Quite often, Back Pain, Hip Pain & Piriformis Syndrome is caused by excessive compression or strain on the tissue in or about the back/hip. This includes things like the joints in the lower back, sciatic nerve, deep hip muscles (including the piriformis), hip joint, labrum, and the glute tendons. The result is often pain, numbness, or tingling in the buttock, groin, hip, or leg.
In actuality, most of time, stretching things just makes these problems worse! (watch the video below to learn more)
Stretching tissue or compressing it- increases strain and lengthens tissue very temporarily, causing less blood supply and oxygen to get to the tissue. What most people don't realize is that there are likely positions throughout the day that are making these issues worse (or keeping them from healing). Positions that have become habits... Like- crossing your legs, standing with weight shifted onto one leg, or sleeping with the hip in a funky position (falling across body). These positions place strain and compression on tissues around the hip and can often continue to "spark" the fire or knick the scab.
Without correcting these positions, exercises may help, but often- the pain will return. To create a more optimal healing environment for problems like piriformis syndrome, sciatic nerve pain, hip bursitis/arthritis, hip impingement, back problems, or gluteal tendinopathy- be sure to correct day-2-day habits (seen in video above) to create the most optimal healing environment.
Call my office at 484-552-3767 to speak with me directly and to see if you qualify for a complimentary Lower Back & Hip Diagnostic Assessment.
There are two types of leg pain… REFERRED and RADIATING. leg pain… OR BOTH. One is Sciatica- the other is not… but they can feel similar and be felt in the same places- in the back, buttock, hamstring, or calf area.
Referred pain is just as it sounds… pain referred or signals sent from one place to another. So, in the spine- the structures like the joints and discs in the back can send pain signals to parts of the body (other than just the back) into the buttock and down the leg. Depending on which structure is irritated will determine where you feel your symptoms… Referred pain is “non specific” and LARGER in coverage than radiating pain. It is often described as deep and achy and hard to pin point exactly…
On the other hand- Radiating pain often involves irritation or compression of the nerve in the back… often termed as sciatica. Radiating pain takes a more specific path- and is often described as electric, shooting, or burning… you might even feel numbness or tingling.
And because a herniated DISC is the number one cause of SCIATICA many people have BOTH types of pain… which can be felt in the buttock, hamstring, or calf area.
The key to solving either of these is to understand the “TRIGGERS” or the activities, things, or positions that make your back, buttock, leg, or calf pain worse. Once you understand what makes it worse- you can often make it better.
Natural treatment involves using movement as medicine to move the spine and leg in ways that reduce pressure on painful structures allowing your body to heal.
I know- complicated right? Well, if you’re in the Royersford, Limerick, Collegeville, Phoenixville, or Trappe, PA area- and have questions about back pain treatment or need specialized physical therapy- call 484 552 3767 or email email@example.com
Do you or someone you know have sciatica? OR do you THINK you have it? Most people think they have sciatica- when in actually they don't. Truth is, if you're dealing with some form of back, buttock, or leg pain- there's only a 4% chance that it's caused by sciatica. Despite what you've been told (and how it seems like everybody says they have sciatica) it's actually pretty rare. Keep reading or watch my video below to learn 5 telltale signs of sciatica, including one simple 30 second self-test to confirm if you have it.
Now, sciatica is simply an irritation of the sciatic nerve as it runs from the back, down the back of the leg, into the foot. Causes include many things like herniated discs, piriformis syndrome, and spinal stenosis. Common telltale signs that you have a problem with the sciatica nerve (sciatica) include:
1-Feelings of Numbness, Tingling, Burning, Shooting down your leg
2-And these feelings travel down your leg in a very narrow path/band (usually 1-2 inches in width that can be traced with your finger down the back of your leg).
3-And your leg pain is now worse than you back pain.
4-And you have pain below the level of the knee (maybe even into the foot).
5-Stretching the sciatic nerve is painful, limited, or uncomfortable. (watch second half of video for self movement test)
If you've got all 5 of these signs- research shows that there is a greater than 90% chance that you have sciatica as the cause of your leg pain.
The first step to relief is to find out what triggers your back pain, numbness, or tingling and modify or tweak those things. The next step is to use specific movements to reduce irritation on the nerve.
