and effect mental wellbeing. Consult with Physiotherapist or Osteopath to help to get to get to the root of the problem. These gentle stretches, together with mild exercises and muscle relaxation, often aided by a physiotherapist when the treatment is too difficult or painful to self-administer, should help to get to the root of the problem.

Are you dealing with bottom pain? Contact us, we are always happy to help! And don´t forget to stretch, ask your physio (or us) about suitable stretches

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

The post Common gluteal injuries in runners appeared first on Perea Clinic.

What is sciatica?

Sciatica is pain which is referred to the back and outside of a leg due to a compression of the Sciatic nerve. The nerve is located in the lower back known as the lumbar and sacral region of the spine. It is made of L4, L5, S1, S2 and S3 nerve roots. Health practitioners may use the term sciatica interchangeably with other terms such as lumbosacral radicular syndrome, ischias, nerve root pain and nerve root entrapment.

What are the symptoms of sciatica?

Main symptoms of sciatica is pain which can feel sharp or achy radiating down a leg. Symptoms usually affect one leg, but in severe occasions can be present in both. However, other symptoms may accompany it such as:

• Tingling.
• Pins and needles.
• Lower back ache.
• Loss of muscle strength (usually not very prominent).
• Loss of sensation in the area of pain (usually not very prominent).

What causes sciatica?

There are several conditions that can cause sciatica:

• Disc bulge – bulging disc can compress the nerve root causing sciatic symptoms. Most of the time disc bulge affects one side, however, if the bulge is central, it might compress the spinal cord and cause symptoms to radiate in both legs.
• Foraminal stenosis – is narrowing of the foramen due to arthritic changes. Foramen is the space on each side of the vertebra where nerve roots are coming out. Symptoms usually affect one leg.
• Piriformis syndrome – is the tightening or a spasm of piriformis muscle which is located under the glutei which are located at your buttocks. Piriformis spans the sciatic nerve, hence, when in spasm, can produce sciatic symptoms. It usually affects one side.
• Lumbar stenosis – is narrowing of the spinal canal where the spinal cord is located. Narrowing of the spinal canal will compress on the spinal cord and most likely result in symptoms in both legs.
• Spondylolisthesis – is a condition where one of the lumbar vertebra slips forward compromising the space of the spinal canal. This may result in sciatic symptoms, patients may feel it in both legs.
• Tumours/malignancies – another cause of sciatica is an abnormal tissue growth in the spine area. It might affect one or both legs.

What treatment is available for sciatica?

This depends on why you have sciatica in the first place. For the majority of cases where only one side is affected conservative, experts recommend a non-operative approach such as physiotherapy, osteopathy, massage, acupuncture and more. Most of the time it produces very good outcomes, however, in cases where symptoms radiate in both legs or when conservative treatment is unsuccessful, minimally it needs invasive operation.

What operation is available for sciatica?

There are two most common operations to treat sciatica:

• Diskectomy – is the procedure where a surgeon removes a portion of the intervertebral disk which is pressing onto the sciatic nerve causing symptoms. Operation is usually performed under a general anaesthetic. Recovery time after the surgery usually varies between 1 – 4n weeks.
• Laminectomy –is the procedure where a surgeon removes/shaves off the back of the vertebrae to increase space of the spinal canal and remove the nerve compression. The surgeon usually performs the operation  under a general anaesthetic and recovery time varies from few days to several weeks.

How long does it take for sciatica to heal?

Symptoms usually affect one leg, but in severe occasions can be present in both.

Healing time very much depends on the cause of the sciatica. If you have symptoms radiating in one leg and they are not caused due to a serious condition, it is likely that your symptoms will improve significantly within 4 – 6 weeks. When a more serious condition is the cause of your sciatica, it might take several months for full recovery.

What to avoid if I have sciatica?

Try to avoid anything that exacerbates the symptoms. You might still be able to do some form of exercises, but  a qualified healthcare professional must prescribe the exercises for you such as an osteopath or physiotherapist. The list of activities to avoid can include:

• Heavy lifting.
• Excessive bending of the lower back.
• Bed rest.
• Certain exercises.
• Sitting down for long periods of time.
• Sudden twisting and turning.

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

We are always happy to help!

 References:

https://mfprac.com/web2021/07literature/literature/Orthopedics/Sciatica_Ropper.pdf 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895638/pdf/bmj-334-7607-cr-01313.pdf 

The post Sciatica: sciatic nerve compression-causes, symptoms and treatment appeared first on Perea Clinic.

1. What is piriformis syndrome?

Piriformis syndrome is a condition which causes pain in the buttock area. This pain may radiate to the back of a leg in cases where the sciatic nerve is compromised. This happens due to a spasm of the piriformis muscle, which is located deep in the buttock area and is very close to the sciatic nerve.

