Twist Stretch Beats Low Back Pain

Another great stretch for the low back and hip regions is the twist stretch.  A bit different than your typical piriformis stretches, the twist stretch hits the piriformis, glutes and lumbar spine erector spinae (or paraspinals).  Because of this, the twist stretch is great for relieving low back pain, hip pain, piriformis syndrome, and can even help in some cases of sciatica.

Watch the video below to learn the best technique for doing the twist stretch.  The key that you must remember when doing this low back stretch is to keep your lower back straight, so sitting up straight before twisting is imperative.  If you fail to do this important step, you do risk the potential for injury.  I find this point so important because I observe many people at the gym doing a twist stretch with rounded backs.  Listen, if you want to come see me as a herniated disk patient, then twist with a rounded back.  But if you would rather fix your low back pain, then twist with a straight back--simple as that.  Have fun twisting.

Piriformis Stretches: Relieving and Preventing Low Back Syndromes

Low back pain, hip pain, butt pain, sciatica--these are all conditions that can occur as a result of a tight piriformis muscle.  But it doesn't stop there.  Gait abnormalities, hip bursitis and knee pain can also result as secondary disorders related to a tight piriformis muscle.

Stretching a tight piriformis is imperative to prevent these conditions from plaguing you.  And if you've already got some of these problems, after you see your friendly neighborhood sports chiropractor, you'll probably need to stretch your piriformis to bring length to the muscle and help open your hips sufficiently.

In the video, I demonstrate three excellent stretches (really two, with one version having two variants).  Start with the first one--lying on your back--if you are very tight OR you could even do that same stretch while sitting in a chair (although I don't demonstrate that version in the video).  You can try the other two variants if you have a little more flexibility.

Play with all three to see where you currently are, and then work at that level for two to three weeks.  Once you've mastered your current level, you can move on to the next.  Have fun and happy stretching.

Conservative Care First

Low back pain is the fifth most common reasons for physician visits in the U.S.  One third of them report persistent back pain of at least moderate intensity one year after an acute episode, and 1 in 5 report substantial limitations in activity.

Sciatica--a painful nerve irritation--can accompany low back pain and can sometimes be present on its own.  Sciatica and low back pain together very often result from disc herniation, predominantly in the lumbar spine.

Several treatment options exist, but which ones are most effective?  A 2010 study set out to determine the efficacy of two of these treatments--chiropractic adjustments or surgery.  Forty patients were chosen through elective referral by primary care physicians to spinal neurosurgeons.  Patients were chosen on the basis that they had already failed at least three months of nonoperative management including treatment with analgesics (pain killers), lifestyle modification, physiotherapy, massage therapy, and/or acupuncture.

The patients were randomly split into two groups: those to receive chiropractic adjustments and those to receive microdiscectomy (surgical removal of the herniated disc--cool video here).  Crossover to the alternate treatment was allowed after three months.

Researchers found significant improvement in both groups.  Hmmm...so, by this study, chiropractic and disc surgery were better than pain killers, lifestyle modification, PT, massage and acupuncture to relieve chronic, stubborn sciatica.  Okay, I'll buy that (well, I am a chiropractor, you know?).  But which one is better?  We've gotta have a 'better', don't we?

The results showed that the two treatments came out exactly the same for all outcome measures for the majority of subjects one year post-treatment.  However, eight patients did crossover from chiropractic to surgery, while three crossed over from surgery into chiropractic.  The three that did not benefit from surgery failed to benefit from chiropractic as well.  The eight chiropractic-didn't-work-for-me crossovers, however, did benefit from the disc surgery...and get this...they did so to the same degree as their surgery-first counterparts.  Dang--now that's a good study!

Here's the take home: When dealing with chronic sciatica due to herniated disc, try chiropractic first, period (authors believe first line should be drugs, physical therapy and lifestyle modification...but I don't).  If the chiropractic doesn't work, go ahead and get the surgery (although I still think I would try chiropractic, rehab and orthotics [if foot dysfunction present] seriously for at least one year before making that decision).  If you do it this way, you won't hurt yourself  (at least within three months) by waiting on the surgery--you will still likely benefit as if you went surgery right away--AND if chiropractic works for you (as it did for a majority in the study), you'll be better off physically and financially, because remember, you'll never be the same or better following a surgery, and microdiscectomies aren't cheap (unless, of course, you are lucky enough to live where there's socialized medicine, and then somebody else will pick up the tab).

Finally, if you decide to get the surgery and it doesn't work for you (10-20% failure rate), understand that there's no going back--chiropractic probably can't help you then.  Get it?  Good.

