Is it truly sciatica? Could the pain be something else?

 

Soft tissue mobilization

 

I mentioned other tools in our tool kit. Soft tissue mobilization is one of our favorites. We love these techniques because they give excellent results, and results are what we are all about. Back pain tends to be multi-factorial, not just caused by one isolated thing. More often than not the soft tissues: Muscle, tendons, ligaments and especially the fascia are involved.

One case that stands out in mind is from a few years ago while working in a more rural setting. Our patient Dan, who was about middle aged and spent most of his days working on his feet, came in complaining of what at first glance appeared to him and all his friends and family to be “sciatica.” Many of us have heard of someone who complains of their “sciatica acting up” or just mentioning their “sciatica.” Well this case proved that symptoms of pain going down the leg with numbness and tingling can be caused by different things and that a proper diagnosis by your health care provider is essential. 

Back to Dan’s story: After careful examination, it turned out that all the tests that would point in the direction of sciatica were 100% negative. Dan did not take this news well because he was convinced that “sciatica” was his problem. What we did find upon our examination were “trigger points” in the gluteal region (small tight spots in the muscle,) and severely tight leg rotator muscles. He also had very tight hamstrings and hip flexors, while his gluteal muscles were weak. Even though Dan was a bit skeptical of our diagnosis, he was a trooper. He hung in there while we used different soft tissue mobilization techniques on his gluteal region, as well as on other areas where the muscles were tight or had trigger points. 

Within a few visits, he was able to report that the numbness and tingling down the leg had gone. A few treatments later he was able to better pin point exactly where the pain was coming from, and lo and behold, just as we had predicted, the pain was coming, not from the low back as he had first identified, but from the gluteal region. This story ends as you might be expecting. In a few more visits, our friend Dan was virtually pain free. This was very meaningful for him because he could work at his job without pain, he could do his personal care routine without assistance. Things like putting his boots and socks on in the morning no longer posed a challenge. The one thing I think Dan appreciated the most, was no pain while lying in bed at night.

Another quick example of soft tissue techniques at work: I have a colleague who is an avid runner. Let’s call her Avia. She was not your typical low back pain patient. She was in her very early 30’s, in great shape, had great nutrition, and seemed at first glance to be practicing all the things that we all teach our patients. But she had bad hip and knee pain which we both agreed was from not stretching before her runs. She had developed a tight IT band and TFL. We used instrument assisted soft tissue technique on the outer portion of the leg with recommendations to continue at home with use of her foam roller. Before long both the hip and knee pains were a thing of the past. Now she remembers to foam roll before she runs and has not had a recurrence of her initial complaint. She has run in marathons since with no associated negative events.

There are many soft tissue techniques. Among our favorites are instrument assisted soft tissue techniques, where we use a special type of tool to get deeper into the soft tissue than one might be able to with just the hands alone. Some other soft tissue techniques involve actively or passively stretching and contracting muscles, or moving them through certain specific ranges of motion in prescribed patterns. We like using kinesiology taping too. It may or may not fall neatly into the soft tissue techniques category but we get great results using it. If you are wondering what kinesiology tape is, think back to the Olympics when all those athletes had brightly colored tape all over their bodies. We have found that for many patients with muscle spasms and cramping, the tape works wonders. 

Another favorite is the foam roller. When used properly by patients on their own at home, we have noticed dramatic improvements in soft tissue complaints. The key here is: just like anything else - when used properly. As I explained earlier on, my background is science and so I am always looking for the evidence to support using something in practice. The good news is that studies show that foam roller use is effective.  A recent study even showed foam rolling to be more effective than stretching! I’m sure more studies are needed in this area but the preliminary evidence is definitely encouraging.

 

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 #BePainFree - The Five Causes Of Back Pain And The Seven Keys To Lasting Relief

Regards in health,

Dr. Davia H. Shepherd

Saporito Chiropractic

 *Disclaimer: Please remember that it's impossible for me to diagnose you and treat you just by you reading one of my articles. I'm superwoman it's true, but even that is beyond my capabilities. So before you engage in any health and wellness activities, do consult your health care provider. Please know that we are happy to address your personal concerns, just call us in office to schedule your personal consultation; and thanks ever so much for reading. We appreciate you.