Sciatica Treatment – Management Versus Cure

71 Comments

  • Peter

    Reply Reply July 23, 2012

    An informative piece.
    Thank you.

    • Dr. George Best

      Reply Reply July 24, 2012

      You’re welcome!

    • shahed

      Reply Reply April 25, 2014

      hi dr george i had seen ur videos iam impress i had a acl tear surgery for my right knee 8 months back and anesthisia had given me after that i had take a electro homeopathy treatment for my back lumber spine this pain iam geeting for past 2yrs my job is totally stainding iam a sales man after taking a electro shocks for 3 times of my left leg nerve the pain is disappers for some days after that it gets worse amd now the pain is coming from lumbar spine two knee joint and down the leg toes i had taken lot of pills and exercises but no use of that i cant even sit for long time also pls suggest me what to do sir show me the way thank u

      • Dr. George Best

        Reply Reply April 25, 2014

        Hello Shahed,

        The first place to start is with the basic McKenzie method and use of cold packs as discussed in the free ebook. If you have not already downloaded the ebook, you may do so from the right sidebar of: . It is important to go through the testing procedure for the exercises to find the one position that best centralizes the symptoms (explained in the ebook) and then use that exercise on a frequent basis throughout the day for at least the first week or two and then continue it as a preventive measure a few times each day once the symptoms are gone. If you have further questions, let me know.

        Good luck!

        Dr. Best

  • Ray

    Reply Reply July 26, 2012

    On you initial video that has 3 video’s the 3rd one starts and stops and this one you sent does the same thing…before you blow this off as a poor computer or I promise you I use a computer all day and It’s the video. I love your information but watching some of the video’s takes 3 times as long as to the stop/start of the video

    • Dr. George Best

      Reply Reply July 26, 2012

      Hi Ray,

      The videos play through fine on my computer, so it’s not the videos either. Most likely the problem was or is your internet connection. During peak usage times, even relatively good broadband service can slow down significantly and since video requires a pretty fast connection for smooth streaming, you’ll get some pauses. What I mean by was is that if you tried to load the video the first time when there was a problem with the internet connection, many browsers will store the video file for future watching in order to make the content load faster. So, if it stores a corrupted video file, the next time you try to load it, it still does not play properly even if your internet connection is better. To solve this issue, you need to clear your browser cache and then re-load the page. Hopefully this will solve the issue for you.

      Dr. Best

  • Gregory Bouie

    Reply Reply September 30, 2012

    It seems the more o learn of this topic the better equipped i feel that i could one day overcome. However.. im wondering if my being overweight has much to do with it as well. Would you recommend focusing on issue at hand first them prepare to lose some weight?
    Thanks!!!
    Gregory
    Rochester

    • Dr. George Best

      Reply Reply September 30, 2012

      Hi Gregory,

      Being overweight in itself does not cause sciatica per se, but it does increase the impact of other factors. It will be difficult to exercise as you need to in order to lose weight while you’re in pain, so as you said, it would be best to focus on getting the sciatica under control and then you’ll be better able to work on weight loss.

      Good luck!

      Dr. Best

  • M.Lawrence

    Reply Reply October 14, 2012

    Dr. Best

    Thank you for the information on Sciatic pain relief, and how to deal with the discomfort of it.
    I injured my lower back on the 1st of this month, which resulted in Sciatic pain. Now I’m experiencing numbness and tingling in my entire left foot. It’s hard for me to walk and it’s painful also.
    What suggection would you reccomend I do at home to relieve the pain in my thigh and the numness in my foot.
    Thank you

    • Dr. George Best

      Reply Reply October 15, 2012

      As with any case of sciatica, I suggest you start with the basic self-treatments in my free ebook. If you do not already have it, you may download it from the link on the right sidebar here. Numbness indicates that there has been fairly major nerve compression. If you are not getting improvement (in the case of numbness, a change to pain and/or tingling is actually sign of improvement) within one to two weeks, I recommend you see a doctor to be evaluated further. As I said before, numbness is a sign of major nerve compression and if it goes on too long, the nerve can be permanently damaged and symptoms may remain even after the underlying cause is corrected.

