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What You Need to Know About Sciatica 'ntroduction ( )ommon causes ( )onser*ati*e care ( +ur,ery ( Dia,nostics ( -natomy -cti*ities Sciatica: & .*er*iew / )auses of sciatica / 0reatments -nimations of: / 1umbar disc herniation / +2inal stenosis / +2ondylolisthesis 3elated information: / 1umbar disc herniation / +2inal stenosis / De,enerati*e disc disease / 'sthmic s2ondylolisthesis ... http://www.spine-health.com/topics/cd/d_sciatica/sc01.html
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Sciatica

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Sciatica exercises 'ntroduction ( )ommon causes ( )onser*ati*e care ( +ur,ery ( Dia,nostics ( -natomy -cti*ities Sciatica e6ercises: & 'ntroduction / 7erniated disc / +2inal stenosis / De,enerati*e disc disease / 'sthmic s2ondylolisthesis / 7amstrin, stretchin, 3elated information: / .*er*iew of s2inal cord and ner*e roots / 8hat you need to 9now about sciatica / 7ow a 2hysical thera2ist can hel2 with e6ercise ... http://www.spine-health.com/topics/conserv/sciaex/sciaex01.html
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Sciatica information and illustrations Sciatica -cti*ities -rticle directory... -natomy -uto accidents De,en. disc disease Dia,nostic tests Disc herniation :ailed bac9 sur,ery :ibromyal,ia 'njections ;ids and teens 1ower bac9 2ain Medications Misc conditions Misc treatments Muscle strain <ec9 2ain .steoarthritis .steo2orosis =ain mana,ement =hysical thera2y =iriformis syndrome =re,nancy =sycholo,ical factors +acroiliac joint Sciatica ... http://www.spine-health.com/search/sciat01.html %#42 4%25 $ 43 Sciatica reatment Recommendations !resented "# a S$ine Sur%eon& 'hiro$ractor and !h#siatrist >ac9 0al9 ( -dditional lin9s ( +2ine :orum ( +2ine Directory ( 0estimonials ( <ewsletters ( -s9 the s2ine s2ecialist -cti*ities Sciatica: & )ase / +ur,eon *iew2oint / )hiro2ractor *iew2oint / =hysiatrist *iew2oint :i, $: M3' - herniated discs ?lar,er *iew@ :i, 2: -6ial scan - 13-14 ?lar,er *iew@ :i, 3: -6ial scan - 14-15 ?lar,er *iew@ 3elated ... http://www.spine-health.com/bt/case/sciacase/scia01.html
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Sciatica

