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A typical experience
I had a new client the other day for an 80 minute massage. I asked him if there is anything that he wanted me to know. He told me that he suffers from a herniated disc that he has had for a few years. He has constant low back and right hip pain that at times radiates down the back of his leg to his knee. He told me that he has had two injections in his low back and has to stay on anit- inflamtory medication. Anything to avoid surgery. The pain is always there. I asked him if he ever saw a chiropractor for his pain. He said yes. But the adjustments hurt his hip so bad that he could not continiue. So here is a guy that thinks he is on the verge of surgery. I knew that there was a very strong probubllity that was not the case. The vast majority of pain people experience is nocioceptive pain( soft tissue- muscle, tendon, ligament, facia). MDs and Chiropractors see pain as neuropathic pain( nerve pain). With that asumption they give the wrong treatments and therapies. Now there is no denying that at times injections and surgery is needed. Not denying that. But most of the time - NOT. 70% to 85% of all pain comes directly from trigger points. Anyway I showed my client a testimonial from a client that I was able to help out of a very painful condition that she had delt with for a couple of years. I showed him that testimonial because all pain has a psychological eliment too it. I wanted him to start thinking maybe he is not on the edge of surgery. I palpated his entire back upper torso, both hips, and right leg. I found a very painful spot on his right L5 erectors. Another very painful spot on his right greater trochantor. A painful spot in the middle part of his lower right hamstrings. And also a tender spot on the right spinous of L3. I knew that if Iwas able to eliminate all those painful palaptory spots that I would most likely eliminate his pain problem. Because a healthy body had no painful spots even with deep massage. Ive been hunting and eliminateing trigger points for thirty years now. He walked out of the massage room pain free. He was pain free for the first time in years. All those other professional people misdiagnosed him because they assume neuropathic pain over nocioceptive pain. I assume the other way around. I'm a Massage Therapist.
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Permalink Reply by Gordon J. Wallis on
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Nine muscles. And there can be even more muscles involved. And the other weird thing about this is. Most of these people diagnosed with sciatica, were never palpated. " What is simple is simple seen....And what is simple is rarely understood. " - from the KUNG-FU tv show of the 70s.
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Permalink Reply by Gary W Addis, LMT on
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The pain caused by entrapment of the sciatic nerve isn't fake: it is very real. So, to me, it ain't fake. DCs, and MDs always blame sciatica pain on the spine. But the spine is seldom the culprit. Examine the two sciatic nerves, where they originate as individual strands branching off the descending nerve plexus within the protection of the spinal column. Outside the vertebral column, on each side of the column, these branches wed to form two thumb-sized sciatic nerves.
Each hip and leg gets an entirely separate sciatic nerve. If the entrapment occurs within the spine, both hips and legs will be affected, will suffer excruciating pain. That seldom happens. Almost all sciatic pain occurs in only one hip and leg-- therefore, spinal entrapment cannot be the cause. Therefore, the cause has to be muscle entrapment of that side's sciatic nerve; the culprit is usually the piriformis muscle. THE cause is almost always trigger points in one or more of the muscles within the hip
Gordon J. Wallis said:Another client came in with long term sciatica. I'm talking years. I think she told me two years, can't remember. But of course it was fake sciatica as usual. Of course she has been to all the usual players. I think that's the most misdiagnosed pain syndrome on the planet.. At least in my experience it is. I almost think now I could run a busy practice just on sciatica alone. The problem is people that think they have sciatica most often run to medical doctors and chiropractors.. Get scanned and anylized. The practioners find arthritis or a narrowing or bulging of discs and think that's the cause. Not even checking for trigger points. Hence the person with the pain thinks they have a serious problem, not just a painful one. And go on with these endless therapies that render little if any help. Or get painful injections that are expensive and render no long term relief. They can also get therapy that actually perpetuates the trigger point pain. I feel as though I know top secret information or something.. And even when I tell people about it. It still remains top secret? The client today was surprised when her sciatic pain vanished. I don't really have a web page presence, or a Facebook. I'm on here all the time..but.. I should get a little more internet media savvy and just advertise my self as specializing in sciatica elimination. I remember the surprise on one clients face when she asked me if I could do anything for sciatica.. And I said, yea, I can cure it. Of course if they really had sciatica, I couldn't . But that would be so infrequent.... The one out of 20 times that happened , I could score points by reffering them to an Orthopedist or something. Hmm,, Just thinking out loud. Anyway, I will post several attachments that make up what really is most sciatica on the planet. You've seem em before. But everything I say in here is the same thing over and over and over again. I could have called this thread, "THE BROKEN RECORED". But then, people not old enough, might not know what that means?