If sciatica is keeping you from doing the things you love (or just keeping you up at night) give us a call at 484-552-3767 and we can help get you back to normal.
Many people with lower back pain or sciatica have pain driving or sitting for too long. In this case, it's helpful to understand why you might be feeling what you're feeling. Watch this video below to learn why most people have back pain when sitting or driving, what 10 second microstretch you could be doing to completely eliminate your pain (and allow you to stand up without being hunched over), and simple DIY changes you can make today to feel immediate lower back pain and sciatica relief. Click the video below to watch...
If you have lower back pain only, start to tweak or modify your sitting position- to see if you can change your lower back pain or leg pain.You could do this first by either slouching or sitting up super tall (rocking pelvis forward so you create an extreme arch in your lower back). You should then ask yourself- do things feel same, better or worse. If slouching makes things feel better- move your seat one inch closer and keep doing that. If slouching makes you feel worse- then try sitting up super tall... and see what that does... IF this helps- do more of this- consider adding a lower back support (small towel roll) behind your lower back while driving. You could also try sitting on a wedge, or tilting the front of your seat down. "Bucket seats" in many cars will cause your knees to be positioned slightly higher than your hips- which often causes your pelvis to rock backwards- resulting in you slouching. Sitting on a wedge or tilting the front of the seat slightly down will help to lessen this. What you'll often find is that changing the position of your spine will change either your back or leg symptoms. If this is the case- GREAT... you've found a switch.
As we know- if something is REPRODUCIBLE it is likely RE-DUCIBLE...
If you primarily have leg pain while you sit (but especially as you drive- because of how your legs may be extended to push on the gas/break...) then you may benefit from doing a couple things. First, move your seat one to two inches closer, or sit on a soft surface (you may find that the surface is a main issue... as sitting may be causing compression/too much pressure on the sensitive structures caused by nerve irritation...In either scenario- the idea is to tweak what bothers you- to see if you can change symptoms or pain... ideally you find a position that gives you relief... so that your pain and problem can start to calm down AND so that you can stop aggravating it every time you need to sit or drive.
Also, consider that movement is your medicine. You should understand that sitting and driving puts you most often in a bent or "flexed" forward position. Many times the spine and nerves can become sensitive to this position and need more of the opposite... and upright or "extended" position.
To apply this concept- try doing 10 standing backbends (I call this a microstretch) before, during, and immediately after driving or sitting for an extended period of time. While sitting- use a small towel roll shoved behind your lower back (at the level of the belt line) to keep you up tall. Every hour- be sure to stand up and take your medicine (10 backbends). This will likely help reduce the stiffness you feel when going from a sitting to standing position. Be sure to end the routine with 10 more backbends after you've gotten up.
Hope this helps.
If you're located in the Collegeville, Royersford, Limerick, Phoenixville, or King Of Prussia area and are struggling with lower back pain or sciatica- but can't seem to find relief... call 484-552-3767 now to speak with a Back Pain & Sciatica Specialist.
If you've ever experienced a pain in the butt- you may have searched around (or been told) that it could be a back issue, hip issue, or piriformis syndrome... and so, I wanted to touch on piriformis syndrome and highlight a trap in the treatment of piriformis syndrome that you could be falling into. This mistake often leads to little progress and prolonged suffering from buttock pain or sciatica...
The single biggest mistake I see people with buttock pain and supposed "piriformis" syndrome is stretching not strengthening...
People in this type of pain are trying to "stretch" their pain away...
They go to yoga, do their own stretches, and think that stretching is the answer to every bodily ache or pain. People are doing "hip openers" and "opening up their chest" or being told to "pull their shoulder blades down and back." And, while there is nothing wrong with stretching, it's making many of their problems worse (rather than better). I've recently told 5 people (in the past week) to stop stretching (like stop stretching COLD TURKEY... just cut it out all together)...
I told them to "STIFFEN UP" instead... and guess what...
Suddenly, their pain started to go away... and instead of stretching (making things longer/more flexible) we began to make things shorter by contracting muscles and strengthening things up.
You might be thinking to yourself- What? That's totally odd and against what everyone else has told me.
Think about it- the chiro cracks your back, the massage therapist works out your knots, yoga twists you up, acupuncture releases your trigger points- all with the goal of getting you to loosen up- or MOVE MORE.