reatments

'ntroduction ( )ommon causes ( )onser*ati*e care ( +ur,ery ( Dia,nostics ( -natomy -cti*ities Sciatica: / .*er*iew / )auses of sciatica & 0reatments -nimation of: / 1umbar microdecom2ression / 1aminectomy / A2idural steroid injection 3elated information: / <+-'Ds / .ral steroids / A2idural injections / =hysical thera2y / -ll about chiro2ractic treatments / =hysiatry ... http://www.spine-health.com/topics/cd/d_sciatica/sc03.html
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What 'auses Sciatica( 'ntroduction ( )ommon causes ( )onser*ati*e care ( +ur,ery ( Dia,nostics ( -natomy -cti*ities Sciatica: / .*er*iew & )auses of sciatica / 0reatments :i, $: Distribution of s9in inner*ation ?lar,er *iew@ -nimation of: / 1umbar disc herniation / +2inal stenosis / +2ondylolisthesis 3elated information: / -natomy / 1umbar disc herniation / 1umbar s2inal stenosis / De,enerati*e disc disease / 'sthmic ... http://www.spine-health.com/topics/cd/d_sciatica/sc02.html
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)ulti*S$ecialt# 'ase Re+iew of Sciatica& 'hiro$ractor ,iew$oint >ac9 0al9 ( -dditional lin9s ( +2ine :orum ( +2ine Directory ( 0estimonials ( <ewsletters ( -s9 the s2ine s2ecialist -cti*ities Sciatica: / )ase / +ur,eon *iew2oint / )hiro2ractor *iew2oint & =hysiatrist *iew2oint Multi-+2ecialty )ase 3e*iews: Sciatica Sciatica: 2hysiatrist *iew2oint 0his is a 4-year-old with a threeyear history of ri,ht le, 2ain. 0he 2ain has been increasin, in intensity o*er ... http://www.spine-health.com/bt/case/sciacase/scia04.html
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)ulti*S$ecialt# 'ase Re+iew of Sciatica& 'hiro$ractor ,iew$oint >ac9 0al9 ( -dditional lin9s ( +2ine :orum ( +2ine Directory ( 0estimonials ( <ewsletters ( -s9 the s2ine s2ecialist -cti*ities Sciatica: / )ase / +ur,eon *iew2oint & )hiro2ractor *iew2oint / =hysiatrist *iew2oint Multi-+2ecialty )ase 3e*iews: Sciatica Sciatica: chiro2ractor *iew2oint 0he ,entleman a22ears to be e62eriencin, 2ain from ner*e root com2ression at 15-+$. - M3' 2erformed in -u,ust ... http://www.spine-health.com/bt/case/sciacase/scia03.html )ulti*S$ecialt# 'ase Re+iew of Sciatica& S$ine Sur%eon ,iew$oint >ac9 0al9 ( -dditional lin9s ( +2ine :orum ( +2ine Directory ( 0estimonials ( <ewsletters ( -s9 the s2ine s2ecialist -cti*ities Sciatica: / )ase & +ur,eon *iew2oint / )hiro2ractor *iew2oint / =hysiatrist *iew2oint Multi-+2ecialty )ase 3e*iews: Sciatica Sciatica: sur,eon *iew2oint >ased on the studies history and 2hysical e6am5 this would not be a ,ood 2atient for a sur,ical candidate. 0he M3' ... http://www.spine-health.com/bt/case/sciacase/scia02.html
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-xercises for Sciatica from a .e%enerati+e .isc .isease 'ntroduction ( )ommon causes ( )onser*ati*e care ( +ur,ery (

Dia,nostics ( -natomy -cti*ities Sciatica e6ercises: / 'ntroduction / 7erniated disc / +2inal stenosis & De,enerati*e disc disease / 'sthmic s2ondylolisthesis / 7amstrin, stretchin, :i,. $$ ?lar,er *iew@ :i,. $2 ?lar,er *iew@ :i,. $3 ?lar,er *iew@ :i,. $% ?lar,er *iew@ :i,. $4 ?lar,er *iew@ :i, ... http://www.spine-health.com/topics/conserv/sciaex/sciaex04.html
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1999-2002 Spine-health.com The information in Spine-health.com is not intended as a substitute for medical professional help or advice but is to be used only as an aid in understanding bac pain and nec pain. ! physician should al"ays be consulted for bac pain or any health problem. Spine-health.com provides lin s to other organi#ations as a service to our readers and is not responsible for the information$ services$ or products provided by these "eb sites$ health professionals$ or companies. See Terms and %onditions and &rivacy &olicy. 7ome ( <ewsletter ( -bout Bs ( )ontact Bs ( +ite Ma2 ( :ind a Doctor ( )linical 0rials

What #ou need to /now about sciatica

0+er+iew +ciaticaC2ain alon, the lar,e sciatic ner*e that runs from the lower bac9 down throu,h the buttoc9s and alon, the bac9 of each le, D is a relati*ely common form of bac9 2ain. +ciatica is usually caused by 2ressure on the sciatic ner*e from a herniated disc ?also referred to as a bul,in, disc5 ru2tured disc or 2inched ner*e@. 0he 2roblem is often dia,nosed as a 1radiculo$ath#1& meanin, that a disc has 2rotruded from its normal 2osition in the *ertebral column and is 2uttin, 2ressure on the radicular ner*e ?ner*e root@. :or some 2eo2le5 the 2ain from sciatica can be se*ere and debilitatin,. :or others5 the 2ain mi,ht be infreEuent and irritatin,5 but has the 2otential to ,et worse. Bsually5 sciatica only affects one side5 and the 2ain often radiates throu,h the buttoc9 and4or le,. .ne or more of the followin, sensations may occur: =ain in the buttoc9s and4or le, that is worse when sittin, >urnin, or tin,lin, down the le, 8ea9ness5 numbness or difficulty mo*in, the le, or foot

