Provides information on low blood pressure and its annoying hypotension signs and symptoms. Clipping is a handy way to collect and organize the most important slides from a presentation. Some patients also experience sciatica pain affecting all the dermatomes in the sciatic nerve, L4, L5 and S1.
When the sciatica symptom is due to a herniated disc, it often affects a single strip of skin or dermatome. Sciatica and pregnancy - The symptom of sciatica can be triggered during pregnancy for three reasons.
Sciatica and Back Pain - Radiating pain down the leg often occurs along with back pain, however, the two symptoms are not always linked.
Sciatica Treatment: Exercise, Accupuncture, and Chiropractors - When sciatica is due to the muscle spasm of piriformis syndrome, specialized exercises - often directed by a physical therapist - can be helpful, but exercises can make sciatica worse if it is due to a herniated disc. One of the most common causes of sciatica is a herniated lumbar disk at either the L4-L5 or L5-S1 level. One place where the entire sciatic nerve is pinched most commonly is in the pelvis, where the nerve exits from the inside to the outside of the pelvis through the sciatic notch and passes under a muscle called the piriformis muscle. Aside from sciatic nerve problems, entrapments of the tibial nerve at the ankle or tarsal tunnel syndrome, or entrapment of the peroneal nerve near the knee at the head of the fibula bone are common.
Hip pain is very common phenomena in our society, Since the hips carry the gravity center in our body, they form the foundation of the all body. We will look at the most common bodily distortion and its effect on the body in the reclining position, while standing and while walking. The supine (reclining) position: When the subject lies on his back, the right leg will extend further forward than the left leg, making the right leg appear longer that the left leg.
In the standing position: When the subject is standing he will automatically shift his weight onto the functionally shorter left leg. This neuromuscular reflex will be carried out as follows: The nervous system will send impulses to muscles on the right side of the trunk to contract, thereby pulling the spine and head to the right, as a reaction to the left tilt of the hips.
The person may not suffer pain at the moment, but eventually this constellation of distortions in skeletal alignment will result in some degree of chronic debility and pain. Psoas - Extremely important muscle, attached to the spine from the front and side, and connected to the inside of the hip and leg. When the Sciatic nerve is involved the patient will experience also tingling and numbness in the calf and foot. Tensore Fasciae Latae - This small muscle on the side of the hip connects the hip bone to the femur (thigh bone) from the side. Gluteus maximus, medius and minimus - These superficial hip muscles cover the whole hip from the waist to the hip joint itself.
Deep Rotators - These five deep muscles connect the hip joint to the bottom of the pelvis from the back.
Lumbar Ligaments - These three ligaments connect the hip joint to the lumbar spine (low back) and the sacrum (tail bone).
You’re worn down, you have trouble sleeping, you have weight problems, you have a hard time remembering things or focusing, you can’t seem to stay warm. In working with thyroid and adrenal problems, I have come to appreciate a most interesting and significant observation.
The general exception to this pattern is in cases where the symptom is due to general low metabolic energy regardless of whether it is caused by thyroid or adrenal dysfunction. The Metabolic Scorecard™ is a quick and easy way to see if there is a predominance of low function of adrenals, thyroid or a mixture of both. We will be adding a Metabolic Scorecard™ Diagnostic Tool to this website to give you feedback on your own symptoms. The pain often starts in the low back - (due to a herniated disc) - or in the buttock - (due to piriformis syndrome) - and extends as far as your toes. This means that it often follows the path of a single spinal nerve root such as the Lumbar 5 (L5) or Sacral 1 (S1).
Sciatica refers to a pain in the leg which follows a particular pattern that is related to the course of the sciatic nerve: starting in the low back, running down behind the buttock and leg, then down the side of the leg and reaching around the ankle into the foot. It can be caused either by an L3-L4 disk herniation, which is relatively rare, or by an L4-L5 disk herniation that happens to point out laterally into the nerve canal. It could be that both your L4-L5 and your L5-S1 disk herniated at the same time; however, the chance of two disk failures happening exactly the same way and at the same time is very small.
Tension and spasm or increased muscle tone in the piriformis can cause a sciatica that affects the buttock and the leg, and reaches down to the level of the ankle but doesn’t go to any one of the toes in particular. Each of these will cause a specific pattern of pain numbness and weakness in the foot that can be mistaken for nerve root impingement by a spinal disk. Every muscle above and under the hips will have to respond automatically to every distortion or change in the location of the hips. In the most common bodily distortion, the right hip is rotated forward approximately ¼ inch to 1 inch more that the left hip.
This is not because of an anatomical discrepancy in leg length, but because the right femur (thigh bone) extends from the right hip which, in our subject, is rotated forward. Next, the nervous system will recruit muscles between the left shoulder and neck to pull the head back to center to level the eyes.
This muscle is the main culprit of lower back and hip pain in our society, since we have become very sedentary. Since 90% of the time during walking the body weight is carried by one hip, the hip muscles are forced to work harder which make them susceptible to get in a spasm. When they are spastic , pain would be felt in the hip and referred to the back and side of the thigh and calf.