      Good luck!

      Dr. Best

  • Danny

    Reply Reply November 14, 2012

    Thanks for the videos and free information Dr. Best. I have been getting sciatica flare ups for the past 5 years but the one that I am suffering now is unlike any other. 5 months later and the symptoms seem to be getting worse by the days. I’ve tried stretching, foam rollers, inversion tables, cut back on lifting weights, ect… I ditched the Motrin and started using your suggestion of icing for 15minutes every couple of hours and that seems to be helping some. I am still not sure if it’s inflammation, compression, or muscle contraction. It might be all 3 the way this pain feels. I have an MRI scheduled for next week assuming my insurance will cover it. I wish you had your practice out here near the Orlando area because I would definitely come for a visit.

    • Dr. George Best

      Reply Reply November 14, 2012

      Hi Danny,

      With the duration and severity of the symptoms, my guess is that you have a severe disc herniation and possibly a rupture. The MRI is definitely indicated at this point to help determine what the problem is and how best to treat it. If you have further questions after the MRI, feel free to contact me. Good luck!

      Dr. Best

  • Danny

    Reply Reply November 14, 2012

    Thanks for the response Dr. Best! The Dr. that ordered the MRI took Xrays and said the only disk that had a slightly smaller gap than the rest was L-5. He said the only sure way to rule out a bulge or rupture was the MRI. I did see a chiropractor today and he made an adjustment on my neck only. I spent a good amount of time with him and he’s convinced that my lower back is fine and that it’s my piriformis causing all the problems. He said it might be spasm-ing out or totally contracted and that I need to relax it. Unfortunately he didn’t offer many solutions on how to get it to relax other than to put some heat on it and stretch it while the heat is on. I’m going to browse your website some more to see what solutions I can find. If you think I can benefit by joining the members area please let me know! Thanks again!!

    • Dr. George Best

      Reply Reply November 15, 2012

      If things are still not improving much, I’d still recommend getting the MRI. X-rays are not very useful in detecting disc herniations and ruptures.

      The piriformis may be involved, but the muscle doesn’t tighten up and stay that way for no reason. The reason can be some type of joint dysfunction in the hip or sacroiliac joints – which chiropractors are usually pretty good with – but it can also be nerve irritation from a disc herniation in the lower lumbar spine.

      My basic rule of thumb is that if a patient is not improving significantly within a couple of weeks, you need to look further into why they’re not improving. Given your history, I think the MRI is a necessity if things don’t start improving soon.

      If you were getting improvement from the basic treatments in the free ebook, I’d say that you might benefit more with the member’s area, but I’d wait on the MRI results before suggesting you join the members area because depending on the results it may or may not benefit you.

      Good luck!

      Dr. Best

  • irra kambli

    Reply Reply December 19, 2012

    hi,

    Dr Best – I really find this iformation helpful for me, as I am already a Sciatica sufferer – i would be glad if you provide me furhter tips on my problems as it will help me in coming through my problem.

    regards

    irra

  • Jennifer

    Reply Reply December 20, 2012

    Is massage good for sciatica, or an irritant? And which position is best for sleeping? I have the muscle contraction issue, and I can barely walk.

    • Dr. George Best

      Reply Reply December 21, 2012

      Massage is usually helpful, but overly-deep work right over the sciatic nerve and sometimes simply lying on a massage table for an hour or more can temporarily increase symptoms.

      The best position for sleeping varies from person to person, but usually either lying on the back with a pillow under the knees or on the side with a pillow between the knees are the best options.

      Dr. Best

  • reinhard

    Reply Reply January 23, 2013

    thank you for your free info I am sure its really helpful not just to me but for every one who has visited your site

    • Dr. George Best

      Reply Reply January 23, 2013

      You’re welcome!

