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sciatica or something else?
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sciatica or something else?

Hi, I recently have had pain in the side of my leg and it only lasts about 5-10 minutes and it is sharp and hurts more when I stand. It goes away and is gone for a couple of days then it came back  for about the amount of time. I only have had it twice so far. It is dull and I know it is sort of there and then it is gone the rest of the day. I have a frozen shoulder on the same side with a injury to the rotator cuff and possibly detoid but not a tear. This pain happened after that so i don't know if it is related or not. I do sit a lot. the pain seems to be in one area. So far I haven't had it for long. I stopped my exercises and waiting to see if that helps.
thanks,
Mkh9
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Avatar_m_tn
Hi there, I think we've exchanged posts a few times over on the Back & Neck forum. I wanted to ask you about your Shoulder? Can you rotate it backwards? Reason I ask is, I have a problem with my shoulder and I can't rotate it. I don't know if the problem is nerve related from my neck( I have serious neck problems) or if this is simply a shoulder problem. Any thoughts?

Sorry to hijack your thread!
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Avatar_m_tn
The pain in your leg might have something to do with compensatory mechanisms related to the pain in other parts of your body.  But it is not directly link to your shoulder condition.  This might just be a muscular strain because of certain activities. By the way, what exercises are you doing on your leg that might possibly cause the pain?  Other possibilities include myofascial pain syndrome, nerve compression, vascular conditions, etc. It might also be a radiating pain originating from the back.  In the meantime, try warm compress for 20 minutes done at least 3 times in a day if the pain comes back.  Try some stretching exercise specific to the muscle involve in the leg to reduce spasm associated with the pain.  If the occurrence of pain increases, then you need to consult a doctor for a detailed clinical evaluation.  I hope this helps. Take care!
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Avatar_f_tn
Thanks for the reply. This morning I had pain (more of a dull ache) when I was walking up a small hill under the right buttock of the same leg where I have the pain in the side of the leg.  So that seems to coincide with a sciatic nerve problem it seems. I am doing a lot of different exercises to try to stretch and strenghten my back because my left side of my back has chronic myofascial pain syndrome for the last three years. I walk 45 minutes a day half flat and half hills and this has helped a lot with my pain on the left side. So, I started doing my physical therapy stretches and these are knee to the chest, kegal, stomach tightening, pelvic tilt, hamstring stretch, pyriformis stretch, clam (lay on side knees bent open one knee). Then later in the day I do Isometric exercises, leg lifts to side and front, kick backs where the knee is bent and you kick the knee backwards, leg lifts while sitting, sitting and briging the knee up and kicking straight forward, circumduction exercise , hold onto a chair or countertop, and lift one leg to the side and make a circle with your leg, squats using an exercise ball agaisnt the wall and squats holding a chair or counter and keeping back staight squat. Each of these about 10 reps. I do some arm exercises as well. I also do a step up onto my porch in the morning I do it 40 times starting with each leg. I was atrophied from sitting too much after my injury. I think I tore a ligament at one point because I couldn't lift my left leg at all so it took me two months to be able to get over the threshold to get outside and walk across the street and also to get into the shower. I progressed and finally I am doing well and the pain is down. So now I have done all these exercises plus walking and going to the stores but I don't lift much weight and can't bend yet.  So, it is frustrating and worrysome to have another injury on my right side. I hope it will go away. I am taking a couple of days off from the isometric exercises. What do you think?
mkh9
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Avatar_f_tn
Yes I can rotate the should forward and backwards. I can't lift the arm all the way though. I can only lift it part way about to the top of my head.  I have a frozen shoulder. It takes a long time to go away. If yours is stuck you may have the same problem. Other injurys can freeze up your shoulder. You may want to get it checked when you go in.
mkh9
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Avatar_f_tn
Oh, also I do two set of 10 reps of bridge exercises.
thx,
mkh9
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Avatar_m_tn
A detailed clinical evaluation is needed to arrive at a correct diagnosis.  Remember that sciatica is a symptom of another medical problem, not a medical condition on its own.  Common causes of sciatica include slipped disk, piriformis syndrome, pelvic injury, spinal stenosis, and other possible conditions.  Because sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.

Doing the wrong type of exercise can worsen the sciatic pain, so it is important to get an accurate diagnosis prior to starting a program of sciatica exercises.

