Monday, September 12, 2011

Sciatica Pain Management

Oh My Lower Back!
I have never heard of this term until a friend mentioned to me about two weeks ago when i had severe numbness just from running a short 20km distance. The numbness to the feet, where the feet felt like it will explode was not a good feeling and it came again when i ran 15km yesterday along the usual running route.
Sciatica is a term used to explain the pain caused by the compression/injury to the L4 and L5 vertebrae. It is also known as lower back.
A Vet friend sort of confirmed the symptom again yesterday morning and it has set me out to understand the condition a bit better.
I first had this pain about a month to 6 weeks ago. Coupled with severe upper back pain where i felt numbness in my fingers and gastric due to (previous) work stress.
Fortunately, my medical examination came back as "GOOD".
Somehow we (i hope i am not speaking generally) that does sports are often in denial about our health condition until sometimes, it's too late.
So, where do i go from here to explain to you readers what this L4-L5 spine and this sciatic nerve does without sounding like i am a medical expert just after ONE day of research?
So, Sciatic-iously
Sciatic nerve is the longest nerve in the human body which runs from the lower back all along the back of your leg to your feet. It usually effects only ONE side of the body. If both sides are effected (which is rare), it's called bi-lateral sciatic. I do not have this and it is right now effecting my right leg.
I looked at my running shoes and noticed severe wear within the last two months on the left side. It tells me that i am putting more weight on the left side to off-set the right side when i was running. While no human has the same leg length, i am very sure both my legs are within the tolerance limit of "defectiveness" as created by God.
I am writing this while my right legs are numbing up from some stretches i just did to manage the pain. I can now vouch that sciatic nerves effects the movement and feeling in the entire leg, including thighs, knees, calves, feet and toes.
I had exactly the said parts of my leg freezing up and numbing up as i ran yesterday. It wasn't funny and it was frustrating.
Those of you that run would know how frustrating it can be. It is like having a "waste of time" workout; the lung felt it still has liters of air. The heart felt it has not surpass the 50% effort. But the leg felt like it weigh a tonne. It just refuses to move the way it should.
Sciatica describes the feeling or symptoms of pain, weakness, numbness, pins and needles feeling and even like how i felt - a lost of control over your own body. It is not a disease. It is a pain that radiates from the lower back or butt, all the way down to your feet.
You will feel the pulsating effect as it synchronise with your heart rate.
Mine is running at about 60bpm now as i am typing this.
What causes it?
I went to a chiropractor about 3 weeks ago as i could not stand the pain on my upper back and lower back. I was told my lumbar section C3 and C4 is out of alignment and my L4 and L5 is "pretty out of shape".
The famous alternative medicine praticioner at Seapark Petaling Jaya treated both at the same time, spending likely to be one of his longer session per patients. The misalignment on C3 and C4 caused my right arms to be numb and has no strength. Nerves were pinched as the "burden" of the shoulder collapse onto the spine. In other words - bad posture due to endless hours in-front of the laptop at work.
I used to think that being given a laptop at work is a privileged and a recognition. It says "you are important". Along with it comes crunched up shoulder to try to squeeze yourself onto the tiny 14inch space. You will be lucky if Carpal Tunnel Syndrome (CPS) don't get you first.
Along came the L4 and L5. It is a common occurrence according to Mr. Chong (the Chiro). He told me it will take at least two or three session to fix it. Again, bad posture, carrying heavy items (read : Ryan and Nadia), bad ergonomics and possibly a mattress that is too hard or too soft will effect the spine as well.
Simply said - Sciatica is caused when the sciatic nerve are being pinched, compressed etc by perhaps a deteriorating spinal bone or possibly a bulging disc as well. Full medical examination including MRI scan might be required if the condition gets worse.
I was also told to exercise more by Mr. Chong. If only he knew.
The Treatment
I bumped into Jamie Pang at Bukit Aman carpark after a run yesterday and i told him about my pain and how uneasy i felt. With him as a senior runner which was introduced to me, and was said to had the same problem. He explained to me on doing "spine exercise".
When i was doing bodybuilding eons ago, i love "good morning exercise" and dead lift. 300kg on the dead lift and slightly more for shrugs were "not an issue". I thought it will be sometime before i will have any "back problem". I had a thick back. Ever since i turned into more of an endurance junkie, i started shedding away those weights; and i forgot that i have shed away those muscles too.


Plus i was not getting younger. OLD people DEGENERATES.