      Dr. Best

  • Arnt Wollum

    Reply Reply March 4, 2013

    Hi and thanks for good advices

    Is there any link between alcohol and sciatica? If so, how does it work….??

    My wife and I has always enjoyed a bottle of wine with dinner…..

    • Dr. George Best

      Reply Reply March 4, 2013

      I do not know of any link between alcohol consumption and sciatica. Alcoholics do sometimes develop a condition called pernicious anemia which can cause nerve damage which might initially be mistaken for sciatica, but the symptoms are not really the same.

      Dr. Best

  • Zissis kitras

    Reply Reply May 15, 2013

    Hi Doctor Best

    I did some of the stretching exercises of the piriformis muscle and immediately there was relief but later on it was worse than before the exercises. What gives?

    sincerely, z. kitras

    • Dr. George Best

      Reply Reply May 15, 2013

      Most likely there is some underlying problem that is causing the piriformis to tighten up as opposed to it being tight from a one-time reaction to excessive exertion or prolonged inactivity. If there is an underlying problem such as sacroiliac and/or hip joint dysfunction or a disc protrusion that is irritating the nerve that supplies the muscle, any relaxation from addressing the muscle alone will usually be short lived and the muscle will usually react again to the underlying problem.

      I suggest you try using the McKenzie method (per the complete instructions in the ebook) in addition to gently stretching the piriformis. If you don’t make much progress within a few days to a week, I’d suggest getting checked out by a chiropractor or osteopath who is experienced with treating sacroiliac and hip joint issues.

      Dr. Best

  • Nandie

    Reply Reply June 24, 2013

    Hello! Thanks for sharing your videos. I learned a lot from it. I would like to ask which exercise machines would be used to lose my weight while having disc prolapse /sciatica. Thanks.

    • Dr. George Best

      Reply Reply June 24, 2013

      It’s generally best to stick with low-impact cardio exercise while you are having symptoms. The best options would be treadmill or elliptical. Stationary bikes and stair climbers may be alright, but you want to be as upright as possible on the bike and even then the position may irritate symptoms, just as the greater muscular demands on the hip and buttock from a stair climber may also cause increased symptoms.

      Good luck!

      Dr. Best

  • Rahmatullah

    Reply Reply July 16, 2013

    Dr. George, Is it possible for you to see my MRI report, if I upload. That’s why I am under treatment of well known local Neuro surgeon. Heaviness of my both legs is developing and to avoid paralysis should I pass through a surgery or otherwise? waiting for your reply so I may upload my MRI Report.

    Thanks.

    Rahmatullh

    • Dr. George Best

      Reply Reply July 16, 2013

      Hello Rahmatullah,

      Yes, you may send me your MRI report and I will give you my opinion on it. It will probably be best to email it to me.

      Send Email To This Link.

      Dr. Best

  • Jenny for Oz

    Reply Reply July 30, 2013

    Hi Dr Best, Im so glad I found you on the internet, you are so helpful, my sciatica started 2 months ago.. prior to that I had never had any back pain, but I did notice after sitting at the computerfor work and a road trip to europe my buttocks would feel numb, after sitting for a long time in the car up to 7 hours a day for 4 weeks.. that was about it, until 2months after a trip back from bali. wham I couldn,t move pain was unbearable i thought it was kidney stones… but dr said after xrays it was Sciatica, compression on the L3 lower back, what I would really like to know has sitting caused this? I have pain in my lower back tingling burning buttocks aching leg calf and a numb little toe, wish I was closer to you. but i live in Gold Coast Qld Australia. thankyou Dr Best keep me up to date with the videos

    • Dr. George Best

      Reply Reply July 31, 2013

      Prolonged sitting can bring on either true sciatica or piriformis syndrome, especially when you have prolonged sitting for many days at a time. The sitting position has been found to place the most pressure on the spinal discs of any common posture. Sitting in general is bad, but sitting in a slouched position is even more damaging because it places the spine in a flexed position which places considerable pressure on the back of the discs, predisposing to bulging of the discs into the spinal and nerve canals.

