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80% of adults suffer from back pain, so I assume this is a concern of meditated for many. Chiropractic as a physician, my thinking perhaps a little biased, but my intention with this article is to present useful information for those wishing to make intelligent decisions about their care back. I'm not anti-medical and medical patients are often called or orthopedists (aka: orthopods) when considered in the best interests of the patient. As a matter of fact, I was one of a handful of chiropractors who experienced hospital privileges for chiropractic spinal manipulation under anesthesia. So, I have worked successfully with and helped to educate the members of the medical profession about the benefits of chiropractic.Quality, competence and humility of doctors To answer the question about chiropractor vs orthopedist, will begin my answer by saying really depends on the doctor and his willingness to be open about what is in the best interest of the patient (s). I believe that both types of doctor could be a primary care physician for excellent diagnosis the of back pain. Physicians in General should be aware of its limitations and understand that they are the panacea Omega for all types of conditions. Long as they have the humility, and are known for being competent diagnosticians, their patient (s) should be in good hands. A tenant of the health care profession is "do no evil" and there is worth much in this simple phrase. Practitioners or profession are trained to use a familiar treatment protocol. In other words, I often make surgery orthopedic surgeons and chiropractors as physically manipulate the spine. However there is no guarantee that the conditions of a patient gives one of such treatments. Sometimes, the treatment needed is as simple as applying ice and electrical stimulation of muscle to a mild strain of the back. The prudent doctor offers a listening ear like a Gentile and technical competence. Only with a complete history and a thorough medical examination will be able to make an accurate assessment, suggesting so the next step in the process of decision of doctor--"treat, or do I mean?"Physician to make a diagnosis is not always the best doctor for treatment I hear you say: "what is it that you're not, you're down on up."
I think it's important for medical advice of any kind to have knowledge of alternative treatments that are outside the scope of its practice. date this knowledge and an open mind, prudent recommendations are likely to be imminent.
The back with the competent doctor of correspondence
Most cases of back pain do not require surgery and often better are handled by a chiropractor. However, it is good for people suffering from backache know what cases are mostly likely to chiropractic care, as well as those which often require the assistance of an orthopedic surgeon or perhaps a neurosurgeon. the chart below should be helpful.
Pinched Nerve (with downhill on foot or drag)
Pinched Nerve (with only numbness or pain)
Herniated disk (with knee pain or numbness partir)
disk broken (pain extends below the knee; weakness)
neurological or soft tissue tumor
arthritis or degenerative disc
infection or swelling puffy hot with or without fever
back pain with loss of bowel or bladder function
DEFINITION Back Strain is defined as an injury to the muscles and tendonous tissues of the back. By definition, it excludes injury to ligaments and joints that is more correctly denoted as a "sprain" .the term Back Strain is the most common diagnosis questionable for back pain of acute origin when a more finely tuned diagnosis can not be derived from the presenting history, symptoms and clinical signs. Physicians are quick to lump the majority of patients into this category of diagnosis. Ironically, they won't really be wrong because almost all back injuries will have "back strain" as at least one component of the injuries. However, a prudent examination should be utilized to rule out more severe and complicated injuries like Sacro-iliac Sprain, Facet Syndrome or Lumbar Disc Herniation. With inadequate care or repetitive use, even a very mild acute back strain can turn chronic. ACUTE BACK STRAIN CAN LEAD TO CHRONIC BACK STRAINAn acute back strain is one that is of recent origin and often has never occurred before. It is most often brought on by an incident. Pain is often sharp, burning, stabbing, pulling and/or intense. It has a probable prognosis of being finite or coming to an end. Application of an ice pack or cryotherapy is one of the treatments of choice. chronic back strain is one that persists with some level of discomfort over a long period of time. A chronic strain can at times become an acute episode, sometimes for no apparent reason. Pain level is usually, but not necessarily less intense than an acute episode and is often described as stiffness, limited mobility, arthritis or fatigue. Application of moist heat packs is one of the treatments of choice. PULLED MUSCLE OR MUSCLE SPASM? The term Back Strain is often associated and used interchangeably with the term pulled muscles. It may be interesting to know that a pulled muscle rarely occurs with the onset of back pain. The Erector Spinae and Quadratus Lumborum muscles of the low back are so strong, that