- constant 2ain on one side of the buttoc9s - shootin, 2ain that ma9es it difficult to stand u2

8hile sciatica can be *ery 2ainful5 it is rare that 2ermanent ner*e dama,e ?tissue dama,e@ will result. Most 2ain syndromes result from inflammation and will ,et better within two wee9s to a few months. -lso5 because the s2inal cord is not 2resent in the lower ?lumbar@ s2ine5 a herniated disc in this area of the anatomy does not 2resent a dan,er of 2aralysis. +ym2toms that may constitute a medical emer,ency include 2ro,ressi*e wea9ness in the le,s or bladder4bowel incontinence. =atients with these sym2toms may ha*e cauda eEuina syndrome and should see9 immediate medical attention. -ny condition that causes irritation or im2in,ement on the sciatic ner*e can cause the 2ain associated with sciatica. 0he most common cause is lumbar herniated disc. .ther common causes include lumbar s$inal stenosis& de%enerati+e disc disease& or isthmic s$ond#lolisthesis. <er*e 2ain is caused by a combination of 2ressure and inflammation on the ner*e root5 and treatment is centered on relie*in, both of these conditions. 0reatments include: )anual treatments ?includin, 2hysical thera2y and osteo2athic or chiro2ractic treatments@ to hel2 relie*e the 2ressure. )edical treatments ?such as <+-'DFs5 oral steroids5 or e2idural steroid injections@ to hel2 relie*e the inflammation. Sur%er# ?such as microdiscectomy or lumbar laminectomy@ to hel2 relie*e both the 2ressure and inflammation may be warranted if the 2ain is se*ere and has not been relie*ed with a22ro2riate manual or medical treatments.
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Next2 'auses of sciatica

What causes sciatica(

0he sciatic ner*e is the lar,est ner*e in the body. 't starts in the low bac9 at lumbar se,ment 3 ?13@. 0he ner*e roots run throu,h the bony canal5 and at each le*el a 2air of ner*e roots e6its from the s2ine. 0he ner*e is named for the u22er *ertebral body that it runs between ?for e6am2le5 the ner*e that e6its at 14-15 is named 14@. 0he ner*e 2assin, to the ne6t le*el runs o*er a wea9 s2ot in the disc s2ace5 which is the reason discs tend to herniate ?e6trude@ ri,ht under the ner*e root and can cause le, 2ain. 0he sym2toms ?2ain5 numbness5 tin,lin,5 wea9ness@ are different de2endin, on where the 2ressure on the ner*e occurs. :or e6am2le5 a lumbar se,ment 5 ?15@ ner*e im2in,ement can cause wea9ness in e6tension of the bi, toe and 2otentially in the an9le ?foot dro2@ ?+ee :i,ure $@. )ommon conditions that can result in 2ain alon, the sciatic ner*e include: 3umbar herniated disc4- herniated disc occurs when the soft inner core of the disc ?nucleus 2ul2osus@ e6trudes throu,h the fibrous outer core ?annulus@ and the bul,e 2laces 2ressure on the conti,uous ner*e root. 'n ,eneral5 it is thou,ht that a sudden twistin, motion or injury can lead to an e*entual disc herniation. - herniated disc is sometimes referred to as a sli22ed5 ru2tured5 bul,in,5 2rotrudin, disc5 or a 2inched ner*e. o +ee also 1umbar disc herniation 3umbar s$inal stenosis40his condition in*ol*es a narrowin, of the s2inal canal. 't is more common in adults o*er a,e %5 and ty2ically results from enlar,ed facet joints 2lacin, 2ressure on the ner*e roots as they e6it the s2ine. o +ee also 1umbar s2inal stenosis .e%enerati+e disc disease48hile disc de,eneration is a natural 2rocess that occurs with a,in,5 in some cases it can also lead to 2ain alon, the sciatic ner*e. 0he condition is dia,nosed when a wea9ened disc results in e6cessi*e micro-motion at the corres2ondin, *ertebral le*el and inflammatory 2roteins from inside the disc can become e62osed and irritate the area. o +ee also De,enerati*e disc disease 5sthmic s$ond#lolisthesis43elati*ely common in adults ?a22ro6imately 5G to !G of adults@5 this condition rarely causes 2ain. 't occurs when a small stress fracture5 often at the fifth se,ment5 allows the 15 *ertebral body to sli2 forward on the +$ *ertebral body. )aused by a combination of disc s2ace colla2se5 the fracture5 and the *ertebral body sli22in, forward5 the 15 ner*e can ,et 2inched as it e6its the s2ine. o +ee also 'sthmic s2ondylosthesis