      I hope you find the self-treatment methods here helpful and I wish you a speedy recovery.

      Dr. Best

  • Michael

    Reply Reply September 5, 2013

    Hello. Thank you for the very informative videos and e-book. I would like to know if it matters whether you do both exercises (bulging disc or muscle) for sciatica? I’ve tried both tests and can’t determine which it is. All I know is that it is more painful when I’m on my feet. (Walking or standing). The pain shoots down the right leg and is quite painful next to the shin bone and foot. Which gets numb a lot. Should I continue the McKenzie method and the other one lying on your stomach and lifting the front half of your body resting on your elbows? Thanks for your time.

    • Dr. George Best

      Reply Reply September 5, 2013

      It won’t hurt anything to do the exercises for both disc and muscle, and if you don’t have a clear indication from the tests that’s what I recommend. The exercise done lying on the stomach propped up on the elbows is one of the McKenzie exercises. The exercise for piriformis syndrome is where you pull your knee towards the opposite shoulder. To clarify, you should only be doing one position for the McKenzie method – the one position that best centralizes the symptoms. If you’re not clear on that, please review the full instructions in the ebook before you proceed.

      If you have further questions, let me know.

      Good luck!

      Dr. Best

  • Michael

    Reply Reply September 5, 2013

    Hello. Is it safe to do both exercises you show in the videos Part 1 & Part 2 if you are not sure whether the cause is bulging disc or piriformis? I tried both tests and can not determine which it is. All I know is that my condition is more painful when I am on my feet. I get a pain from my right buttocks down to my foot. So painful in fact that I have to sit immediately and then the pain subsides. In the morning, after awakening, it is so painful that it almost brings tears to my eyes. is this normal with sciatica?

    • Dr. George Best

      Reply Reply September 6, 2013

      From your description, it’s more likely to be disc related with associated inflammation. In most cases there is at least some contribution to the nerve compression directly from the disc and some from the inflammatory swelling. Symptoms are commonly at their worst first thing in the morning because when you are lying in bed and not moving much the inflammatory swelling builds up. Once you begin to move around, circulation increases and “pumps” the swelling out, easing the pressure on the nerves.

      Standing places the spine in slight extension, which mildly narrows the openings where the nerves exit the spine, whereas sitting puts the spine in slight flexion which increases the space in those openings a little. In cases where swelling is a major factor or when there are other sources of narrowing such as degenerative bone and ligament thickening at the back of the spine, extension positions will tend to increase symptoms and flexion will tend to ease them, especially when you are upright and the spine is compressed by gravity. With the McKenzie exercises, the dynamics change somewhat because you are lying down and the spine is not compressed, but even then it is important to follow the testing procedure to see what position works the best to reduce the nerve pressure.

      Dr. Best

  • Michael

    Reply Reply September 5, 2013

    Thank You Dr. Best.

  • Arlene

    Reply Reply October 28, 2013

    Dr. Best, I am 89 years old and have had a liver transplant 18 years ago and I take lots of medication, I also have very bad osteoarthritis in my left knee, it stops me from excercise, my sciatica is just ravishing my body with continued pain and as a result I am house bound and my husband of 60 years has loads of patience but I am at my wits ens as to what to do, I cannot have an epidural and must take a half of a Vicodin almost every day, do you reccemend a chiropractor? I have never been to one but will try anything at this point.I would appreciate any advise.

    • Dr. George Best

      Reply Reply October 29, 2013

      Hello Arlene,

      Depending on the nature and severity of the underlying causes of your sciatica, a chiropractor may be able to help, and if not, can probably assess the situation and recommend the best treatment options for your circumstances. Because of your age and arthrtic issues, I’d suggest seeing a chiropractor who uses a low-force method such as Activator (for information, visit http://www.activator.com), Arthrostim (www.impacinc.net), or other instrument-assisted adjusting.