it takes incredible forces to actually pull, strain or tear the muscle fibers. On the other hand, muscles spasm in response to the shock of injury. This occurs because an unexpected or jerky "shock to the body may either elicit inflammation or irritate sensitive nerves adjacent to the joint capsule. This often causes the body to respond with a muscle spasm as a result of an overload of stimulating nerve impulses. Consistent spasm leads to a vicious cycle of pain, persistent inflammation, vertebral subluxation (misalignment) and a repeating barrage of nerve impulses offering feedback to the brain and spinal cord that something is wrong. Spasm is the body's protective mechanism, acting to splint the area to prevent movement, not unlike putting a brace or back support on. GOALS AND PROTOCOL OF TREATMENTUnfortunately, a rather minor back strain can become chronic and produces a battery of systematic sequelae that lead to future generative changes. Such changes in adjacent joints manifest in the form of arthritis of the posterior facet joints or degenerative changes in the spinal disks. Salter's work on joint degeneration with immobility proved this point. Dr. Salter provided extreme examples by reporting what happened when he restricted the movement of a joint in dogs to virtually zero. These estate joints would degenerate and become completely fused within a relatively short period of time. As a more minor example, this is why old sports injuries come back later to haunt us or the reason an old injury becomes a good weather forecaster someday.Two factors responsible for converting an acute strain to a chronic strain with degeneration:Lack of movement and inflexibility of the spinal joints. Movement is restricted by muscle spasms and later the infiltration of scar tissue and/or joint capsules adhesions. Inflammation and low oxygen concentration are impetuses for scar tissue formation. Lack of oxygen (O2), water (H20) and nutrients for healing. With lack of movement comes lack of all 3 of these. Beyond the age of 25 years, our spines are very dependent on individual joint flexibility for the flow of nutrients, O2 and H20 into our joint cartilage and surrounding structures.The two ultimate goals of treatment for back strain are (1) to increase (maintain) flexibility and (2) to reduce inflammation. Treatment ProtocolICE IS NICE-15-20 minutes of ice packs or ice massage twice per day to control inflammation is always a good initial therapy because it helps break the cycle of pain and lessens scar formation by reducing swelling and inflammation. REST – Initial rest for the back is necessary to give the body a chance to begin healing. However, it is important to begin a program of movement exercises beginning no more than 4-7 days after the initial injury. SPINAL MOBILITY THERAPY – should be specific hands on mobilization by a trained physical therapist, chiropractor or medical professional. This is often referred to as spinal manipulation or an "adjustment". EXERCISE ROUTINE-These may begin with simple isometric quote contraction and relaxation of core muscle groups, depending on the severity of injury. The important thing is that this procedure be progressive whereby the number of reps, intensity and complexity of exercise increases with the tolerance of the patient. The overall program should strengthen and stretch all core muscles of abdomen, lower back, gluteal, hip and even thigh muscles. Regimen should at least begin under the guidance of a trained rehabilitative exercise specialist to guarantee proper form in the performance of such. NUTRIENT CONSIDERATIONS – To properly heal and maintain the integrity of the spinal joints and soft tissues, we need an abundant supply of oxygen, clean water, amino acid proteins and other micro-nutrients necessary for building strong joints and producing copious amounts of joint lubricants. If you learn nothing else from this article, start drinking at least ½ ounces of water per pound of body weight per day. This should be either distilled or purified, spring water, preferably with a PH of 6 or greater (more alkaline is better). Your joints will degenerate without it, not to mention the rest of your body. Other nutrient considerations are numerous and probably beyond the scope of this initial article. Let it needed to say, that you eat a well balanced diet with lots of good protein, omega 3 fatty acids, olive oil and take a good natural multi vitamin-mineral supplement. Additional supplements of Glucosamine and MSM have proven benefits for joint healing and maintenance. LIFESTYLE CONSIDERATIONS – let's just put this in very simple terms and say: "what you walk in, what you sit in, what you sleep on and what you think about are all extremely important." I know, consider things like having an orthopedic foam mattress and an ergonomic chair if you spend lots of time sitting. These are simply necessary tools for healthy living. HEAT PACK THERAPY – note that I put this last. I did this on purpose because it is the first thing most people think of (including physicians) when someone strains their back and really a bad idea in initial or acute stages. It is however great for chronic strains or to alternate with ice treatments once the pain has become dull and the condition is healing.