2. What causes piriformis syndrome?

There are few causes for the development of piriformis syndrome. The most common are the overuse of the muscle and sports related trauma. Prolonged sitting on a regular basis can also contribute to the development of the piriformis syndrome because muscle is constantly being compressed. 

There are some biomechanical considerations which may predispose the development of piriformis syndrome. Experts suggest that the piriformis syndrome is more prevalent in women than men because of the increased Q angle, which is due to a wider pelvis. They also estimate that 22% of the population have the sciatic nerve going right through the piriformis muscle which makes them more susceptible to development of piriformis syndrome with radiations to the back of a leg.

3. What are the symptoms of the piriformis syndrome?

Most common symptom is pain in the buttock area during the inactivity for 15 min and longer. Because piriformis muscle is very close to the sciatic nerve, you may also experience many other symptoms such as:

• Shooting pain radiating at the back of the leg down to a foot (sciatica).
• Lose or altered sensation at the back of the leg or foot.
• Tingling or pins and needles radiating to the back of a leg and foot.
• Numbness at the back of a leg and foot.
• Loss of strength of the foot and ankle (feels like one foot is dragging).
• Difficulty walking.

4. How do I treat the piriformis syndrome?

First, experts recommend a conservative, non-invasive treatment approach. It can include, but is not limited to, deep tissue or sports massage, physiotherapy which may include stretching; foam rolling and strengthening exercises for your hips and core area; and osteopathy which may offer a variety of joint mobilisation/manipulation and muscle tension release techniques. Acupuncture, yoga and Pilates are also effective types of exercises in some cases. Moreover, postural and lifestyle education can also have a significant impact on the recovery.

5. How long does it take for the piriformis syndrome to recover?

In most cases it only takes a few days to a few weeks for the piriformis syndrome to get fully better. However, there are cases where piriformis syndrome might not respond to the conservative treatment and might require an invasive approach.

6. Does piriformis syndrome need an operation?

It can, but in very few cases. For example, if the piriformis syndrome is caused due to unique biomechanics such as when the sciatic nerve is running through the piriformis causing the muscle to irritate the nerve constantly. It is then less likely that conservative treatment will have a long lasting effect, hence, a health practitioner may suggest an operation. Also, in cases where the conservative treatment was ineffective an invasive procedure might be considered.

7. What procedures are available for the piriformis syndrome?

To treat the piriformis syndrome which does not respond to the conservative treatment, corticosteroid injection, surgical release of piriformis and decompression of the sciatic nerve operations are available:

• Corticosteroid injection – is an injection of manmade steroidal hormones into the affected area. It helps to reduce the inflammation of the tendon/muscle most of the time resulting in symptom relief.
• Surgical release of piriformis – is an operation where the piriformis muscle is being cut at the attachment of the head of the femur, which is the top of our thigh bone, in order to reduce the tightness of the muscle.
• Decompression of the sciatic nerve – Is the operation where piriformis muscle is cut at the compression point of the sciatic nerve in order to relieve the compression.

8. Can I exercise with piriformis syndrome?

Yes, you can, and you should. However, try to avoid any type of physical activity that makes your symptoms worse. We would recommend you consult a healthcare professional trained in exercise prescription for optimal exercise routine which would help you to keep active without making your symptoms worse.

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us 3 mins away from Angel station in Islington. We are always happy to help. If you like this blog, please share!

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997212/pdf/586_2010_Article_1504.pdf 

10.7556_jaoa.2008.108.11.657.pdf 

cios-9-136.pdf

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Many of us think about massage as something that is just for relaxing, a luxury, pampering or a treat. However, many studies have shown the important role of massage as an effective treatment for different musculoskeletal conditions.

After many years working as a soft tissue therapist, massage therapy is one of the most important elements I use in my practice to release muscle tightness; speed up recovery from injury and even to prevent them. Massage works not only in a physical level, but also it helps your mental health too.

In addition, massage therapy has been used for centuries to help with back pain, to treat injuries and medical conditions that are muscle related. Most importantly, massage therapists works in collaboration with other professionals such as an acupuncturist, osteopath, physiotherapist, sports therapist or adults and kids chiropractor.

