dcmurf

I had sciatica and neck pain on and off for a few years. Once I got into a regular regimen of stretching, both disappeared (along with most of my knee trouble).

Stretching, by Bob Anderson - under $20 and worth triple that!

Sailorman13

Pain radiating from the butt/lower back, down the back of the leg to the heel or even the toes indicates a herniation. Pain that stops in the knee area indicates a bulging or "slipped" disc. It is critical to find out which condition, if either, is causing your pain as the treatments are quite different and the penalty for choosing the wrong one can range from needless agony to permanent paralysis.

Chiropractors, spinal massage, PT are rarely successful with a disc(s) that are truly herniated. Herniated discs sometimes spontaneously heal themselves as the escaped lubricant gel dries up and stops exerting pressure on the nerve. Sometimes this happens concurrently with chiropractic treatment, exercises, etc., but the treatment is not responsible for the relief of pressure beyond some degree of muscle strengthening which can prevent the problem from manifesting itself even more severely. Think the jelly in a donut. No chiropractor or masseuse can force it back inside where it came from, although it may shrink up and/or dry out over time so that the pressure on the nerve is stopped or reduced.

PT, chiro., anti-inflammatories etc. can treat bulging or slipped discs, mainly by helping to prevent the problem from being aggravated by inflammation and poor muscle alignment and tone while it heals on it's own and/or you adapt to it. Direct manipulation cannot "unslip" or "unbulge" a disc. Vertebrae and the lubricating discs between them are attached to each other at the rims. A slipped disc is not like a hockey puck that slips from between two tuna cans and can be slipped back. It's more like a balloon being squashed between two tuna cans to which it is glued. Healing slipped discs just takes time and patience.

A large majority of disc problems are the slipped disc (more accurately "bulging") varieties. This explains a poor surgical success record. But unlike the case of a slipped disc, surgery is often effective for herniations where the escaped gel can be physically removed. A myleogram or possibly an MRI is necessary to distinguish for sure between the two. Be absolutely sure which you have. Chiropractic manipulation of a back with a herniated disc can cause permanent, debilitating damage including but not limited to permanent paralysis. PT for a herniated disc can easily exacerbate the problem unless it's exactly the right kind for a confirmed diagnosis. Sometimes PT can prevent more disc problems and buy you time while the inflammation heals itself. More likely though, if you have a herniation you'll be putting yourself through a lot of unnecessary pain and risking making the problem worse.

An Osteopath or Orthopedist is a good specialization for dealing with slipped discs. If you truly have a herniation, a Neurologist should be the leader of your team. You're dealing with the most important nerve in your body so a nerve doctor is even more important than a bone doc.

Good luck with it. Given the location of the pain as you described, it doesn't sound to me like a herniation or even a sciatic nerve problem, but if that's diagnosed by a G.P., get it confirmed by a neurologist. The atypical pain pattern is reason enough for a second opinion and test. A herniation is an entirely different animal than a bulge. Make double sure what's going on and if you ever have a true herniation, stay the hell away from chiropractors!!

Denny Koll

Another clarification: In order to be seen by a PT you first need to be seen and diagnosed and referred by a physician.

In other words by the time you would get to physical therapy it would have been determined that you need pt. Kind of obvious..but still.

Let us know how it turns out.

BluesDawg

Now I'm wondering whether I'm remembering my diagnosis correctly, whether it was "herniated" or "bulging". I do remember that the pain went all the way to my toes. I'll never forget waking up in the middle of the night with what felt like a terrible cramp plus an intense burning sensation from my lower back, down the back of my right leg shooting down to my foot and toes. It hurt so bad I was crying like a baby.

But my GP and the very reputable Neurologist he sent me to both fully supported the PT treatment I received and the PT treatment was very effective in moving the pain up my leg, through my hip to my lower back and eventually subsiding. The only thing they were not successful with was a slight numbness remains in the bottom of my right foot to this day.

so my symptoms sound like the above description of a herniated disc while the treatment results sounds like the description of a bulging disc. I'm thinking I remember "herniated", but honstly, it has been several years and I could be wrong.

DnvrFox

Depends on the state.

In Colorado, one can see a Physical Therapist directly as primary care.