heart disease and a portrait of a healthy heart. However, not always this ring true and my self-portrait is such testimony. In fact, as friends and family can attest, I was always a little different. Some of my friends that eat cardboard and precisely, but this is far from the truth. Organic food and eating healthy can often be very tasty and highly misunderstood. Probably exemplify the phrase "healthy lifestyles". Eat what some might call health food, organic, when possible and almost always low fat/low sugar. For much of my life that I suffered from an addition of sugar, so today exert great discipline in this regard. When eating sweets (usually only on weekends), are composed of whole wheat flour, use coconut oil or oil palm and generally are sweetened with Agave Nectar, fruit juices or real maple syrup d '. I eat many meals out, but I'm selective in my choice of restaurant, menu items and cooking technique. Did you know that you can maintain a healthy way of eating while travelling or eat out, even at fast food restaurants? I'll get more into this later or maybe in another post. I'm also a self-proclaimed fitness fanatic, 14 years old, after my heart was broken by the refusal by the first girl that I asked about a date. Was a cheerleader, and I wasn't a jock. I wasn't terribly overweight, but I've been a sugarholic and was what you might define an appearance pudgy, non-athletic. So, I started running and working at a time when the runners themselves were the ones on a team of track and when working with belted jocks or bodybuilders. Gyms were not equipped with air-conditioning and so-called "health club" were exclusively for club goers of rich countries. Inspired by the likes of Jack Lalane, Steve Reeves (Hercules) and Paul Bragg I was determined to be suitable, ripped, and more important to have a date with the girl I had turned in down .This has become a lifestyle for me, continued in college and reported in education and in my professional career. I thought about being what is now called an exercise physiologist, and yet the field of education did not exist at the time. I started with the physicist and pre-medicine in college with the intention of being guru in the world of fitness. Wow, amazing how be rejected by a beautiful girl so greatly influenced my life? Well, unexpectedly, I hurt my back in an accident and the treatment of my and recovery for those sparked my interest in becoming a chiropractic physician. So, that is exactly what I did. As I always say: "life is what happens while you're making other plans." Actually, it was a way I could live and preach to all techniques of healthy living that I was incorporated in my life. I've lived a healthy lifestyle, SO why was my heart sick? to summarize and make a long story short, I am a fitness and health nut; lives and breathes the. Ironically, but that's true, recently almost died of a heart problem. How can also be? I have never smoked, rarely drank alcohol, lived a life healthy and again in March 2008 I was suffering from congestive heart failure grade IV. This was a revelation to me. I understand that there are circumstances beyond our control, and no matter how good we are, we can still get sick. I had no heart disease, coronary, no any disease and atherosclerosis, however, my heart just shorted. I developed a severe arrhythmia that my heart was beating out of control, not to pump blood. Fluid was the creation in my stomach, liver, lungs and I was literally drowning in my secretions. Thank God and medical experts by Dr. John Seger (electro-physiologist), my heart has a normal sinus rhythm again. Dr. Seger perform ablation, a surgical procedure by which short-circuit paths of rhythm of my heart were blocked from overheating of cells in specific areas of my heart muscle. He also required a small amount of a block of beta called Bystolic to calm my heart and reduce the fight/flight response to stress. Also and I agree, I take supplements health and continue my healthy lifestyle. What's TO BE GAINED FROM THIS EXPERIENCE?Some might say that all my efforts of health have been wasted because I got very sick, in spite of my healthy lifestyle and Ode to clean life. To accept that it would be a tragedy because I believe in my heart that I would have not survived the accident nor returned to my current state of health if I had lived a less than healthy lifestyle. Also, my yield fast enough to "jaws of death" and suitability was hendered if I hadn't followed my surgery with extra good program, healthy eating, stress reduction and an awareness of feedback of my body. I live, I breathe, I feel very lucky and I'm here to tell you about it. I learned that the integration of conventional Western medicine with traditional alternative methods is often indispensable. I realized that a broken heart is not always a bad thing and that when one door slams closed, another one will open. I found the love of my life and I am still here to share the challenges and rewards of life with her. SO WHAT's next?Are concepting of what might be the well-being neatest, change of life, health-spa-rifugio ever conceived. We have selected a place of choice in the mountains, to be revealed later. The concept will integrate Eastern and Western philosophies, healthcare, under the pretext of conventional medicine and alternative medicine. Here, guests will learn how to live well and to be well while towards objectives of current health and fitness and overcome their obstacles.Be well!