I'll be the first to say... sometimes you just need to MOVE LESS and be more stiff (less mobile)...
A youtube video I created last year is causing a total ruckus on youtube by talking about this concept... and has helped hundreds of people who have been stretching the heck out of their lower back and hips to finally feel relief...
Click the video below to watch.
FYI- this concept applies to people who have chronic neck and shoulder pain and have been "stretching things out" or seeing the chiro and massage therapist for years without relief.
Applied correctly to the right person- this idea can work for any body region where things "feel tight"... and stretching only gives temporary feel-good relief...
And so, if you're in pain and have been "stretching things out" with little to no long term relief then consider that stretching is not the solution... In fact, I say- rock the boat and do the opposite- stiffen up.
Comment below if you're searching for physical therapy in Royersford, Collegeville, Limerick, or Phoenixville, PA and are dealing with any form of pain that has NOT been relieved by "stretching" things out.
Herniated Disc Treatment: Step One- A self question and answer quiz to help you get in touch with what’s going on and help you determine if you have the symptoms of a herniated disc… Knowing what could have caused your back pain, when it started and what makes it better/worse as well as where you’re feeling things- are all super important questions to know and understand.
Once we know the answers to these questions we can start to to get to the root cause of your back pain and begin treatment for you herniated disc and begin specific exercises to get you relief from your lower back pain.
Click the video below to learn how to start healing your own back..
If you live in the Philadelphia or King Of Prussia area- and are looking to get to the root cause of your pain naturally, over drugs, injections, or surgery…
Call 484 552 3767 to learn about our lower back pain treatment program.
While there are many causes of lower back pain- the single most common cause is a herniated, bulging, or slipped disc… however you want to say it, disc problems often cause central lower back stiffness. This stiffness often occurs after sitting, driving, or spending time in a bent over position AND then trying to stand up straight. You may feel resistance or some transitional pain. As you move- you feel better and the stiffness subsides.
Understanding what could be causing your stiffness can be key in treating it. Learning what makes it better and what makes it worse, along with specific exercises can give you relief from your lower back pain.
Call 484 552 3767 if you’ve got lower back stiffness that you’re looking to resolve.
What causes Sciatica? Well, a whole host of things… but the single most common cause of sciatica is a herniated disc. A herniated disc is the number one cause of sciatica because of where the disc is located… and how it is commonly injured.
The purpose of the disc is to act as a cushion between the bones in your spine. Commonly, herniated discs are injured by way of bending, lifting or twisting- which places a bending stress on the spine. This stress places pressure on the front of the disc- causing material inside the disc to move towards the back- putting pressure on the back wall of the disc. In many cases- only the disc is injured… but in some cases- if the disc herniates- then pressure can be placed on the nerves which exit behind the disc.
In most cases- the disc material herniates out the back and to one side… leaving you with pain numbness or tingling down one leg.
Keep in mind, while a herniated disc is the #1 Cause of sciatica- there are many other things that can cause it… be sure to consult with a physical therapist in your town for further direction if you have questions.
If you live in philadelphia, royersford, limerick, collegeville, or phoenixville, pa and are looking to get to the root cause of your pain with natural treatment over drugs, injections, or surgery…
Call us directly at 484 552 3767
Did you know that the biggest predictor of whether or not you’ll have lower back surgery is your ZIP CODE? AND people who have an MRI are more likely to have spine surgery. Even more fishy… if the surgeon who recommends the MRI owns the MRI machine, well- the likelihood of spinal surgery increases 34%. – (Lurie, Birkmeyer et al. 2003).
If you live in the Limerick, Royersford, Phoenixville, or Collegeville area… you’re aware that surgery centers (Rothman) are popping up everywhere. And you guessed it… the more surgeons in your area… the more likely you are to have back surgery- NOT COOL… and straight up wrong if you ask me.
With spinal surgery, especially spinal fusions, on the rise… I can’t help but ask myself- What’s going on? Why not PT 1st…
And, I’d be okay with more spine surgery… if research supported that it was the best thing for people with back pain…
Unfortunately, commercials and many surgeons are still recommending fusions despite growing evidence that suggests spinal fusion is NO BETTER THAN conservative treatment (physical therapy).