It is fine to stop doing the isotonic exercises for a while just to observe if the pain is triggered by the exercise that you were doing or not.  

These are just some of the guidelines in doing the exercises that you have mentioned:  Be sure that the muscle is flexible before you do any strengthening exercise.  For example, before starting pelvic bridging exercise, be sure that the gluteals and hamstring are flexible. If these muscles are tight, doing pelvic bridging might further contribute to the tightness.  Usually tightness of the gluteals and hamstring further aggravates the symptoms of sciatica.  Another thing, when doing straight-leg-raising (SLR), you have to tighten your abdominals first before lifting the leg.  If not, you’ll be putting yourself at risk of lumbar strain or much worse disk herniation, which can also be a factor causing sciatica.  

Try to observe proper body mechanics especially when getting up from the bed. You have to assume sidelying position first before raising yourself up, instead of raising yourself straight from lying down.  Try bending your knees and maintain back in straight position when you have to pick something on the floor, instead of bending at the waist.  Get into the habit of standing to stretch every 30-45 minutes of sitting.  This will minimize pressure on the lower back.

I hope this information will help you. Take care!



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Avatar_f_tn
Yes this helps a lot. I have had two MRI's before this and had nothing at all wrong with my spine. I could have another one done since this was a new problem but I did nothing to injure myself. Anyway, the question Ihat I have is that when you said make sure your gluteals and hamstrings are flexible before doing bridging and hamstring stretches. What do you have to do to get flexible? Should I walk around before doing these or? I am trying to stand up more often and also I do get out bed correctly as my PT showed me how. I can't bend to pick something off of the floor because I hurt myself doing this several times in the past so I do squats but I am not sure when it will be safe to be able to get down to the floor without hurting myself.again. This from another injury to my left side (myofascial pain syndrome  or a muscle strain to start with which then I was injured by two PT's and then I also hurt myself and I think tore a ligament etc.). I have a complicated case. I'm sure you don't want to hear the whole thing. I have been to three PT's and haven't had any luck getting better I got worse- A lot worse. Two of three were doctoral level and one was a bachelors level. So, you see why I am trying to progress on my own. I have a lot of instructions on how to do the stretches and strenthening but don't know where to go from here. My doctor even apologized for sending me to the last PT because he recommended him. It is rare when a doctor apologizes.
There is a PT I like and would like to go but I husband is fed up with them due to the various injuries I have had. I feel lost.
mkh9
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Avatar_m_tn
I’m sorry to hear about your experiences with PTs.  I would suggest you try a PT certified in manual therapy to help you this time.

Regarding the gluteals and hamstring, you’ll be able to tell if they are flexible or not by doing stretching.  If you feel pain and not reach the end range of movement then the muscle is tight. You can also assess the hamstring if it is tight by doing active straight-leg raise. The normal range is at least 70 degrees without pain.  When doing stretching exercise, try to hold the position for at least 15 seconds at end range.  Avoid ballistic stretching!

It would be advisable to engage in warm-up exercises and that includes stretching before you walk.  This will help prefer your muscles to prevent injury.