After a detailed bio-mechanical and practical evaluation of the MBT shoe for both training and recovery I’m really a fan of this so-called “anti-shoe”. It is the contention of this researcher that MBTs will be validated as the new best running shoe for those suffering or recovering from back pain, hip injuries, arthritis, knee problems and conditions of the foot and ankle.However, unlike the info most prevalently available about MBT shoes creating instability, I believe MBT shoes actually enhance overall stability because of their unique self-righting sole and its ability to act in symphony with the postural muscles. This improves stability as the user's foot interfaces with hard surfaces. The only portion of the gait whereby there is instability in MBT footwear is at heel strike. This functions to absorb the shape of the terrain and lessen pressure on the heel.MB
T functionality could be likened to that of the old Joe Palooka Bob Bag of the 1950's. This was a self-righting punching toy with a counter-weighted bottom. No matter what one did to it, it righted itself in a perfectly vertical format.WHAT ARE MBT SHOES?Quite simply they are rocker-bottom soled footwear that enhance a user’s ability to maintain natural and proper postural balance. They are super comfortable and nature’s answer to many sports’ injuries and orthopedic complaints of the back and lower extremity. “MBT” is an acronym for Masai Barefoot Technology and the shoes were engineered as a result of studying the Masai Tribe in Kenya. These people have a significant lack of knee, foot and ankle problems.Most running shoes are designed to lessen the need for a good set of balanced muscles. However, MBT design facilitates muscle activity and the recruitment of muscles maintain the balance of the user. This is similar to the benefits to be gained by running barefoot in semi-soft sand.Although orthotics can be worn inside MBT Shoes, we find they are often unnecessary. That’s right, MBT shoes are a better substitute for most foot orthotics that were prescribed to either relieve heel pain or improve the biomechanics of the foot.DESIGN OF THE MBT SHOE
The above diagram showing how MBT design aids the walking/running gait.
The diagram above demonstrates lateral stability and balance fore and aft with MBT footwear.
The sensor cushion is located under the heel, but is longer, less dense and has a different shape than most cushions in the heel of a shoe. On one hand its properties simulate uneven ground, subconsciously soliciting a proprioceptive response from the stabilizing muscles. This compensatory response facilitates adaptation to the terrain.The balancing action of the mid-sole, with its integrated self-righting/rocker bottom technology, actively exercises the muscles and precisely guides the mid-stance through toe-off motion in a very controlled manner. All parts of the shoe, work in harmony with the wearer, exercising the entire lower torso and lower extremities while virtually eliminating the stress to joints and ligaments. MY PERSONAL EXPERIENCEThis researcher is now an avid MBT wearer. After a stay in the hospital as a result of cardiopathy, I noted that my right knee and right heel were in peril giving me trouble walking. Apparently, the lack of oxygen and immobility resulting from a hospital stay had caused a previously minor condition to rapidly deteriorate. Upon examination by a competent physiatrist (doctor of physical medicine), MRI showed a ruptured Baker’s Cyst combined with severe degeneration of my medial cartilage. I was also suffering from a heel spur and plantar fasciitis. I was determined to walk to rehabilitate my heart condition, so I went shoe shopping and purchased a $120 pair of Salomon XT Wings GTX Trail Runners. These shoes are really top of the line and I rather enjoyed them. My condition was slightly alleviated by them, but not to my satisfaction. After 2 months I purchased a pair of ASCIS Gel Kayanos which although nice and light and comfy, made absolutely no improvement. I’ve always been a fan of New Balance, so I looked for their best trail running shoes and purchased those; again to no avail. I then tried Pearl Izumi’s SynchroSync III, which is a wonderful shoe and the best running shoe I have ever tested by far. This made it possible for me to walk with less pain and even run a little bit. However, after 2 months of wearing those, I was still in pain and not complacent with the results. Only out of curiosity and with lots of skepticism did I try MBTs. I had already decided that Pearl Izumi made the best shoe on the market and since MBT is the “anti-shoe” I suppose that is still true. I was accompanying my sister on a quest for a good walking shoe and this led to my first MBT experience. Wow, I was sold the first time I put them on. The pain in my knee and heel were present, but tolerable. I bought a pair and within 3 day of wearing them I was able to run with minimal heel or knee pain. I’ve saw continual improvement over the next 3 months and today, I’m virtually free of the pain.