      Good luck!

      Dr. Best

  • Arlene

    Reply Reply October 28, 2013

    Dr. best, I am 80 year sold not 89, sorry about that,

  • Narayan Kanti Sarker

    Reply Reply November 9, 2013

    I want to join.

  • Vidhu

    Reply Reply November 20, 2013

    My wife is affected by sciatica.she got this attack close to 20 yrs back but got totally cured by some homeopathic medicine.now again she got the attack due to mismanagement of her body while visiting our daughter in US who has been blessed with a baby girl.she is now on allopathic medication & her pain is going down.we want to go for physiotherapy,but just waiting for dr’s advice.her is nerve compression case as shown in x-ray.please advice for your comments

    • Dr. George Best

      Reply Reply November 20, 2013

      My advice is for her to start with the self-treatment methods in my ebook, particularly the McKenzie method and the use of cold packs. If you do not already have it, you may download it from the link on this page:

      http://www.sciaticatreatmentathome.com/sciatica-treatment-exercises/

      The video on that page may be helpful as well.

      Good luck to her,

      Dr. Best

  • Vidhu

    Reply Reply November 20, 2013

    Very educative

  • Terry

    Reply Reply December 27, 2013

    Dr. George first of all I would like to thank you for your generosity in sharing valuable information to those of us suffering sciatica. I recently had surgery on Nov. 5th, 2013 and I was very happy afterwards with only the surgical pain, which pales in comparison to the nerve pain I had been experiencing, but about 4 days after leaving the hospital I started having nerve pain down to my knee once again. The only difference I see is that I do not wake up in the middle of the night with a very sharp pain in my upper hip which caused me to wake up screaming pretty much every night for almost 2 years, the pain still comes, a little less intense tho still very painful and it returns like clock work just as before. It comes no matter what I do. Now that I have had surgery and I am still in a lot of pain and discomfort, what should be my next step?

    • Dr. George Best

      Reply Reply December 27, 2013

      Hello Terry,

      There’s a few potential reasons for the pain to be back a few days after the surgery. First, there may be some inflammatory swelling that has built up around the nerve. If this is the case, then applying cold packs and using anti-inflammatories should help. Another common problem is that you may have some piriformis reaction going on and that will usually respond to massage over the muscle and/or stretching (be careful with the stretching to make sure you aren’t pulling on the incision). Finally, the worst case scenario is that there could be an infection that was introduced during surgery. Generally you will see a lot of redness (getting worse since the surgery) and increasing swelling around the incisions if this is the case and it will be noticeably warmer to the touch than the surrounding tissue. You might also have some discharge of yellow or white milky fluid from the incision. If you notice any signs of infection, notify your surgeon immediately and if he or she is not readily available, go to the emergency room. Even if you’re in doubt, have it checked because spinal infections can be extremely serious and should be treated ASAP. Hopefully it is just some inflammation or residual piriformis reaction.

      Good luck!

      Dr. Best

  • Jordan

    Reply Reply February 19, 2014

    I cant figure out why my lower leg got so weak after getting sciatica and the pain first began by my hip area, I had this before and got a epidural shot and everything was all good about 3 yrs ago but not this time, my leg has just gotten so weak I can bearly walk without falling to the ground. My back just feels a little stiff yet but other than that havent seen change.