!iriformis s#ndrome40he sciatic ner*e can ,et irritated as it runs under the 2iriformis muscle in the buttoc9s. o +ee also =iriformis syndrome - another irritation to the sciatic ner*e Sacroiliac 6oint d#sfunction4'rritation of the sacroiliac joint can also irritate the 15 ner*e5 which lies on to2 of it5 and cause sciatica. o +ee also 8hat is sacroiliac joint dysfunctionH Next2 reatments

>ac9 to common causes

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7ow is sciatica treated(

0he ,ood news is that if 2ain alon, the sciatic ner*e is ,oin, to ,et better on its own it will usually do so within a cou2le of days or wee9s. 'n fact5 the *ast majority of this ty2e of bac9 and4or le, 2ain usually heals on its own within si6 to twel*e wee9s. 'onser+ati+e care2 Durin, an e2isode of sciatic 2ain there are a number of conser*ati*e care o2tions a*ailable to hel2 alle*iate the 2ain and discomfort. Heat/ice :or acute 2ain alon, the sciatic ner*e5 heat and4or ice 2ac9s are most readily a*ailable and can hel2 alle*iate the 2ain5 es2ecially in the acute 2hase. Bsually ice or heat is a22lied for a22ro6imately 2% minutes5 and re2eated e*ery two hours. Most 2eo2le use ice first5 but some 2eo2le find more relief with heat. 0he two may be alternated. o +ee also -hh...'ce massa,e Medications .*er-the-counter or 2rescri2tion medications may also be hel2ful. <on-steroidal antiinflammatory dru,s ?<+-'Ds@ or oral steroids can be hel2ful in reducin, the inflammation and 2ain. o +ee also <+-'Ds5 .ral steroids Epid ral!steroid!in"ections 'f the 2ain is se*ere5 an e2idural injection can be 2erformed to reduce the inflammation. -n e2idural is different from oral medications because it injects steroids directly to the 2ainful area to hel2 decrease the inflammation that may be causin, the 2ain. 8hile the effects tend to be tem2orary ?2ro*idin, 2ain relief for as little as one wee9 u2 to a year@5 an e2idural can be *ery effecti*e in 2ro*idin, relief from an acute e2isode of 2ain. 'm2ortantly5 it can 2ro*ide sufficient relief to allow a 2atient to 2ro,ress with a conditionin, 2ro,ram. o +ee also A2idural injections #onservative!care!specialists - *isit to a 2hysical thera2ist5 osteo2athic 2hysician5 chiro2ractor or 2hysiatrist can be hel2ful both to alle*iate the 2ainful sym2toms and to hel2 2re*ent future recurrences of sciatica. 0hese conser*ati*e care 2rofessionals can assist in 2ro*idin, 2ain relief and de*elo2in, a 2ro,ram to condition the bac9. o +ee also )onser*ati*e care Sur%ical treatments2 'f the 2ain is se*ere and has not ,otten better within si6 to twel*e wee9s5 it is reasonable to consider s2ine sur,ery. De2endin, on the cause and the duration of the 2ain5 one of two sur,ical 2rocedures may be considered: a microdecom2ression ?microdiscectomy@ or an o2en decom2ression ?lumbar laminectomy@.