disease and a portrait of a healthy heart. However, this does not always ring true and my self-portrait is testimony to such. Actually, as friends and family might attest to, I have always been a little different. Some of my friends think I eat cardboard and birdseed, but this is far from the truth. Organic foods and healthy eating can often be very tasty and highly misunderstood. I probably exemplify the phrase “healthy lifestyle”. I do eat what some might call health food, organic when I can and almost always low fat/low sugar. For much of my life I suffered an addiction to sugar, so today I exercise great discipline in this regard. When I do eat sweets (generally only on the weekends), they are made from whole grain flours, utilize either palm oil or coconut oil and are generally sweetened with agave nectar, fruit juices or real maple syrup. I eat many meals out, but I’m selective in my choice of both the restaurant, menu items and cooking technique. Did you know that you can maintain a healthy eating style while traveling or eating out, even at fast food restaurants? I’ll get more into this later or perhaps in another post. I’m also a fitness fanatic, self-proclaimed at 14 years of age after my heart was broken from rejection by the first girl I asked out on a date. She was a cheerleader and I was NOT a jock. I was not terribly overweight, but I was a sugarholic and had what one might call a pudgy, non-athletic appearance. So, I began running and working out at a time when the only runners were those on a track team and when working out with weights was for jocks or bodybuilders. Gyms were not air-conditioned and so-called “health clubs” were exclusively for the wealthy country club goers. Inspired by the likes of Jack Lalane, Steve Reeves (Hercules) and Paul Bragg I was determined to be fit, ripped and most importantly to have a date with the girl who turned me down.This became a lifestyle for me, continued throughout college and carried over into my education and professional career. I had originally intended to be what is now called an exercise physiologist, yet that field of education did not exist at the time. I started with physical ed and pre-med in college with the intention of being the world’s guru to fitness. Wow, isn’t it amazing how being rejected by a pretty girl so greatly influenced my life? Well, unexpectedly, I hurt my back in an accident and my treatment and recovery for such sparked my interest for becoming a chiropractic physician. So, that is exactly what I did. As I always say: “life is what happens while you’re making other plans.” Actually, it was a way I could live and preach all the healthy living techniques I was incorporating into my own life. I LIVED A HEALTHY LIFESTYLE, SO WHY WAS MY HEART SICK?To summarize and make a long story short, I’m a health and fitness nut; lived and breathed it. Ironically, but true, I recently almost died of a heart problem. How can that even be? I never smoked, rarely drank alcohol, lived a healthy lifestyle and yet in March 2008 I was suffering grade IV congestive heart failure. This was quite an eye-opener for me. I realized that there are circumstances beyond our control and no matter how “good” we are, we can still get sick. I had no heart disease, no coronary disease, no atherosclerosis and nonetheless, my heart just short-circuited. I developed a severe arrhythmia whereby my heart was beating out of control and not pumping blood. Fluid was building up in my stomach, liver, lungs and I was literally drowning in my own secretions. Thanks be to God and the expert medical care of Dr. John Seger (electro-physiologist), my heart has a normal sinus rhythm again. Dr. Seger performed ablation, a surgery whereby the short circuit pathways of my heart’s rhythm were blocked by overheating the cells in specific areas of my heart muscle. He also prescribed a small amount of a beta blocker called Bystolic to calm my heart and lessen the fight/flight response to stress. In addition and on my own accord, I take health supplements and continue my healthy lifestyle. WHAT’S TO BE GAINED FROM THIS EXPERIENCE? Some might say that all my health efforts were wasted because I got very sick in spite of my healthy lifestyle and ode to clean living. To accept such would be a tragedy because I believe in my heart of hearts that I would not have survived the incident nor returned to my current state of health if I had lived a less than healthy lifestyle. In addition, my fairly quick return from the "jaws of death" and return to fitness would have been hendered if I had not followed up my surgery with a good supplement program, healthy eating, stress reduction and an awareness of my body’s feedback. I live, I breathe, I feel very lucky, and I’m here to tell you about it. I’ve learned that the integration of western conventional medicine with traditional alternative methods is often imperative. I’ve realized that a broken heart is not always a bad thing and that when one door slams shut, another pops open. I did find the love of my life and I’m still here to share life’s challenges and rewards with her. SO WHAT’S NEXT? I’m concepting what might be the neatest, life-changing wellness, health-spa-retreat ever conceived. We've selected a choice spot in the mountains, to be revealed later. The concept will integrate western and eastern philosophies of health care under the cloak of both conventional medicine and alternative medicine. Here, guests will learn how to live well and be well while working toward current health and fitness goals and overcoming their obstacles to such.Be Well !
WHAT IS BURSITIS?
Bursitis is dysfunction in the fluid-filled sac (bursa) that normally provides buffering and lubrication for tendons gliding over a joint. It is often caused by new or old injuries or can be a result of lack of important nutrients to the joint. Acute Bursitis is inflammation of the sac and perhaps over-production of fluid (swelling). Chronic bursitis actually presents with dryness, lack of fluid and poor lubrication for movement of tendons.