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Gary. A disc can bulge or leak out on one side, and cause sciatic pain down one leg. I'm trying to remember if I have ever seen anyone with Piriformis syndrome? I can't recall. But I have seen trigger points and fake sciatica almost weekly, monthly for sure, for twenty years. I have had people tell me that they have Pirifomis syndrome. But it's still just trigger points in the Piriformis and leg. I guess I have not seen real Piriformis syndrome? Piriformis syndrome is when the sciatic nerve is pinched by the Piriformis muscle.
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But yea, the medical docs and chiropractors always blame it on the discs. It's just so weird to me? Nine times out of ten, it is not. But ya know what. Lots of massage therapists don't know that either. Or physical therapists( except perhaps the ones that do soft tissue work).
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http://abbottcenter.com/bostonpaintherapy/?p=3447
This person knows the truth.
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The sciatic nerve doesn't become the sciatic nerve until it is a couple of inches out of the spine; inside the spine what becomes the sciatic nerve are nearly microscopic strands that come out of several vertebra. So, respectfully, my friend and mentor Gordon, IMO, it ain't sciatica if the entire sciatic nerve isn't involved. And, imo, that would require that the sciatic nerve (which is formed after all the little nerve strands have escaped the spine) is compressed by a skeletal muscle. Since the thumb-large sciatic nerve passes through the hip directly behind the piriformis, when it develops trigger points, the pain sent through its ipsilateral hip and thigh can be excruciating.
The nerves that make up the sciatic nerve come out of the bottom two lumbar vertebrae (L4 and L5 and the top three sacral vertebrae S1, S2, and S3). In the posterior thigh, the conjoined sciatic nerve separate to form the tibial and the peroneal nerves. So, technically speaking, if the pain extends into the calf or foot, it isn't sciatica. But you have taught us that a tp in, say, the neck can often be released by manipulation of the back of knee or the sole of the foot. So, nothing I've said should be written in stone. :)
Gordon, again in my own personal opinion, if the pain runs down both legs and possibly all the way to the feet, then, yeah, a vertebral subluxation is probably at fault, and almost certainly above L4. But if the pain occurs in only one hip and thigh-- IMO only-- the cause has to be myofascial trigger points.
Gordon J. Wallis said:Gary. A disc can bulge or leak out on one side, and cause sciatic pain down one leg. I'm trying to remember if I have ever seen anyone with Piriformis syndrome? I can't recall. But I have seen trigger points and fake sciatica almost weekly, monthly for sure, for twenty years. I have had people tell me that they have Pirifomis syndrome. But it's still just trigger points in the Piriformis and leg. I guess I have not seen real Piriformis syndrome? Piriformis syndrome is when the sciatic nerve is pinched by the Piriformis muscle.
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At any rate. I can remember only one client, maybe 15 years ago, that had pain running down one hip and leg that was not trigger point pain. He had no trigger points what so ever. The pain was mostly in his hip though. . And I myself had a bulging leaking disc several years ago that effected my entire left hip and leg. All the way down to my foot. Although the worst pain was in the low back, hip, and groin. That fluid in the discs is quite caustic, and leaks all over the lumbar area irritating those small nerves. I had no trigger points. The pain was nauseating. Luckily for me, I had no insurance at the time or I would have gotten surgery. It took me 14 months to heal, but now I'm fine. I hate to think how I would be now if had I gotten the surgery? But reguardless of what sciatica is or is not. In my experience it's most often trigger points. You've seen this video before. She is now pain free. She had trigger points in her hips and leg on one side. She was told it was pinched nerves by a medical doc.
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it's 6pm here in central FL and still 89 degrees-- and really humid. A chiro will always claim a pinched nerve, an MD always is gonna pick up a needle. I could sure use your help with my shoulder, it hurts even hanging down not doing anything. I think it might be biceps long head tendon strain.
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