Microdiscectom$!%microdecompression& 'n cases where the 2ain is due to a disc herniation5 a microdiscectomy may be considered after 4 to wee9s if the 2ain is not relie*ed by conser*ati*e means. Br,ent sur,ery is only necessary if there is 2ro,ressi*e wea9ness in the le,s5 or sudden loss of bowel of bladder control. - microdiscectomy is ty2ically an electi*e 2rocedure5 and the decision to ha*e sur,ery is based on the amount of 2ain and dysfunction the 2atient is e62eriencin,5 and the len,th of time that the 2ain 2ersists. -22ro6imately #%G to #5G of 2atients will e62erience relief from their 2ain after this ty2e of sur,ery. o +ee also Microdiscectomy ' mbar!laminectom$!%open!decompression& 1umbar s2inal stenosis often causes 2ain that wa6es and wanes o*er many years. +ur,ery may be offered as an o2tion if the 2atientFs acti*ity tolerance falls to an unacce2table le*el. -,ain5 sur,ery is electi*e and need only be considered for those 2atients who ha*e not ,otten better after conser*ati*e treatments. -fter an lumbar laminectomy ?o2en decom2ression@5 a22ro6imately !%G to "%G of 2atients e62erience 2ain relief from their 2ain. o +ee also 1umbar laminectomy "#2 Ste$hen 78 7ochschuler& ).
'arch (0$ 2000 )pdated *ctober 9$ 2001 >ac9 to common causes

Sciatica exercises
+ciatica is a commonly used term for 2ain ori,inatin, from the bac9 that is felt alon, one of se*eral ner*e distributions in the buttoc95 hi25 thi,h5 le,5 an9le or foot. +ciatica in*ol*es com2ression or irritation of one or more ner*es e6itin, the lower s2ine that ma9e u2 the sciatic ner*e. 0he sciatic ner*e branches off as it tra*els down the lower e6tremity5 and thus 2ain can be e62erienced alon, this route. - 2hysical thera2ist5 certified athletic trainer ?-0)@5 or other s2ine s2ecialist who treats the bac9 2ain and le, 2ain associated with sciatica may recommend e6ercise as 2art of a treatment 2ro,ram. 0he s2ecific e6ercises recommended will de2end on the cause of the sciatica. 0he major causes include: 7erniated disc +2inal stenosis De,enerati*e disc disease 'sthmic s2ondylolisthesis 0hese e6ercises are recommended for s2ecific conditions. 0hey must be done re,ularly ?ty2ically two times daily@ and correctly to be effecti*e. )lose attention to 2osture and body mechanics is one 9ey to ,ettin, ma6imum benefit from the e6ercises. )arin, for your sciatica should be considered 2art of your daily li*in,5 not just somethin, to add to your routine at the end of the day. 't is recommended that you consult with your 2hysician or 2hysical thera2ist 2rior to be,innin, any e6ercise 2ro,ram. >ac9 to conser*ati*e care Next2 7erniated disc