Foot Dysfunction Captured on Tape

I often have to explain overpronation to a number of my Los Angeles, Beverly Hills and West Hollywood chiropractic clients.  I have finally found a video (please see below) that does a great job illustrating what happens to the feet during the gait cycle when overpronation is an issue.

Overpronation is an excessive turning out of the feet (to be more accurate for you doctors out there--pronation a combination of eversion, abduction and dorsiflexion).  Pronation is a natural movement that we all do (or are supposed to do, anyway) during the toe-off phase of the gait cycle (walking).  Pronation is necessary to launch off our big toe in order to take a step.

Overpronators, then, turn their foot excessively causing a chain of events occurring up the foot, leg and thigh, and eventually into the back, which can lead to excessive wear and tear on joints and cause pain.  Some common maladies attributable to overpronation are:

• foot pain
• plantar fasciitis (burning heel pain)
• tight calves
• shin splints
• knee pain
• meniscal tears
• tight iliotibial bands (leading to outer thigh and knee pain)
• tight hip flexors
• sciatica
• low back pain
• and more

The real way to correct overpronation, and thus prevent any of the above issues from becoming chronic and leading to breakdown, is the use of custom-made orthotics.  Despite a current trend toward believing (hoping?) that barefoot running is the solution to all foot dysfunction, low back pain, goiter, syphilis and every other malady of the modern world, I can assure you I have seen nothing better for resolving musculoskeletal problems caused by overpronation than orthotics (and, believe me, people have been trying).

Watch the video below to get a clear picture of what is happening during overpronation.

Piriformis Syndrome: Pain in the Butt

Buttock pain has many sources, none more irritating than piriformis syndrome.  Piriformis syndrome is a condition of a tight, inflamed piriformis muscle that clamps down on the sciatic nerve.  Piriformis syndrome, then, can lead to sciatica, a sharp, burning electrical pain down the leg and sometimes into the foot.

Piriformis syndrome needs to be diagnosed by a doctor--preferably a sports chiropractor, since you can get diagnosed and treated in the same office.  There are, however, some things that can be done at home to alleviate the symptoms.

Watch the video below to get some tips on how to take care of your own hip or buttock pain caused by piriformis syndrome.  Or you can also read the article here to learn more about piriformis syndrome

Hip Stretch brings Sciatica and Low Back Pain Relief

Low back pain, hip pain and sciatica can result from a tight piriformis muscle.  The piriformis runs from the sacrum (tailbone) to the femur (thigh bone), and is an external rotator of the hip.  Its function is essentially to prevent the inward collapse of the leg during walking.  It can become tight from lack of stretching (most common), overuse (especially with an overpronation foot dysfunction) and pregnancy.

Because the muscle crosses the sacroiliac joint and sits atop the sciatic nerve, a tight piriformis can cause low back pain, hip or sacroiliac pain, and sciatica.  If you've never had sciatica, consider yourself lucky, because it is characterized by a sharp, electrical, burning pain that shoots down a leg, sometimes to the foot, causing numbness or tingling.  Sciatica is not a pleasant situation and can be quite unnerving for the sufferer.

For sciatica caused by a tight piriformis muscle (as opposed to one caused by a herniated disk), you can try a simple stretch at home to get relief from the numbness, tingling and hip and low back pain that you might be suffering.  Watch the video to learn the best low back pain exercises and stretches available.  And while you are on the floor, pick up your phone and call your local sports chiropractor today.  If you work or reside in Los Angeles, Beverly Hills or West Hollywood, chiropractic can be found a phone call away at 323-651-2464.

West Hollywood Chiropractor on Orthotics for Back Pain

Low back pain can be caused by a number of things, but one of the most common disorders I see in my West Hollywood sports chiropractic office happens to be a gait dysfunction. Our gait--or the way we walk--is dependent on a number of factors, one of which is the structural make-up (or breakdown) of our feet.

One such dysfunction is called overpronation, which is an excessive turning in of the feet during the gait cycle. Overpronation is usually the result of flat feet or collapsing arches. This excessive turning in causes a dysfunctional chain of events up the legs and to the low back. Some common symptoms, along with low back pain, are shin splints, sciatica, tight hips, and poor posture, among other things.

The answer to low back pain caused by overpronation is to have custom orthotics made for your feet. We cast orthotics in my West Hollywood chiropractic office, and within two weeks you'll a comfortable and effective pair of shoe insert arch supports that are made specifically for your natural arch.

Please watch the video above to see overpronation in action, and a sample of custom-made orthotics. If you are having low back pain and you suspect that your feet may be part of the problem, please contact your local chiropractor today. If you are in West Hollywood, Beverly Hills or Los Angeles you can contact this chiropractor and we'll evaluate your feet so you can kick low back pain to the curb.