    • Dr. George Best

      Reply Reply February 19, 2014

      Hello Jordan,

      In addition to sensation, the components of the sciatic nerve also control some of the major muscles of the leg. Weakness is a sign that the nerve is being more severely compromised than when there is just pain or numbness. In most cases the underlying issues can still be managed with the self-treatment methods, medication, and other non-surgical treatments, but it may take significantly longer to get back to normal than when you only had pain before. The general rule of thumb is to look for overall change (there’s usually some ups and downs, so you’re looking for the overall trend) over every two week period. If you’re not getting that improvement, I’d recommend having an MRI to further evaluate the situation and to help in deciding on treatment options such as surgery. While it’s generally OK to tough it out for longer with only pain, when weakness is present, waiting too long to get the necessary treatment could result in some permanent loss of muscle strength, so it’s important to take prompt action if things aren’t improving.

      Good luck,

      Dr. Best

  • inan

    Reply Reply February 21, 2014

    hi,
    I am writing from Turkey
    2years ago I had an parachute accident and I had hernia
    after treatment I started back my life.
    I do exercises (running,swimming,crossfit even freefall parachuting) and during day time I do not have any issue with my low back.
    But when I wake up it is like I crush the wall,it is so stiff and moving is so hard.
    after half an hour it gets better and finally I am again Ok.
    so what should I do?
    thanks….

    • Dr. George Best

      Reply Reply February 21, 2014

      If you are fine most of the day except for the half an hour or so right after you get up in the morning, the most likely problem is that your bed is not providing adequate support. The best solution to that issue is to get a new bed. If you can’t do that, the next best thing is to try to improve the support from the bed you have. Usually it will help to place a piece of plywood between the mattress and box spring and/or use some type of mattress topper (memory foam is best, but high-density “egg crate” foam rubber works OK and is a lot cheaper).

      Good luck!

      Dr. Best

  • Mudaser Jaura

    Reply Reply April 2, 2014

    Doctor George,

    I saw your website and couple of videos, I am suffering from Sciatica since few months gone to two different physio therapists but no improvements so far. I also went to a spine treatment center they said ” my spine alignment is not correct so they did it with sound wave technology. but I am still having pains, my pains start when I stand for more than 10 minutes..

    Please advise me something.

    Best Regards,

    Mudaser Jaura
    ceo@futureplannerz.com

    • Dr. George Best

      Reply Reply April 2, 2014

      Hello Mudaser,

      As a chiropractor myself, I know very well the importance of good spinal alignment; however, although it may have indirectly led to your sciatica, poor alignment by itself is probably not the direct cause of your symptoms. My advice is to start with the methods in my free ebook (if you haven’t already downloaded it, you may do so from the link on the right sidebar of this page. If you are not improving significantly within a couple of weeks, my recommendation would be to look into getting an MRI to more fully evaluate the situation. If it comes to that and you’d like my opinion on the MRI findings, let me know.

      Good luck!

      Dr. Best

  • Peter

    Reply Reply April 21, 2014

    hello Dr. George, thanks for all the usefull information in the video´s.
    I have a question about the McKenzie excersices. The point of doing this is to ¨centralize¨ the pain. This helps : at first I had the sciatica pain leaving my back, through the buttock and leg all the way to the ankle/foot.
    Now the pain is centralized in the lower back and most of the time not even there – but often I feel the sciatica pain ONLY in the ankle/foot. So not in the lower back, buttock or leg. Is there an explanation for that ? Best regards, Peter

    • Dr. George Best

      Reply Reply April 22, 2014

      Hello Peter,

      Most likely the residual symptoms in the ankle and foot are not sciatica per se. They could be referral pain from trigger points in the calf muscles and/or possibly the piriformis muscle. When you get the symptoms, try stretching the calf and the piriformis and if either of those stretches alleviates it, that’s the problem. Bouts of sciatica commonly result in contraction of those particular muscles and often knots of contraction will remain after the nerve irritation has been resolved. Besides stretching, you would probably benefit from some deep massage of the involved muscles.

      Another possibility is that in the course of limping due to the sciatica, you may have caused some dysfunction in the ankle. If the stretching doesn’t help, I’d suggest getting the ankle checked by a sports chiropractor.