I’m willing to give an advice to help you. Take care!
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Avatar_f_tn
Thanks, all of the PT's I went to were certified in manual therapy and had their Masters or Ph.D. in manual therapy. So, that wasn't the problem. Anyway, Yes when I do the hamstring stretch I lay on my back and bring my leg up and can only go about 75 degrees when it gets tight. I don't push it. I used to be more tight so I'm improving so I have less pain when I for example get into a dental chair.I am trying to build my normal strength back as I had loss a lot because my doctor told me to stop lifting anything that would cause pain. I was getting pain from almost any movement. I couldn't even walk across the street without pain I couldn't bend enough to wash myself, and couldn't cross my legs in a sitting position. Three years later I am walking hills, and flat combo for 45 minutes every morning going to the stores, but not carrying more than a couple of things at a time, I can cross my legs now in a sitting position so I can put my shoes and socks on and shower. It has been a long road. I was sitting most of the day so I got strophied. So I started with just stretches, then did only what I had been trained to do with the exercises I mentioned , now i can do also the step up into our house 40 times starting with each foot. Then I do isometrics. So, I want to try to continue to improve so badlly a set back is hard for me. I lose strength much quicker than others I think because they have more muscle mass to start with I believe.  I am going to stop the front leg raises as I think those aren't a good idea. What is ballistic stretching? Any other ideas to go forward in different types of ways to get stronger on my own? Of course I have to see if this leg problem is going to go away or not. It was ok yesterday but I did my exercises today so we'll see. I appreciate it if I can ask you quesitons.
thank you,
mkh9
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Avatar_f_tn
p.s. regarding my frozen shoulder. i have several stretches I am doing. most people I know that have had a frozen shoulder  seem to say they got over theirs without PT or they went to PT and it hurt too much and then months later it just went away. I am doing some stretches that are on the website from asos..org (american society orthopedic medicine I believe.). plus the two the doctor gave me. They are all stretches. My family practise doctor just gave me few stretches and said would I be willing to go to PT since I had been injured and I said yes but when I got home my husband said no way. So, I don't know if I have to go to get better or not. The family practise doctor said I have a injury (not a tear since there was no bruising) to the rotator cuff and possibly deltoid but though it was the rotator cuff that is deferring pain to the deltoid area. He said to stretch the area for a month and if not getting better by then to get an MRI. So I'm doing various stretches and the pain isn't as bad as it was though it still hurts of course.
thanks,
mkh9
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Avatar_m_tn
Ballistic stretching uses the momentum of a moving body or a limb in an attempt to force it beyond its normal range of motion (bouncing motion).This type of stretching is not considered useful and can lead to injury. It does not allow your muscles to adjust to, and relax in, the stretched position.   The correct way to stretch a muscle is for you to move the limb in slow motion and when you reach the end range, hold the position for at least 15 seconds before you relax and repeat the process.  Another thing, avoid stretching more than one group of muscle at the same time.  For example, in stretching the hamstring the foot should be pointed downward.   If your foot is pointed upward, you will not be able to stretch the tight muscle (hamstring) effectively.  What happens is that the more flexible muscle (calf) will compensate for the tight muscle (hamstring) resulting to overstretching of the more flexible muscle while the tight muscle is not being stretch.

Unilateral straight-leg raises should only be done if you have a strong abdominals, because you need to contract (tighten) your abdominals to stabilize your lower back before raising your leg, and then when you reach the end range (70 degrees), hold the position of the leg for about 7 seconds before you lower it down to the bed. If you cannot maintain the contraction of the abdominals while holding the position of the leg at 70 degrees, then your abdominals are still not that strong.  If your abdominals are not strong, I would advise doing the basic exercises which are posterior pelvic tilt and partial sit-ups.  Posterior pelvic tilt is done in supine while your knees are bent.  It would be better to place one hand underneath your lower back to serve as biofeedback. Try to contract (tighten) your abdominals and then hold it for 7 seconds before relaxing and repeating it 5-10 times.  You will know if you’re doing the exercise correctly if you feel your hand (the hand place underneath your lower back) being press down while you’re contracting the abdominals.  Regarding partial sit-up, always do the exercise with the knees bent.  You can start by raising your arms at the side of your body, then progress the difficulty of the exercise by placing the arms across the chest, and eventually placing both hands at the sides of the head.  In doing partial sit-up, you only need to clear the scapula from the bed (not the whole back) and then  hold the position for 7 seconds before you return to the starting position and repeat the process.  Continue with the unilateral and bilateral knee to chest exercises, as these exercises will stretch the lumbar extensors. Avoid holding of your breath (especially during the holding of the position) while doing all these exercises to avoid blood pressure from increasing.  These are the basic exercises for the lower back to prevent recurrences of pain.  

Let me just emphasize that not all of the exercises are applicable to all patients with back problems.  Some exercise may actually aggravate the pain if done by patients with other back conditions.  That is why it is always best to consult your doctor before starting any exercises.

hope this helps!

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Avatar_m_tn
Regarding your shoulder, try to apply moist heat for 20 minutes before and after doing any exercise.  Start with gravity-free exercises within painless arcs of motion. Progress the exercises when active inflammation subsided by doing range of motion exercises (antigravity exercises).   Shoulder FLEXION is the forward movement of the arm with external rotation (palm up) upon reaching 90 degrees until the end range, while shoulder ABDUCTION is the sideward movement of the arm with external rotation also (palm up) upon reaching 90 degrees until the end range.  Shoulder HYPEREXTENSION is the backward movement of the arm. Shoulder rotation is done with the shoulder in 90 degrees abduction (less than 90 degrees in painful cases) and the elbow bent at 90 degrees, and then moving the forearm upward for EXTERNAL ROTATION and downward for INTERNAL ROTATION.  You can also try doing fingertip wall-climbing exercises for shoulder flexion and abduction.  Try to hold the position for at least 15 seconds at end range.  This exercise will try to maintain the available range and prevent further limitation of motion.  