HIP PAIN ON THE DOWNSIDE
Although there are many facets of treatment and self-care for bursitis of the hip joint, a pressure point relieving, supportive foam mattress is one very important aspect of treating it. REASONING: (1) It is important to not have pressure on the inflammed bursa while lying on that side. (2) Additional to excessive pressure, poor mattresses lack support and often sag or hammock. That places an undesirable stretch on the muscles associated with the hip on the downside, thus irritating the bursa and impeding healing. One might wake up with pain, clicking, stiffness and limited mobility which may lessen after being up and about for awhile.
HIP PAIN ON THE UPSIDE
Alternatively, your pain may occur in the hip that faces upward. I know this seems sort of odd, but it is actually quite common. REASONING: (1) In most people, their hips are wider apart than their knees. This is especially true in women. This anatomical truth can create tension on hip muscles as the knees come together and stretch such muscles. (2) Or perhaps, one stretches their leg out in front of them twisting the spine and pulling on hip muscles. In those with bursitis, this can wreck havoc with the sensitive bursa. (3) Of course, a supportive, pressure relieving mattress is advisable to prevent excessive hip rotation.(4) However, in this case it is often advisable to also utilize a nice space occupying pillow between the knees. The pillow should be soft enough to not impede circulation but substantial enough to maintain a distance between the knees perhaps equal to the width of the hips. Please note that hip bursitis often is complicated by a component of hip tendonitis which may also be alleviated with the advice of this article. Please also note that this is not the panacea of care for hip bursitis. Functional care involving nutrition, stretching, strengthening and physical medicine are advisable but beyond the scope of this article.
HELPFUL SLEEP SOLUTIONS FOR HIP BURSITIS
Mattresses to consider:
Nimblepedic Memory Foam MattressPincore Latex Foam MattressOr, if your mattress is extremely firm, it likely causes pressure points and will actually bend the spine. In such cases, instead of a new mattress, one may consider a memory foam mattress overlay for firm mattresses.
Pillows to consider:

Plantar Fasciitis defined is simply an inflammatory condition caused by strain and over stretching of the ligament that spans the bottom of the foot. This plantar ligament functions to provide spring in your step as well as support the longitudinal arch. Inflammation of such can cause severe pain, particularly when barefoot, when first standing, upon awakening, or standing after prolonged sitting. Plantar fasciitis often precedes and plays a major factor in heel spur formation. As a side note, Plantar Fasciitis has a funny sort of spelling and is often mis-spelled as plantar facitis or plantar fascitis.
The use of gel or cushion under your foot can temporarily relieve or soothe plantar fasciitis. However, this offers temporary relief at best and should not be considered a long term solution. It is a common misconception by both sufferers and physicians alike that a soft cushion under the foot resolves a bevy of foot problems. In reality this measure compromises foot support in the long run, similar to the lack of support for the spine when sleeping on a soft mattress. I prefer to recommend proper support of the arch of the foot, thus relieving strain on the plantar fascia. This functions to actually reduce pressure on the attachment point where the plantar ligament (fascia) attaches to the heel. Excessive tensile forces at this point of insertion over time are the etiological factors that form heel spurs. In essence, a heel spur is your body's response to the ligament pulling on the bone, forming what doctors call a traction spur.
STEP BY STEP SOLUTIONS TO PLANTAR FASCIITIS
The first step is to break the cycle of inflammation (swelling) and pain with ice and cold therapy.
A search query of Google for a definition of wellness ("define: wellness") elicits 15 different results, some sensible and similar and others as simple as a brand name for pet food.
The first search result on Google for the query define: wellness was as follows: "a healthy state of wellbeing free from disease; physicians should be held responsible for the health of their patients." Since Google's search algorithm often presents the most popular definition first, this is apparently one of the most read and perhaps more accepted definitions.
Wow, that's a real debacle for me because it puts the responsibility of a patient's health in the hands of their physician. Is personal accountability for one's health not a priority?
Ironically, the recent focus on wellness involves a desire for awareness and self involvement in the quest to get well. In my opinion this desire was brought about by the fact that many physicians are focused on treating disease symptoms rather than zooming in on the holistic or overall portrait of their patients' health. Patients are no longer viewing physicians as God-like authoritarians for health, but are asking questions and seeking alternative methods or advice for self help, nutrition and exercise. New terms are cropping up like "well care", anti-oxidants, polyphenols, PPO and HMO.
This brings up the question of whether HMO really means Health Maintenance Organization? Maybe HMO should have the acronym of PPO or as I liken it: "Pissed-off Patient Organization". In any event, in the minds of insurance executives, HMOs are economical in spite of the fact the costs of health care keep rising. Hopefully they will someday figure out that prevention and maintenance is more cost effective than conventional symptomatic medical care. Chiropractors have preached this for years, but insurance carriers are clearly blinded to recognizing chiropractors as candidates for primary care physicians.
