Top 10 Questions about Sciatica Pain

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Do you suffer from Sciatica Pain? If you're considering seeking a Physiotherapist but aren't quite sure where to start, here are the Top 10 Questions we receive and how we answer:

 

Q1 - How long does it take before the pain starts to go away?

Well, it depends on YOU. In general, it takes to 4 to 8 weeks to go through the first 2 phases of healing (no pain, all movement and strength back to normal). It may take another 1 to 4 months to get back to all activities you want to do...depending on how active you are. This is the third phase of healing.

Here are 10 variables that determine how fast someone can heal:

- Overall health. Healthy people heal faster. Younger people heal faster.

- Other health issues such as diabetes, heart disease, high blood pressure, tobacco use, alcohol abuse and body weight all influence healing rates…and make the time to heal longer.

- Diet. People who consume more nutrients in their calories heal faster than those who primarily eat processed foods.

- Rest levels. Our bodies need sleep and rest to rebuild. A lack of sleep slows healing time.

- Stress levels. People who have high levels of stress heal more slowly.

- Sedentary lifestyle. People who sit all day for work or to watch TV heal more slowly.

- People who follow advice and instruction from top level healthcare professionals heal more quickly than those who do not follow-through with care.

- People who are highly aware of their daily postures and habits heal more quickly…because they can adjust habits such as sleep or sitting positions more quickly.

- Readers heal more quickly. People with higher attention spans are more likely to be self-educated on a topic and more likely to follow-through with successful treatment.

- People who think there’s hope tend to be more persistent and won’t let anything stop them.

 

Q2 - How long before I see improvements?

Most people we see in the clinic feel better in 2 to 3 visits…or within 1 to 2 weeks. If you go longer than 2 weeks without feeling better or moving better…you may be wrong about the cause of your sciatica regardless of what your X-ray or MRI shows.

 

Q3 - Can I be completely healed or will this come back again?

Most people we see who complete the 3 Phases of Healing (meaning they no longer have pain, motion and strength are back to normal and they’re back to doing all the activities they want to do without pain)…they have a minimal chance the pain will return. The stronger the person is…the less likely the sciatica symptoms will come back. Your body is a bit like a car. If you take care of it, regularly change the oil and keep it running and fine tuned…little chance of break down. If you ignore it…very likely to break down and be in need of repair.

 

Q4 - Do I need any special equipment?

At Dynamic Health Physiotherapy, we use a minimalist approach… We don’t use big, fancy, expensive equipment… Most exercises can be done with a simple ball, exercise bands and a safe place to exercise. Our model focuses on world-class hands-on physiotherapy, a table and some basic exercise equipment you can use at home or on the road if travelling. This works best for most people.

 

Q5 - Should I use heat or ice on my leg?

The cause of most sciatica (pain, numbness or tingling in the leg) is in the lower back. Ice or heat on the leg will not change that. Consider that sciatica is “inflammation.” So if you’re inflamed…do you want to put heat on it and make it more inflamed? Or ice to calm the inflammation down. We have seen some people use ice on the lower back to calm down the inflammation temporarily.

 

Q6 - Which exercises should I do?

The best exercises for you depend on what the cause of your sciatica is. We cover the 3 most common causes… Herniated discs Stenosis, arthritis Pelvic or SI joint problem.

 

Q7 - How often should I do the exercises? Do I need to do them forever?

Most people we work with in the clinic for sciatica do the exercises at least once per day… every day. Some will do them up to 3 times per day. Doing the same exact exercises for years without changing could be a mistake. In general, to get stronger, your exercise should progress and get more difficult. With training your body adapts. Keeping that in mind, there are 2 rules to training: 1. Everything works. 2. Nothing works forever. This means that any exercise (although painful) may make you stronger. But once your body adapts, it’s time to move on to something different or more challenging. One of the best programs you can move on to once you complete the 3 Phases of Healing for your Sciatica is a consistent walking program. People who walk every day have less risk of re-injuring their back and sciatica.

 

Q8 - What do I need to do for complete care? Am I going to relapse?

