Sciatic Pain

[naveenedin]

Hello folks,

Let me thank all for your time.

Firstly to the notice of smshaffe, i cud see where u r coming from. i did mentioned that i have cleared his hip and SI jts. He got negative hip scour and SI Shear. I can reproduce his symptoms by adjusting his lumbar spine, and switch off symptoms by easing movts of lumbar spine. i know u mean by easing hip and si joints, and to check if tat eases symptoms. but as i say, his lumbar flexion itself eases his symptoms. He was never able to touch his toes, for a long time( tight hamstring++++). I will add hip flexor stretches, if needed.

If you look at him, he has sway back posture, there is no huge movt of lumbarspine on palpation, he also might be having some associated hip and SI stiffness, as said by sm shaffe. But i am trying to target the first tissue, which makes his symptoms, and also indeed to treat secondary impairments.

To Hallamshire, his symptoms are easily brought by spine ext and rot, when he does service during golf( i feel doing a quadrant action of lumbar spine, is the culprit). How much can he sustain symptom free, by keeping his spine on flexion when playing golf. specifically during service actions of golf. He only had two episodes of sciatic pain. this second episode is worse.

He is doing QL,piriformis stretches, pelvic tillts n gymball. He certainly feels an improvement, but no longlasting effect. He is labourer, not been off work so far. I agree with all you of compensatory impariments of hip and SI, but how can i ease his lumbar spine.

Thanks
Naveen

[Canuck Physio]

Hi there,

I highly recommend taking pictures and/or video of static postural stance, and then during golf swing.

Have the patient uncover themselves enough so that you can see trunk action, and hamstrings, and as many muscles as you can during this activity. You may be surprised by what you find. Then take the same golf swing and ask them to repeat it to their other side (obviously their weaker and perhaps less efficient side), but it will help spot any differences. You may find that along witht he stiffness in the spine, there is rapid contraction of the obliques which may be promoting spasm, or the lat dorsi, which is related across a muscular sling to the hamstrings.

Ideally, stiffness aught to be decreased, but in relation to the type of overload/activity the patient performs. As well this posture also need be taken in reference to the specific movement pattern as Hallamshire mentioned.

Regards