7erniated disc
7erniated discs commonly in*ol*e dis9 material 2rotrudin, bac9wards and irritatin, or com2ressin, a ner*e root. +ee .*er*iew of lumbar disc herniation +ee 'nteracti*e s2ine animation D lumbar disc herniation A6ercises to treat this condition are 2rescribed accordin, to which 2ositions will cause the sym2toms to mo*e u2 the lower e6tremity and into the low bac9. :or many 2atients5 this is accom2lished by ,ettin, into a bac9wards bendin, 2osition. 0he low bac9 is ,ently 2laced into e6tension by lyin, on the stomach ?2rone 2osition@ and 2ro22in, the u22er body u2 on the elbows5 9ee2in, hi2s on the floor ?:i,ure $@. 0his should be started slowly5 since some 2atients can not tolerate this 2osition initially. 0his 2osition is ty2ically held from fi*e to 3% seconds 2er re2etition5 for $% re2etitions. -fter 2racticin, this e6ercise5 the s2ine s2ecialist may recommend a more ad*anced form of the e6tension: :rom the 2rone 2osition5 2ress u2 on the hands while the 2el*is remains in contact with the floor ?:i,ure 2@. 0his 2osition is ty2ically held for $ second5 re2eated $% times. - similar e6ercise can be done standin, by archin, bac9ward slowly with hands on hi2s if the 2atient is unable to lie flat ?:i,ure 3@. 7owe*er5 the 2rone 2osition is usually 2referred. 0hese Ie6tensionJ e6ercises are done re,ularly5 about e*ery two hours. More im2ortantly5 the s2ine s2ecialist may recommend that the 2erson with this condition should a*oid ,ettin, into a forward fle6ed ?bent o*er@ 2osition. 0his tends to counteract the effects of the e6tension e6ercises. 0he s2ecialists may as9 the 2atient to correct forward fle6ed 2ositions immediately with an e6tension e6ercise. -s the 2ain wor9s out of the lower e6tremity5 the e6ercises ty2ically are ad*anced to stren,then the low bac9 and abdominal muscles to 2re*ent recurrences of the condition. 0o stren,then the low bac/ muscles: 'n the 2rone 2osition and hands clas2ed behind the lower bac95 raise the head and chest sli,htly a,ainst ,ra*ity ?:i,ure 4@ while loo9in, at the floor ?stay low@. 'n the 2rone 2osition with the head and chest lowered to the floor5 li,htly raise an arm and o22osite le, slowly5 with the 9nee loc9ed5 2-3 inches from the floor ?:i,ure 5@. 0o stren,then the abdominal muscles: :or the u22er addominals5 lay on the bac9 with 9nees bent5 fold arms across the chest5 tilt the 2el*is to flatten the bac95 and curl-u2 liftin, the head and shoulders from the floor ?:i,ure @. Do not attem2t to lift too hi,h5 and brin, the head and chest towards the ceilin,. :or 2atients with nec9 2ain5 2lace the hands behind the head. :or the lower abdominals5 ti,hten the lower stomach muscles and slowly raise the strai,ht le, " to $2 inches from the floor ?:i,ure !@5 9ee2in, the low bac9 held flat a,ainst the floor. 8ater e6ercises are also e6cellent5 e*en just wal9in, in waist-dee2 water.

-erobic conditionin, may also be encoura,ed for ,eneral body fitness. 8al9in, is an e6cellent form of e6ercise for the low bac95 wor9in, u2 to three miles 2er day at a bris9 2ace if able. >ac9 to conser*ati*e care Next2 S$inal stenosis