The best thing to do for sciatica, if you are worried about it coming back again in the future, is to complete all 3 phases of healing. Phase One is where you focus on getting rid of the pain, numbness and tingling. Phase Two is where you focus on getting normal movement back and full strength. Phase Three is where you go back to previous activities you want to do. In our clinic, after we see a person who had sciatica…and they are now pain free and have full motion and full strength, we ask: “What activities have you avoided in the past month that you want to get back to doing?” Some will say walking, or golfing or gardening…something along those lines. And we’ll tell that person to take the next month or two and do everything you want to do that you could do before. They keep doing their exercises at home to get stronger and stronger. Most come back for a recheck appointment in 2 months and have no trouble at all. Some do have a relapse. We then take a look at the activity and at the program and help them get on the right track. 

 

Q9 - How do I know the cause of my pain? 

There are 3 common causes of pain…and here are some general guidelines for each. People with sciatica from a herniated disc usually have pain bending forward, twisting, coughing or sneezing. The sciatica pain they experience is usually sharp and runs specifically down the back of the leg…possibly into the foot. Herniated disc sufferers are usually 35 years of age or younger. People suffering from sciatica because of stenosis or arthritis usually answer yes to these 3 questions:

- 50 Years of age or older?
- Pain with standing or walking?
- Relief with sitting?

People suffering with sciatica from SI Joint or Pelvic problems usually have pain with sitting for long periods. The sciatica they experience is usually on the outside of the thigh. Symptoms may include heaviness of one leg or feeling twisted.

 

Q10 - Which position should I sleep in?

On your back is best. Next would be on your side. Last would be on your stomach. Regardless, an important key is to keep your spine in “neutral”. This means that it is not twisted to the right or left…but keeps the natural curve it normally has. Pillows of folded towels can be placed under your knees, under your side, or under your feet to help you sleep in the least painful position for you.
 

 

Thanks for reading! If you have any questions that were not answered here, give us a call!

 

 

25 Stretches to Improve Daily Life

Everyone knows that stretching before physical activity is important, but did you know it is also just as important when starting your day? Stretching as you begin your day can help improve your motivation, your attentiveness, and give you an overall good feeling - not to mention help avoid drowsiness! Daily Stretching also gives you these benefits:

- Improves and strengthens posture
- Enables flexibility
- Increase stamina
- Encourages optimistic outlook and reduces stress
- Reduces the risk of injury
- Increase energy levels
- Promotes blood circulation
- Reduces general soreness
- Reduces cholesterol

If you feel like you might be having an off day- try some of these stretches!

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The Best Thing You Can Do For Foot Pain

Foot Pain, specifically pain in the heel or arch of the foot is very common. It can be caused by many factors. It can come on gradually or start spontaneously. And while the causes and presentation may vary, the best way to fix it is often the same.

Before we talk about how to best fix this type of foot pain, let's talk about the most common reason this condition occurs.

The foot, while it may look like a simple structure upon first glance, is quite complex. It is made up of several bones, joints, muscles, ligaments and tendons which all work together to give our foot structure and allows us to endure significant forces when we stand, walk and run. 

One of the structures which helps to support the arch of our foot is made up of a tough tendon-like sheet. It is constantly under tension while we are on our feet. When this structure (called the plantar fascia) becomes overtaxed or stressed, it can begin to tear. Now sometimes this goes unnoticed and heals quickly, however, other times the stress that causes the initial tearing continues. If this is the case, the fascia can reach a point where it becomes painful when you try to walk on it, especially first thing in the morning.

Whether the pain starts all at once or gradually gets worse over time, the first thing I always recommend is to check your footwear!! 

The most common culprit for this type of foot pain is poor footwear with little to no arch support. While arch pain can happen to any type of foot, 9 out of 10 times it is someone with a low arch or no arch that doesn't have good shoes or insoles to support the foot.

So instead of waiting for the pain to just subside on it's own, at least take the time to make sure your shoes, sneakers, sandals, etc. aren't constantly re-aggravating the foot!

P.S. - A routine of stretching and strengthening is also going to be extremely important for the full recovery of your foot. Make sure to choose someone qualified who will be able to guide you when choosing proper footwear AND in setting up a personalized program to ease your foot pain.

How Posture Can Affect That Nagging Shoulder Pain

Have you ever hurt your shoulder and thought, "It will heal on it's own if I just give it time."? There are many factors that can affect recovery from a shoulder injury, but the first one I look for EVERY time is posture.

Posture is such a powerful word. It often evokes memories of being told to 'sit up straight!' by parents and teachers. As soon as I mention it during a physiotherapy session, there is an immediate reaction (correction) in their sitting posture.