When they are spastic, pain would be felt in the low beck hip and would be referred to the back of the thigh. Rind's Metabolic Scorecard™ is a method of using signs and symptoms to help distinguish between the two most common causes of low metabolic energy: thyroid and adrenal hypo-function. The diagnosis for many of these symptoms is low metabolic energy, the cause in many cases is either adrenal fatigue or low thyroid function. For example, both poor thyroid and poor adrenal function can cause hair loss or poor mental memory and focus.
Light skin individuals have a tendency toward weaker adrenals and dark skin individuals have a tendency toward weaker thyroids while olive skin individuals tend not to have weak adrenals or thyroids. This will tell you if our condition is predominately low function of thyroid, adrenals, or a mixture of both. As your adrenals and thyroid receive the needed support, use this tool to periodically monitor your progress. This condition is due to a muscle in the buttock that goes into spasm and pinches the sciatic nerve. The expanded uterus in the pelvis can press on some the lumbar and sacral spinal nerves that help form the sciatic nerve. Also, a herniated disk will occasionally cause buttock and leg pain with virtually no back pain.
Chiropractors can be helpful or harmful in any case of sciatica depending on their skill and experience. When the L4-L5 disk ruptures, it tends to rupture in a particular location on the posterior and lateral corner of the disk (toward the back and to the side), on either the right or the left. When the L4 nerve is pinched, the pain runs down the leg and may reach the ankle but not necessarily the toes.
This symptom pattern tends to lead to the question of whether the whole sciatic nerve is being pinched somewhere along its course from the sacrum to the knee rather than one of the spinal nerves that leads into it. If the physician considers these problems they may be sorted by physical exam, electrical nerve testing or by specialized imaging such as MR neurography (see Chapter 9). To enable the body to function in the most efficient way the hips have to be leveled horizontally. This occurs because there is frequently a tendency to use the right leg more than the left leg, for instance, as in the operation of an automobile with automatic transmission.
This change in head position will involve the righting reflex, which will be called into action to reestablish the eyes on the horizontal plane.
While the subject is standing, his right hip will be higher than the left hip, and his left shoulder will be higher than the right shoulder. This muscle is the most used and abused in the body, because we use it all the time, while walking, standing and sitting. When the piriformis is in a spasm it will compress the thigh bone into the hip socket increasing the pressure on the joint.
To get a brief understanding of Rind’s approach to identifying and correcting metabolic energy problems read his overview on Metabolic Therapy™. Examples of these general low metabolic energy symptoms can be found in the symptoms table of the Metabolic Therapy™ overview. Nobody has all the above symptoms, however, the more severe the problem the greater the number of symptoms will be present. If the cause is in the lumbar spine, the sciatica - or leg pain - is often accompanied by back pain. When you have back pain alone but no sciatica, then your problem is generally something other than a herniated disk.
The other trick to an L4 nerve pinch is that the resulting pain can have a more prominent presence in the knee and on the anterior thigh.
In this case, use of the right leg activates the muscles of the right hip, causing these muscles to shorten and consequently to pull the hip forward. When this muscle gets tired and spastic, it will pull on the femur (thigh bone) onto the accetabulum (the hip socket) and increase the pressure on the hip joint. Also, when this muscle is spastic it will compress different nerves roots which exit the Sacrum (tail bone), including the "famous" Sciatic nerve. The adrenals help us manage stress and maintain stability, while the thyroid turns on energy product. While, in poor thyroid function, we see weight gain, reddish complexion, hypo-reactive systems, etc.
The patient’s detailed distribution of symptoms must match exactly with the MRI findings in the spine before a back surgery can be recommended. Back pain alone can even have it's roots in life stress, however sciatica is almost always an indication of a specific nerve related problem. That pinch almost invariably causes sciatica that runs all the way down the leg into the big toe. The effects of this mechanical distortion may be clearly seen by examining the subject in various positions. The simple act of standing results in excessive muscular activity that distorts skeletal alignment, all in reaction to the initial simple forward rotation of the right hip. If the pressure lasts for a long time it will cause deterioration of the cartilage of the hip joint and hip replacement will be unavoidable when this muscle is spastic it will refer pain to the lower back, the front of the hip and leg. The piriformis muscle syndrome is frequently characterized by such bizarre symptoms that may seen unrelated. This ‘opposite’ pattern has powerful implications in diagnosing and treating individuals in a low metabolic state because it allows the root problem of either adrenal or thyroid dysfunction to be addressed. Similarly, an L5-S1 disk herniation usually pinches the S1 nerve and the resulting sciatica also runs down the leg, but it goes out to the little toe (See figure 7.1).
One characteristic complaint is a persistent severe, radiating low back pain extending from the sacrum (tail bone) to the hip joint, over the gluteal region and the posterior of the upper leg, and behind the knee. In the most severe cases the patient will be unable to lie or stand comfortably, and changes in position will not relieve the pain. Intense pain will occur when the patient sits or squats since this type of movement requires external rotation of the upper leg and bending the knee.
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