Denny Koll

Yes. You are one of three states that you can directly access pt...although for insurance purposes you probably still need the referral.

bigjim1

I've had this problem for 5 years. Had all the MRI scans and x rays. now they decide it is sciatic and they can do nothing for me. It is all related to weight bearing. has its good and bad days but always there. Cycling does not bother it, as it is not weight bearing. So I don't walk far, just cycle and upper body workouts at the gym. If thats all thats wrong with me at 60 it will do.

Sailorman13

Your description of the pain sounds like a herniation. PT can be effective for that, but a lot depends on how bad the herniation is and how much "gel" has leaked out into the channels housing the sciatic nerve. Also, which vertebrae are involved can make a difference in your treatment. Some are riskier than others and sometimes a neurologist will go to great lengths to avoid surgery on certain vertebrae, especially in the neck area.

Properly exercised, PT can strengthen critical muscles and lead to a better posture. Exercise can reduce inflammation and prevent relapse or aggravation of an existing herniation. Most importantly, it can allow you to put off more drastic treatment while the herniation heals. Meanwhile, if the sciatic pain is being caused by a relatively small piece of escaped material, there's a realistic chance that it will shrink up and out of the way over time.

I had a laminectomy about 22 years ago. A wad of gelatinous material was clipped off flush from an L5-S1 herniation. The relief was instant and for the first time in 8 months, I could stand upright for more than 5 minutes after getting out of bed. First time I stood up after surgery, I had to grab at the nurse because I was convinced that I was falling over backwards!! I *did* find a lot of change on the ground during those bent over months" though.

Three years after that surgery, a minor "relapse". I could stand upright, but a myleogram showed that the some of the remaining gel escape the disc and the nerve was being pressured again. This time, the options were to either remove the disc entirely and fuse the vertebrae, or do some PT, be careful, take ibuprofen and hope and pray it goes away on it's own. It took about a year to gradually subside and, (knock on wood), I haven't had any significant pain with it since.

Perhaps your herniation was similar in severity to my second round with sciatica. Perhaps, as in my case, PT bought time for you to be functional while waiting on the natural healing process. Had your herniation been more severe, past the point that shrinkage is likely to relieve the pressure, you would have figured out in short order that PT was not going to cut it. It took me 3-4 months of agony the first time around to give up on it. The second time I tried it, it took about a month to notice the benefits.

PT, (not to be confused with chiropractic manipulation), sometimes works that way for herniations. It's just about the only thing helpful for slipped discs. Severity counts and a herniation is not a herniation. My guess is you had a moderately severe herniation and the PT, always the first option, allowed you to avoid surgery or the need to limit yourself physically for the rest of your life.

con

The very best advice I can give.

Don’t get your medical advice from internet forums.

HIPCHIP

Not necessarily true. I have a Masters' in Kinesiology with an emphasis in sports medicine and was a certified athletic trainer, so my advice is valid. My advise... go see a MD!

con

Sorry, here you are nothing more than another bike rider. Heck, for all I know, you may not even be a bike rider

HIPCHIP

Ditto!

djnzlab1

HI,
Many problems come from large abdomens , weak muscle groups in the back bone.
I had problems after many years of pounding the pavement (joggin), this with weight bearing exercise can cause changes in the bone structure of the back, leading to narrowing of the nerve passages to the lower extremities, in my case it was early stenosis of the back where the nerves exit the spine.
This is very common as we age. in my case it caused a pain and cramping upon standing for hours at work. My back was sore after jogging and seemed to get worse doing weights training.
My DR said no weight bearing exercise, and reccomended biking.
To my amazement my back pain actually improved and have been pain free for months.
As with any problem X-ray, and or MRI are the only way to DX true changes in structure.
Anything less is a Guess.
Doug

more on stenosis with normal aging
https://en.wikipedia.org/wiki/Spinal_stenosis

133Racer

At 22 I had a microdiscectomy. I'm now 29 and recently suffered from severe pain in the left butt and on down the left leg. The pain was severe enough that I had trouble getting out of bed for a week. I thought I had somehow irritated the disc which was operated on at 22. I was wrong.

A combination of a lot of road biking and no stretching caused my quads to pull my pelvis forward and pinch my sciatic.

Stretch your quads like crazy for a few days and also your piriformis (just Google for more information) and you will see results. Chiropratic, doctor and physical therapy visits didn't get me any results. Simple stretch routines and some IB Profin, to get me through the day, worked wonders in just a few days. The area is still sore, but I feel a lot better (I'm now 2 weeks in recovery). This problem started almost 4 months ago and grew progressively worse. Again, I had no idea what was wrong until now.