Most of us know we could do with some improvement in our resting posture, but have you ever really thought about what it may be doing to your body if you don't fix it? 

While people often think of how poor posture may lead to a rounding of the back while seated, it can also have serious implications for the neck and shoulders. 

If you have poor shoulder posture, or rounded shoulders as it is commonly called, several things can happen within the shoulder to cause irritation and changes to the joint.

One of the most common conditions seen with poor shoulder posture is called shoulder impingement. In this condition, the alignment of the joint has changed enough to cause pinching of the tissue as you move your shoulder and upper arm. As the tissue gets pinched again and again, it can become inflamed or swollen and decrease the amount of space even further. Over time this can cause tearing, typically in the rotator cuff tendons, which leads to increased pain and loss of normal range of motion of the shoulder.

Another common issue is that the top of the arm bone (the humerus) can slide forward in the joint and put extra pressure on the front of the shoulder joint. As this soft tissue becomes irritated and inflamed, it can cause swelling in the tendons in the front of your shoulder. You would often experience this as pain in the front of the shoulder joint.

Poor posture can also lead to muscle imbalances in the shoulder. Typically the muscles that make up the back of the shoulder joint become stretched and weakened, while the muscles of the front of shoulder get tighter. This leads to an increase in poor shoulder posture because it feels even more comfortable to stay in this position.

Even if your shoulder injury is due to another cause, like a fall or a car accident for example, your healing time may be much slower if you are starting with rounded shoulders. Because the joint is already at a disadvantage and the tissue around the joint is constantly under stress, it makes it difficult for the injury to heal. Longer healing times and chronic injuries are often the result.

- So what should you do?

- The short answer is sit up straight.

The longer answer is that the shoulder joint is very complex and there are many factors that can affect your chances of injury and length of healing. It is important to keep your shoulders back, but you also need to make sure the muscles surrounding your shoulder are working properly to allow for proper movement as you move your shoulder and lift your arm.

If you are experiencing shoulder pain and think that posture may be causing it to linger or worsen, make sure to have it assessed by your physiotherapist so they can give you an appropriate specialized treatment plan for your particular condition.

Knee Pain - 3 Things You've Been Told To Do That May Be Slowing Your Recovery

Knee pain is another one of those common conditions that many of us have experienced. Because it is so common, we often hear advice from others who have had knee pain about how to manage it.

Here are 3 recommendations I hear frequently in the clinic and why you may need to be cautious about following these words of advice without first having your knee or knees examined. 

Rest it.  

Easily one of the most common pieces of advice someone with just about any injury will hear. And while rest is VERY important at the appropriate time, it can also lead to poor recovery outcomes if you don't move enough.  

Many of the cases of knee pain that come for treatment at our clinic are due to weakness of certain muscles or over-training in other areas. In these cases, it may just be a matter of adjusting exercise routines or modifying movement patterns to get the knees moving properly again. 

Getting the knee assessed will give you a better indication of whether the knee should be rested or not.

Wear more comfortable shoes.  

Sometimes people realize that their footwear is causing their knee pain. When they wear their old sneakers or boots, their knee pain really acts up. Many patients have come in with very soft soled shoes or 'rocker bottoms' (shoes that don't allow your foot to rest flat on the ground) saying they were told to get something with more cushion for their foot. 

While each case needs to be evaluated individually, most often your foot actually needs more support, not less. The soft sole can temporarily relieve symptoms by decreasing the impact on your joints as you walk. Without stability however, the joints often become overtaxed and irritated as they try to compensate.

Wear a pull-on fabric knee support.

These knee supports are very popular and are often the first thing people suggest as a fix when you first experience knee pain. While they CAN help to reduce swelling in the knee and the feeling of compression can make the knee feel better temporarily, a pull-on sleeve doesn't help to fix the root causes of knee pain. Actually, a small brace like this may give you a false sense of support and lead to further injury if you rely on it for stability.

As with most pain or stiffness, it's important to have the knee assessed in order to figure out the root cause of your knee pain. Wearing a knee brace that you picked up from a store or a friend may actually slow down your recovery if it wasn't recommended after proper hands-on assessment.

 

You may notice a bit of a theme in this post. While any or all of these suggestions may be helpful at the appropriate time, it is ESSENTIAL to have your knee assessed.