Spinal fusions were originally performed to help those with severe scoliosis, fractures, and a condition where the spine is unstable (fusing the bones helps make it stable again)… they were not designed to help people with general back pain.
The only true reasons for back surgery are for problems where your nerves are being compromised… losing function- if you notice severe leg weakness or numbness in your leg that is getting worse, or loss of bowel or bladder function. In these cases, back surgery may be used to restore health of the nerve.
Here’s a video I created that chats about when you need back surgery…
I’m consistently amazed by the number of people who have general lower back pain that are recommended to have injections or even surgery as the first step in relieving their back pain or sciatica. Makes no sense.
So why do people continue to get spine surgery and whose fault is it anyway? 3 reasons that I can think of…
1- People think it will be a “quick fix” to their pain.
2- People/society continues to have a “fix me” vs “fix myself” mindset.
3- Healthcare providers not advocating for or educating their patients as they should (lack of time, insurance constraints, MONEY?!)
The takehome? If you’ve got lower back pain- stay active, be informed about your options, and remember- surgeons do surgery!
If you live in the Limerick, Royersford, Phoenixville, Collegeville, Valley Forge, King of Prussia, or Philadelphia area call 484 552 3767 to resolve your back pain naturally.
1. Institute of Report from the Committee on Advancing Pain Research., 2011)
2. Surgical predictors: Lurie JD, Birkmeyer NJ, Weinstein JN. Rates of advanced spinal imaging and spine surgery. Spine. Mar 15 2003;28(6):616-620.
3. Mannion AF, Brox JI, Fairbank JC. Consensus at last! Long-term results of all randomized controlled trials show that fusion is no better than non-operative care in improving pain and disability in chronic low back pain. Spine. 2016;16:588-50
I’m seeing a trend… and I don’t care for it.
People getting injections for their back pain before they ever try physical therapy! CRAZY… what’s the rush… why cut the lock when you could simply unlock the door… and walk inside? In other words- why do more than necessary…
Quick, but funny real-life story that I think helps represent how crazy getting injections as the first line of defense for back pain really is…
So about 3 months ago, I was pulling a late night in the clinic… it was a long day and I was tired. I was closing up shop… and locked my clinic keys inside the clinic… I had no car keys, and from what I could recall… no spare set of clinic keys. I was screwed…
I called my wife Heather annoyed, and she came to the clinic with a “So what are we going to do?” type attitude. First things first, I asked- “Do you just so happen to have a spare set of keys.” NOPE- was her response…
I said- okay then, we can try the old credit card trick, maybe a bobbie pin to pick the lock, or I’ll pry/cut the handle off (cheaper than calling a locksmith at that time of night… plus, I needed in… and had a full schedule starting at 7 the next morning).
To make a long story short… nothing worked.. and so I began prying the door handle apart… it was my last resort.
Halfway into the process, handle half ripped to shreds… my wife says- “Oh, wait- I HAVE A KEY…”
And just like that, she opened the door.
WHATTTTT- I sat there in disgust trying to channel my energy and find the fun in it…
Eventually we laughed at the silly mistake…
AND NOW- looking back, I think of how unnecessary all that was…
Why would anyone in there right mind know that they could simply “unlock” the door, but instead choose to break the handle off?! HAHA
They wouldn’t… or at least I hope not.
Point being, going to injections as your first step to manage your back pain.. is like breaking the door handle off before trying the key (physical therapy)…
I have a couple issues with and injections for back pain…
Of all these issues… the fact that injections act like a bandaide and cover up the symptoms is a MAJOR PROBLEM…
This leaves many people feeling good temporarily… and they keep lifting, sitting, bending, and twisting all the ways that got them there in the first place…
And then… people wonder why their back pain COMES BACK? It’s a no-brainer… in fact, people should expect it to…
I created a short video that chats about why meds and injections are mostly USELESS in the treatment of back pain (if you actually want to solve the root cause).
So, if you’re scheduled for an injection… and are looking for the best solution for your back pain… call 484 552 3767 or email me directly at firstname.lastname@example.org
Also, if you know of anyone who’s suffering with back pain… and thinks injections are “all that can be done”… could you share this post with them?
Thanks a million,
Dr. Charlie Johnson, DPT