• Post Covid-19 recovery process
• Back and neck pain
• Muscular tension
• Sciatica
• Piriformis syndrome
• Knee pain
• ITB syndrome
• Shin splint
• Plantar fasciitis
• Shoulder pain
• Frozen shoulder
• Trapped nerve
• Headaches
• Jaw pain
• Myofascial pain syndrome
• Help to recovering from different kind of surgeries even mayor surgery
• Muscle Strains
• Muscle spams
• Tennis elbow
• Golf elbow
• Rotator cuff syndrome
• Carpal tunnel
• Fibromyalgia
• Sports conditions
• Tendinitis & tendinopathies
• Scoliosis
• Depression
• Anxiety
• Stress
• Insomnia
• Help to reduce side effect of cancer medications
• Arthritis

How does massage help treat these conditions?

Remedial massage works at a deep muscle level releasing, tight muscle, tendons, fascia and restoring movement, hence, improving joint mobility. We aren’t talking about the spa type of massage, we are talking about the medical application of massage.  Furthermore, this involves having a huge knowledge and understanding of the human anatomy, your muscle function, the symptoms, causes, pathology and which muscle groups are causing the injury or pain.

This modality of massage can be uncomfortable sometimes, especially the first session, and not as relaxing as the normal relaxing massage you find in spas. Remedial massage therapists combines different massage techniques, use tools, stretches, examination gloves, medical equipment and even acupuncture to help release tight muscle and restore movement.

In addition, massage therapy can reduce the need of surgery in the long term when the condition is treated on time and by the appropriate professional.

What does research say about massage Therapy?

Research conducted on massage therapy demonstrated the importance and effectiveness in reducing chronic or acute pain. Also, it helps you recover faster from surgeries and injuries; in addition, it boosts your immune and endocrine systems; and positively changes your number of lymphocyte (they are very important in defending your body from diseases).

Massage therapy and mental health

Nowadays, mental health practitioners recommend massage therapy as an important tool for reducing stress hormones. As a result the patient will feel better without the intake of medications or reducing the consumption of them. Remember that if your mind is calm, your body feels good and is in good health, too.

Moreover, massage therapy changes your biochemistry in a positive way, rising positive mood hormones (dopamine and serotonin) and reducing stress hormones (cortisol and epinephrine) which is the responsible of 80% of all diseases.

In conclusion, massage therapy has become an integral discipline when you talk about body and mental health. At the clinic you can find different types of massage such as:

• Tension release massage
• Pregnancy massage
• Hot deep tissue massage
• Remedial massage
• Relaxing massage

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help.

If you like this blog, please share!

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Understanding Sciatica is important. It is certainly something to watch out for. It is a widespread condition. However, it’s difficult to know exactly how common it is. This is because it is often an underlying cause of a more generalized problem.

So, for example, you might have regular lower back problems. Or you might experience shooting pains down the back of your legs. Or even experience buttock pain. In many, but not all, of these instances, sciatica could be to blame. It’s not always easy to know.

But, according to NICE, between 13-40%  of us will suffer an episode of sciatica. If not often, at least at some point in our lifetime. So what is it all about? And how can it be treated?

Understanding Sciatica

Understanding Sciatica – what is it?

Sciatica is a catchall term that refers to a set of symptoms. These may include pain, tingling, numbness, and/or weakness.  These sensations radiate along the path of the sciatic nerve.

The path runs from your lower back through your hips and buttocks. And then continues down the back of your leg. Sciatica typically affects only one side of the body. But in some rare instances, it can affect both sides.

The term is used as a description of certain symptoms. It is not a diagnosis as such.  That’s because it is often due to a combination of several possible causes.

For example, a herniated disk in your spine. Or possibly an overgrowth of bone in your vertebrae are common causes. Other causes include compression by a tumor or damage to the nerve. These, in turn, are sometimes a result of diseases such as diabetes.

Small tips for avoiding sciatica

One of the key steps is to practice good posture. If you are sitting or standing, find out some of the key steps to proper posture. And even work on posture as you sleep. If you work in an office, try and get a DSE assessment done. Get advice from professionals if you can.

Also, try and work on the strength of your back and abdomen. This will help support your spine. Disciplines such as Pilates and Yoga are excellent for this.

If you do work in an office. Try and get up at regular intervals. Sitting for long periods of time will not help your cause.

Dealing with Sciatica

A program of exercises and stretches can help reduce sciatic nerve compression. In addition, Osteopathic manipulative treatment can be used to help relieve pain. It also helps increase your range of motion.

Acupuncture and massage therapy have been shown to provide benefits. These include increased blood circulation, muscle relaxation, and release of endorphins. (Endorphins are the body’s natural pain relievers).

Pain killers, anti-inflammatory medications, muscle relaxants, or injections with a corticosteroid or anesthetic may also prove useful.

At Perea Clinic we offer massage and other forms of therapies that are effective in managing sciatica. If you want a better understanding of sciatica please contact us.

We hope this information is useful. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always glad to help!

 If you like this blog, please share! 

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