Thomas Edison once said: "the doctor of the future will not dose us with drugs, but will interest his patients in the care of human frame, in diet and in the cause and prevention of disease. The simple truth is you cannot improve on nature." Now that sounds like a mantra of wellness to me.
The quest for wellness is a journey and begins with personal accountability; supported by a symphony of factors like committment. Key components are highlighted below:
Personal commitment (1) self-reliance and determination to be healthy and well.My father instilled the most basic concept of wellness in me when I was a small child by repeatedly saying: "Son, everything in life is balance".
Wellness; defined:
"Wellness is a personal commitment to seek harmonious balance of body and mind with that of nature and others. It is the process of monitoring and fine tuning the underlying mental and physiological processes that are often in a state of flux and when out of balance result in disease".

Defined, "sciatica" is a description of a particular path of pain following the sciatic nerve as it traverses the buttock (hip) and/or continues down the back of the thigh, outside of the leg and perhaps the foot. As our article title denotes, sciatica can be a real pain in the buttocks.
Generally, the worse the condition, the further down the leg the pain travels and will often affect the foot. However, there are certain cases that although severe, only affect the buttock. It suffices to say that the symptom picture can be quite varied from one individual to another. Although most commonly associated with nerve compression from a low back disc condition, there are many causes of sciatica, some of which are not back related. Interestingly enough even those cases originating from a low back condition may not exhibit any back pain.
Some authorities would argue that if the origin of pain is not compression of a nerve root in the lower back, the result is not a "true sciatica", but a pseudo-sciatica. Synonyms for sciatica would be sciatic neuralgia or sciatic neuritis.
ANATOMY OF THE SCIATIC NERVE
The sciatic nerve is about 1/2 inch in diameter and is known to be the longest and largest nerve in the human body. The nerve originates in the lower spine as nerve roots exit the spinal cord (between the vertebrae in the spine), and combine to extend all the way down the back of the leg to the toes.
It is thus composed from a combination of 5 nerve roots exiting foraminal openings between vertebrae in the lower lumbar and sacral region. This includes the following nerve roots: L4, L5, S1, S2, and S3. Nerve roots in this area of the spine are named by the vertebrae above. Thus if the nerve root exits between L5 and S1 it would be considered the L5 nerve root. By understanding this one can correlate the area of symptoms with a specific spinal level.
The five nerves combine anterior to (in front of) the piriformis muscle to become the sciatic nerve. This nerve then travels down the back of each leg, branching out to innervate specific regions of the leg and foot. It should be mentioned here that a spasm of this piriformis muscle where it crosses the sciatic notch can cause sciatic neuralgia and often mimics sym
ptoms of a herniated lumbar disc.
Just above the back of the knee, the sciatic nerve divides into two nerves, known as the peroneal and tibial nerves, going to various parts of the lower leg:
The peroneal nerve innervates the shin and outer aspect of the leg down to the upper foot.
The tibial nerves innervates the posterior portion of the leg and traverses all the way to the feet to innervate both the heel and sole of the foot.
The sciatic nerve supplies both motor input (eliciting muscle movement and reflexes) as well as sensory innervation.SYMPTOM PICTURE OF SCIATICA
Pain: searing , stabbing, usually intermittent pain is generally the overwhelming symptom. The pain can be felt in the low back, buttock, posterior and outer side of the thigh or leg and possibly all the way to the toes. The pain is most often felt in certain positions, while walking or while straightening the leg. It may occur on both sides (bilaterally), but it is more often unilateral. Pain is sometimes exacerbated by sneezing, coughing, laughing or pushing during a bowel movement (Valsalva's Maneuver).
Numbness/tingling: sometimes the pain is either accompanied by or replaced by numbness and tingling known as paresthesia or radiculopathy.
Weakness: in the most severe cases of sciatica there is actually impairment of the motor nerve functions causing weakness in the leg and/or foot. The most common sign of such would be foot drop or the inability to pull the big toe up toward your knee (aka: lack of dorsiflexion).
CATEGORIES OF CAUSES
Mechanical Spinal Nerve Compression: most often from a herniated, ruptured or extruded disc but can be from severe misalignment or vertebral subluxation.