I was a hefty 90kg Second Row Forward when i was playing Rugby for my Alumni. I could throw a 70kg player up to win a line-out. Nowadays, lifting Ryan or Nadia at 20-odd kg felt i would break my back. Not nice.
As i research into more ways to fight this inconvenient pain, bearing in mind the options for possible surgery, i became even more aware of my body.


The tingling on the little toes that i never knew existed except the pain caused by ingrown nails.


The stretch i never knew at the Achilles.


The burn that comes faster than relatively fast car as i run up an incline.


The numbness and pain i never felt from my butt, along my hamstring, knee, calf and feet.


And i blamed my worn out Lunarglide.


Here are what i read that could possibly do good for your spine, and perhaps, save you readers that is reading this entry a possible reprieve from Sciatica.


Stretch.


Yeap. Stretch. That was what the "Doctors Online" recommend. I believe that was what Mr. Chong meant. if you are not active and has backache, perhaps the easiest solution is to get active.
if you are active, perhaps, the best solution is to stay injury-free by stretching.


Sciatica Stretch #1 - Hamstring stretch
I have never stretched my hamstring. I thought i had flexible supple hamstring as i used to be able to perform split when i was an Taekwondo exponent. I could do spinning split kick - hitting a target twice as i jump and spin in the air with both my feet stretched out in split.
Key word here was USED TO. Guess reality hits hard.
For this stretch, you lie down flat on the ground. Slowly bring one leg up to your chest, hands behind the knee. Now, extend the leg slowly and straighten it. Feel the stretch at the back of the leg.
If your hamstrings is as tight as mine - your legs will shiver and shake as it tries to keep up with the stretch. Hold it for a count of 10 and work towards 30 second. Do not bounce the stretch and hold out as smoothly as possible.
For extra deep stretch, consciously push your toes down towards you so that your feet is like planted on an imaginary ceiling.
I felt immediate numbness from my hamstring to all my toes. The pain radiated from the hamstring and travels slowly towards the end of every toes.
Do it twice a day for as many reps as you can possible performs.
You can do this in the office as well when you sit down - depending on your level of flexibility, you might need something to elevate your heel as you stretch. Keep the leg straight under the desk with the heel as the pivot point. Now, move the body down towards the thighs and feel the stretch. It will not be as effective, but it is a stretch nevertheless.
Sciatica Stretch #2 - Pelvic Lift
Lie down flat with your feet shoulder width apart and knee bent. Lift the pelvic up and hold for 10 seconds. Work towards 30 seconds. Aim to complete 2 sets of 10 reps.
I did this and Oh-My-Gawd i never knew my pelvic and core muscle is so weak despite all the exercising! Needless to say, i broke sweat in a 24degree C room.
This exercise is good too, as it works your Kegel muscle. You will then have a stronger sphincter muscle to hold the shit in should you be stuck in a jam and not drive like an @$$hole. ;)
Sciatica Stretch #3 - Curl Up and cheat on those Crunch.
Assume sit-up/crunching position i.e. lie down flat per Stretch #2. Now, lift the shoulder up slightly and hold it there. It is like a crunch but not a full crunch. At best it's lifting the shoulder up by a couple of inches. This position helps to maintain a proper lower spine position and strengthening the core to support them.
Now, you finally found the "cheat" should your gym mate or instructor commented that you did not do your crunch correctly. You can always tell them that you are exercising your spine. ;-)
I did this and i believe my abs will be more defined as the pain caused my those misaligned L4 and L5 improves.
As usual, do it for 10 seconds and build towards 30 seconds, 10 reps and 2 sets.
What's Next?
I will continue to research more and find out ways to deal with the pain. As a few friends tell me, it will not heal 100%. From now onwards, it is learning to deal with the pain. Just because you are actively fit, doesn't meant it will not hound you. In fact, those i spoke to about this pain and those that told me about this...they are all accomplished athletes in triathlons, adventure racing and running!
if you do not have these pains, count yourself lucky - but do consider to stretch those spines so that you can continue to be able to do the sports until you are 80!



4 comments:

  1. Thanks for sharing. I have similar episodes but not the degree of intensity like yours. Strengthening the core muscles helps greatly. You may want to look at the Piriformis muscles and its relationship with the sciatic nerve, google 'Piriformis Syndrome'. Do update on your recovery.
    Take care.
    rgds, Simon T

    ReplyDelete
  2. Simon T - thanks. wifey is asking me to re-consider Yoga. I went for a couple of classes before and i tell you...it's tough.

    I will read up on piriformis and see what i can get from that.

    ReplyDelete
  3. Hi,

    Since am having the same injury, am taking a 6 weeks total rest. only doing stretching & strengthening exercise. hope it works & come back stronger in 2013

    ReplyDelete

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