S$inal stenosis
+2inal stenosis can also cause ner*e root irritation or im2in,ement throu,h a narrowin, of the ner*eFs 2assa,eway. +ee .*er*iew of lumbar s2inal stenosis +ee 'nteracti*e s2ine animation D s2inal stenosis 8hen treatin, stenosis5 the s2ine s2ecialist may encoura,e fle6ion e6ercises. :le6in, the lower s2ine increases the siKe of these 2assa,eways and allows the irritation or im2in,ement to resol*e. 0his is accom2lished by stretchin, the muscles of the bac9 that hold the s2ine in e6tension ?bac9wards bendin,@ and stren,then the muscles that brin, the s2ine into fle6ion ?forward bendin,@. Stretches for the low bac9 e6tensors are ty2ically held li,htly for 3% seconds. 1ay on the bac9 and ,ently 2ull the 9nees to the chest until a comfortable stretch is felt ?:i,ure "@. :rom all fours5 sit bac9 on the heels with the chest down and arms outstretched ?:i,ure #@. Stren%thenin% exercises for the lower abdominal muscles: 1ay on the bac9 and 2ress the low bac9 into the floor by ti,htenin, the lower stomach muscles ?:i,ure $%@5 hold for $% seconds. :or a more ad*anced e6ercise5 hold this 2osition while marchin, in 2lace in the hoo9lyin, 2osition5 slowly raisin, alternate le,s 3 to 4 inches from the floor ?:i,ure $$@. )url-u2s ?:i,ure @ may be recommended by the s2ecialists here as well. 0hese e6ercises alone will not necessarily ma9e the 2atient better5 but they will allow the 2atient to more easily hold a 2osterior 2el*ic tilt durin, acti*ities5 es2ecially standin, and wal9in,. 0his 2osture will allow the 2atient to 2erform more acti*ities with less 2ain. 0he 2el*ic tilt is often *ery difficult for 2atients to learn and can ta9e a ,ood deal of 2ractice with the ,uidance of a 2hysical thera2ist before it is used effecti*ely. >ac9 to conser*ati*e care Next2 .e%enerati+e disc disease

.e%enerati+e disc disease

De,enerati*e dis9 disease can also cause a form of sciatica. +ee .*er*iew of lumbar de,enerati*e disc disease 0he form of e6ercise ty2ically recommended for treatin, disc de,eneration is a dynamic lumbar stabiliKation 2ro,ram. 0his includes findin, the most comfortable 2osition for the lumbar s2ine and 2el*is and trainin, the body to maintain this 2osition durin, acti*ities. 'n doin, this correctly5 one can im2ro*e the 2ro2rioce2tion ?sense of mo*ement@ of the lumbar s2ine and reduce the e6cess motion at the s2inal se,ments. 0his will in turn reduce the

amount of irritation at these se,ments5 relie*in, 2ain and 2rotectin, the area from further dama,e. 0hese e6ercises often reEuire s2ecific hands-on instruction because they offer much less benefit if done incorrectly5 and they tend to be much more difficult than they a22ear. 0his ty2e of 2ro,ram is 2ro,ressi*e5 startin, with the easier e6ercises and ad*ancin, to the more difficult e6ercises once the first lower le*el 2ro,ram is mastered. 0he most im2ortant as2ect is sensin, and controllin, motion in the s2ine. .nce learned5 the body can e*entually ta9e o*er and do this without the le*el of concentration it ta9es early on. A6am2les of these stabiliKin, e6ercises done while on the bac/ include: 7oo9-lyin, march5 with 9nees bent5 arms at sides5 ti,hten stomach muscles and slowly raise alternate le,s 3-4 inches from the floor ?:i,ure $$@. 7oo9-lyin, march with arms5 lowerin, the o22osite arm o*er the head ?:i,ure $2@. >rid,in, from a bac9 lyin, 2osition with 9nees bent5 slowly raisin, the buttoc9s from the floor ?:i,ure $3@. 0hese should all be 2erformed with a ri,id trun9. 0he 2el*ic tilt ?:i,ure $%@ will be used to find the most comfortable 2osition for the low bac9. 0his same 2el*ic 2osition is maintained while 2erformin, stabiliKin, e6ercises from the 2rone 9on the stomach: 2osition: 8ith elbows bent and hands under the shoulders5 raise one le, 2 to 3 inches from the floor ?:i,ure $4@ 8ith elbows strai,ht and arms stretched about the head5 raise an arm and the o22osite le, 2 to 3 inches off the floor ?:i,ure 5@. +imilar e6ercises can be done in the 4-2oint 2osition 9on hands and /nees:5 raisin, the arms and le,s only as hi,h as can be controlled5 maintainin, a stable trun9 and a*oidin, any twistin, or sa,,in,: 3aise one le, behind with the 9nee sli,htly bent and no arch in the bac9 or nec9 ?:i,ure $5@ 3aise one le, with the o22osite arm with the 9nee sli,htly bent and no arch in the bac9 or nec9 ?:i,ure $ @.
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Next2 5sthmic s$ond#lolisthesis