Compression by Muscle Spasm: most commonly known as a "Piriformis Syndrome" whereby the muscle underlying the gluteus maximus (buttock) is spasmed applying pressure to the sciatic nerve underneath. This is known to clued physicians as an "entrapment neuropathy" and is often misdiagnosed as a low back disk herniation because it mimics many of the symptoms of such. This can prudently be differentially diagnosed from a disc herniation by either MRI studies, CT scan or just a good old fashion history and exam including questions regarding pain during coughing, sneezing and bowel movements.
Trauma to the Sciatic Nerve: bruising, puncture wounds, or over-stretching injuries to the nerve itself can produce the symptoms of sciatica.
Spondylolisthesis: this is a slippage of one vertebral body on top of another and may be a result of fracture or a genetic defect in the pars interarticularis. If in the L4 to S1 region, sciatic neuritis symptoms can occur. Although many authors seem to describe a compression of nerve roots resulting from a spondylo-listhesis, it has been my experience both clinically and in my review of the literature that the most accepted authorities believe the nerve root irritation to be a result of traction or stretch of the nerves vs. an actual compression.
Spinal Tumors: space occupying lesions, of the spinal vertebrae, spinal cord, cauda equina, or surrounding muscles or sciatic nerve itself can cause sciatic symptoms.
Sacro-iliac Joint Sprain or Subluxation: this is actually one of the least understood or recognized conditions causing sciatica, but in this clinician's experience is one of the most common causes of sciatica that does not extend below the knee. Coughing and sneezing does not increase the symptoms in this case and often Kemp's sign will NOT be positive. Subluxation or sprain of the sacro-iliac joint leads to a referred sciatica in this case. This is generally best treated by a chiropractic physician.
Chemical Irritation: although not even known or considered by most practicing physicians, chemical radiculalgia is one of the causes of back pain with associated sciatica. This is an actual irritation to nerve roots caused by the swelling pressure of inflammation against the nerve. It is a major factor in what is called the "cycle of pain". It may be interesting to note that it has been this practitioner's experience that this is often the factor that is most concerning when dealing with the sequela of a disc herniation or injury. It is the overwhelming reason that Lumbar Epidural Steroid Injections have been so effective in relieving the symptoms of herniated or ruptured disc conditions. It leads some researchers to believe that inflammation may play an even greater roll in symptomatology than the mechanical pressure of displaced disc material.
Viscerally Referred Pain: although not as common as some of the other causes of sciatic symptoms, paresthesias, pain and odd sensations may be felt along the sciatic nerve distribution as a result of problems with internal organs. For example, problems with the prostate gland or female organs can refer sensations along the sciatic nerve. This can easily be ruled out by a thorough examination.
TREATMENT OF SCIATICA
Certainly the best treatment practices for sciatica would include addressing the cause in addition to alleviating the symptoms. Thus the approach may be different dependent on the cause. Sitting, driving and arising from the sitting position is usually a problem for all sciatica sufferers and thus one of the most recommended items would be a pressure relieving seat cushion known as a memory foam seat wedge. Make sure that it has a cut-out for the coccyx or tailbone and that it is solid, very dense memory foam. Ice is nice in the case of sciatica and heat should generally be avoided in acute cases.
Other treatment protocol is more causal specific and usually requires a battery of prescribed and self-care. Some of these are listed below:
DON'TS
Avoid irritation and stretching of the nerve during the healing process. This would eliminate toe touching with the leg straight.
Avoid running, fast walking or other physical activities that increase pain.
Avoid heavy lifting, stooping, squats or prolonged bending.
Avoid sitting on soft overstuffed chairs or couches or desk chairs that fall away when leaned against.
Avoid fast movements.
Avoid arising out of bed w/o first turning on your side
Avoid stomach sleeping or sleeping on your back with both legs straight out.
Avoid straightening the involved leg when sitting.
DO'S
Do see a physician or chiropractor for a proper diagnosis and treatment. Depending on findings your doctor of choice may suggest: spinal adjustments or manipulation, deep tissue massage of the buttocks, core muscle strengthening and stretching, repair of a disc herniation, oral anti-inflammatories, lumbar corset or lumbar epidural cortisone injections. Lumbar traction and/or gravity inversion may be advisable in some cases. For less common causes like tumors or referred pain from internal organs, your doctor will likely refer you to a specialist for further investigation.
When sleeping on your back, keep at least the involved leg slightly bent with an orthopedic bed wedge or soft fluffy pillow.
When side sleeping, place a soft pillow between your legs starting at the knee and positioned downward from there.
Do utilize a memory foam seat wedge to keep good posture and remove pressure from the sciatic nerve when seated or driving. For chronic sciatica seated workers should consider the purchase of a Bodybilt task chair.