With proper assessment, you will know what is wrong and, together with your physiotherapist, you can determine a treatment plan and even discuss which of the suggestions might be helpful.

 

 

Neck and Shoulder Pain - Why Sitting Isn't Doing You Any Favours

Sometimes it seems like that nagging neck or shoulder pain comes out of nowhere! And when you try to treat it with some heat, or painkillers, or cooling creams, etc., nothing seems to work. You get that slight improvement for an hour or two...maybe a day. Next thing you know...BAM! the pain is back again.

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Most people that present with this type of injury are baffled by the pain because they "didn't do anything strenuous to hurt it lately".

The crazy part is, it might not be any one thing that sets off the injury. In fact, it's much more common to see an injury that's the accumulation of all the little things we do on a daily basis that add up to one big, bad, sore neck or shoulders.

One of the main culprits I see almost daily is actually your sitting posture. The way you set yourself up at your desk, in your car, on the couch...all can play a role in how much stress is being put on the neck and shoulders throughout your day.  

Take a look at your posture right now, for example:

  • How are you sitting in your chair?
  • Do you have good support?
  • Are you leaning forward?
  • Are you hunched over a laptop, tablet or phone?

All of these things can affect your neck and shoulders and lead to pain and stiffness over days, months, years of sitting in poor postures.

So what should you do about that nagging neck or shoulder pain? You may not have to look much further than changing your sitting position and correcting posture. 

If you are sitting for long periods of time during your day, here's 4 things to keep in mind to help reduce stress on the neck and shoulders:

1) Mare sure you are sitting at the back of your chair and not perched on the edge.

Often times when we are focusing on our work, we tend to move out toward the front of our chairs. This means you have to lean forward, which causes more stress on the neck and shoulders.

2) Adjust your chair (and lumbar support if you have it) so you have good support for your low back?

Supporting your lower back typically leads to better posture for your upper back, neck and shoulders.

3) Sit closer to your desk and make sure your back is resting against the back rest of your chair. 

If you are leaning forward, just like when you perch on the edge of your chair, you increase neck and shoulder workload...not to mention low back strain too!

4) When possible, mare sure your shoulders, back and arms are supported.

This is most easily accomplished with a high back chair with adjustable arms, back and seat. This way the chair can be set up for YOU, instead of you trying to get comfortable in one that isn't suited suited to you.

 

One last thought...

Are you usually hunched over a laptop, tablet or phone and you're not at a desk on seated in a good chair?...Try to remember: head up, shoulders back! 

That is really a topic for a whole other blog post, but I had to at least mention it before I sign off. 

Remember, try out these tips to get you started if you are having neck and shoulder pain. You may be surprised how much it helps! 

Back Pain And Why You Should Ignore Friendly Advice

Okay, that might be a bit harsh... 

Don't ignore everyone completely when they talk to you about back pain. Just make sure you keep a few things in mind when getting that well-meaning advice.

First, let's set up the scenario...you may have gone through a similar situation. You start to have back pain or maybe you've been dealing with it for a while. When asked why you're looking a bit bent over today, you mention to a friend that your back has been getting pretty bad lately and it's starting to affect your everyday life. 

Suddenly, you see them light up. They look like a kid in class with their hand shot straight up in the air and a giant grin on their face because they know all the answers. 

The reply usually goes something like this: "I've had that before! I know just what you should do!"  

This is where you insert advice 'X'...

Now, X can be anything from stretching and strengthening to getting painkillers and surgery....I've heard it all. Not that there isn't a time and a place for these options (and many more), the issue here is that the advice is based on THEIR experience. And despite what they may think, back pain comes in many shapes and forms. 

Just for a few quick examples of different structures that can be affected...you can have strained muscles of the low back, herniated discs, degenerated discs, nerve pinching or irritation...or even combinations of these conditions. Within these broad structure categories are several sub-categories and variations. 

Now I'm honestly not writing this to scare you away. The point is that your back pain is not necessarily the same as your friend or family member's back pain.

To fully understand and properly treat your very individual circumstances, you need to be assessed by a licensed physiotherapist. A diagnosis of your condition will be given, along with a customized treatment plan and schedule.

The point is...while that friendly advice is well-meaning, you might want to talk to your local physiotherapist first.