5sthmic s$ond#lolisthesis
'sthmic s2ondylolisthesis can cause ner*e root irritation or im2in,ement. +ee .*er*iew of isthmic s2ondylolisthesis +ee 'nteracti*e s2ine animation D s2ondylolisthesis 'sthmic s2ondylolisthesis is ty2ically treated with a 2ro,ram that is a hybrid of the fle6ion based e6ercises ?as in stenosis@ and the stabiliKation 2ro,ram ?as in de,enerati*e dis9 disease@. 0he ,oal of this method is to teach the lumbar s2ine to remain stable in a fle6ed 2osition. 0herefore5 the e6ercises are a combination of both 2ro,rams. +2ecialists treatin, 2atients with s2ondylolisthesis freEuently recommend the 2el*ic tilt ?:i,ure $%@5 as it will hold the lower s2ine in the fle6ed 2osition. 1ay on the bac9 with 9nees bent and flatten the bac9 by ti,htenin, the lower stomach muscles. +tren,thenin, the abdominals with the curl-u2s ?:i,ure @ will also hel2 maintain a 2ro2er lower s2ine 2osition. 1ay on the bac9 with 9nees bent5 fold arms across the

chest5 tilt the 2el*is to flatten the bac95 and curl-u2 liftin, the head and shoulders from the floor. Do not attem2t to lift too hi,h5 and brin, the head and chest towards the ceilin,. :or 2atients with nec9 2ain5 2lace the hands behind the head. 0he hoo9-lyin, marchin, ?:i,ure $$@ and hoo9-lyin, combination ?:i,ure $2@ are a,ain useful here as well. Next2 7amstrin% stretchin%

>ac9 to conser*ati*e care

7amstrin% stretchin%
-nother im2ortant consideration is hamstrin, stretchin,. 0he hamstrin,s are muscles located in the bac9 of the thi,h. 0hey hel2 bend the 9nee and e6tend the hi2. 0i,htness in the hamstrin,s will 2lace increased stress on the low bac95 a,,ra*atin, or e*en causin, low bac9 2ain. Most 2atients with bac9 2ain will benefit from hamstrin, stretchin, by lyin, on the bac9 and su22ortin, the thi,h behind the 9nee5 slowly strai,hten the 9nee until a stretch is felt in the bac9 of the thi,h5 tryin, to ,et the bottom of the foot to face the ceilin,5 one le, at a time ?:i,ure $!@. "#2 Ron S8 )iller& !
+ecember 1,$ 2000 )pdated *ctober 9$ 2001 >ac9 to conser*ati*e care

0ut$atient bac/ sur%er# for sciatic $ain Bsin, minimally in*asi*e lumbar microdiscectomy5 this doctor is able to ,et you out of the hos2ital the same day and ,reatly reduce the at-home reco*ery time. -s someone who s2ent 3 days in the hos2ital and a month reco*erin,5 ' li9e the sound of it. (n!the!new!s r)ical!proced re*!a!small!incision!is!made!in!the!spine*!and!a!port!or!c$linder!is ! inserted.!(t!splits!the!m scle!as!it!ma+es!its!wa$!in*!and!enlar)es!to!)ive!the!s r)eon!a! wor+able!space.!,rom!there*!the!press re!is!removed!-rom!the!nerve. (n!the!older!proced re*!a!lar)er!incision!wo ld!be!made!and!the!m scle!wo ld!be!moved!and ! peeled!awa$!-rom!the!bone.!.his!is!the!reason!-or!the!lon)er!recover$!time!and!a-ters r)er$!pain.! /-!co rse*!the!new!s r)er$!is!not!-or!ever$one.!.he!best!candidate!has!a!standard!dis+! problem*!and!is!o-!avera)e!wei)ht.!#ertain!sit ations*!li+e!bein)!ver$!overwei)ht!can!hinder! the!proced re.