Isometric exercises are also very important to prevent muscular atrophy.  Isometric exercise requires contraction of the muscle without any movement. Isometric exercise of the shoulder is practice by pushing an immovable object like a wall.  For shoulder FLEXION, the patient should be facing the wall and then pushing his close hand against the wall, holding the contraction for 7 seconds then relaxing before repeating the process 10 times.  The elbow should be straight while doing the exercise.  For shoulder ABDUCTION, the patient is standing with the wall on his side.  For shoulder HYPEREXTENSION, the patient is standing behind the wall. For shoulder rotation, try to bend the elbow at 90 degrees and then use the other hand in resisting the movement. Resist outward push of the forearm for EXTERNAL ROTATION and inward push of the forearm for INTERNAL ROTATION.  

It would be advisable if you consult a PT for proper demonstration of these exercises.  If the condition gets worse, you need to consult an orthopedic doctor to rule out any other underlying conditions.

I hope this helps!
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Avatar_f_tn
Hi Kurizu,
thanks for your information. I don't know if you would be willing to look at this video on Youtube. It is a video about frozen shoulder and I think is talking about the same type of exericses that you are talking about with shoulder flexion etc. I was wondering if you think these are good exercises to do now in addition to my stretching. I was doing them but then thought well he is just a weight trainer maybe i shouldn't do them. Let me know if you think they are the same as what are you are trying to tell me.

http://www.youtube.com/watch?v=eznYUuwRCqc

I'm doing the wall climbing and trying to keep the height range.
Yes I would probably need demonstration of the isometrics. I'll ask my husband to read what you said to see if he understands it. But is sounds like you are using the wall for counterweight.  When you say if the condition gets worse consult an orthopedic doctor. What am I looking for to get worse, more pain or ? So far I have less pain than when I started. My range of motion has gone down but from what I have read that is normal according to the American Academy for orthopedic medicine you go into freezing stage where there is a lot of pain, then frozen where it gets more stiff but less pain and then thawing stage where it gets more lose and then comes out of the frozen should by itself in 90% or more of the cases. So, I hope that is the case.
Thank you so much.
Mkh9


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Avatar_m_tn
Regarding the video on this link:  http://www.youtube.com/watch?v=eznYUuwRCqc

You can do the exercise shown from 2:30 to 5:40, but with some modifications.  

Regarding the FRONT RAISES, just do the exercise stating with your palm on the side and then raising it up.  When you’re about to reach 90 degrees and above, slowly rotate your palm upward until you reach the end range.  The rotation of the palm is necessary to avoid impingement of tendon upon elevation. The video only showed movement of the arm up to 90 degrees.  I would not advise starting positions with the palm up and the palm down positions.

Regarding the SIDE RAISES, just do the exercise starting with palm on the side and then raising it up.  When you’re about to reach 90 degrees and above, slowly rotate your palm upward until you reach the end range. The rotation of the palm is necessary to avoid impingement of tendon upon elevation.  The video only showed movement of the arm up to 90 degrees.   I would not advise starting positions with the palm facing forward and the palm facing rear positions.

Regarding the movement of the arm backward, start with the palm on the side and then moving the arm backward. I would not advise starting positions with the palm facing forward and the palm facing rear positions.

You can also do the exercise shown from 7:45 to 8:55, but without the resistance.  You don’t need any resistance while doing isotonic exercise at this time.  Our focus right now is to maintain available range and prevent further increase in limitation of motions.

This link shows how isometric exercise of the shoulder is done.

http://www.youtube.com/watch?v=r3XQ2VKNIp0

A lot of times, part of the recovery process, is that you’ll feel some pain so if it really INTENSE then stop.  If it’s BEARABLE, you’re probably doing the right thing.

I hope this helps! Take care!
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Avatar_f_tn
Ok, great
thank you very much! I thought it would easier to show you a video and see if that was what you were trying to explain. I was will add these to my stretches.
mkh9
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