      Finally, the sciatic nerve is composed of several nerve roots that branch off from the lower spine. When one or more of those nerve roots is significantly irritated, the entire sciatic nerve will produce symptoms. In cases of mild irritation of just one ore two nerve roots though, you may only get symptoms from those individual nerve roots. In this case, continued use of the McKenzie exercise should get rid of it.

      Good luck,

      Dr. Best

  • José

    Reply Reply August 1, 2014

    Hello, Dr. Best.
    Almost 2 weeks ago, I started experiencing pain on my right side mostly in my left buttock and hip. My Dr. gave me a cortisone shot to reduce the nerve inflammation, a shot for pain and a muscle relaxer. It didn’t help much. Most of the relief I got came from a deep tissue massage. Now, my right leg, from the knee to above the ankle is often tingly and numb, especially when I sit. This is essentially my only symptom now. Your thoughts?

    • Dr. George Best

      Reply Reply August 1, 2014

      You didn’t say, but I’m guessing the symptoms are on the outside of the leg (and not the back of the leg). If that’s the case, the most likely culprit is the gluteus minimus muscle. Additional massage and stretching for the gluteus minimus should help. While the muscle can contract abnormally as a result of excessive sitting or unusual exertion, there is often an underlying functional problem in the sacroiliac and/or hip joint. If a little more massage and stretching fails to bring lasting improvement, I’d suggest getting the joints checked by a chiropractor.

      If you have further questions, or if my assumption about the location of the symptoms was incorrect, let me know.

      Good luck!

      Dr. Best

  • Glyn Tomos

    Reply Reply September 28, 2014

    Hello Dr. Best,
    I would just like to thank you most sincerely for supplying free advice and guidance in such a simple and straightforward manner.

    My sciatica ( which was caused by extensive DIY plastering of walls in my home) was excruciating, and despite getting medical assistance that did alleviate the problems to a certain extent, it did not really answer any questions as to why, how long, and how permanent my pain would be.

    Your website provided ALL the answers, specific guidance, and was a huge comfort to a man who was physically fully fit but was in a state of mental quandary as to what had occurred to him.

    Thanking you most profusely,

    Glyn Tomos

    • Dr. George Best

      Reply Reply September 28, 2014

      You’re very welcome, Glyn. I’m glad that you found my information helpful!

      Dr. Best

      • Jerry

        Reply Reply December 19, 2016

        Finding this post has anserewd my prayers

  • stanley kozar

    Reply Reply February 20, 2015

    Dr.George Best
    For a week or so I have a very sharp pain in my left leg,especially in the back of the calf and in the back of the upper leg.I have no problem/notyet/sleeping but when I get out of bed in the mornig the when the sharp pain starts.It feels like a spasam or cramps but it is very painful and it takes me a long time walking before it loosens up a little and the pain lets up a little.I can walk fairly well latter in the day with not much pain but makes me wonder why is that stiffnes and the pain in the morning and where is that coming from
    Please giwe mi some answer on that
    Thank you
    Stan

    • Dr. George Best

      Reply Reply February 20, 2015

      Hello Stan,

      Symptoms that are worst first thing in the morning that improve after you move around are typical of inflammatory swelling. Chances are you have a disc protrusion or some other issue that partially narrows the nerve canal,but not enough by itself to cause enough nerve compression to create symptoms. When you are moving around, the movement helps to “pump” away inflammatory fluid to reduce the amount that collects in the area. When you are relatively still, such as when sleeping, the inflammatory swelling builds up and increases the pressure around the nerves. In addition, the discs take in fluid (as a normal process) when you are lying down and they are not under compression from gravity. This is desirable with normal discs, but in the case of one that is already bulging, that increased fluid volume inside the disc causes it to bulge more when you first get into an upright position. So, extra disc bulging plus extra swelling results in the maximum pressure on the nerve when you first get up.

      Dr. Best

  • Marigold

    Reply Reply January 11, 2016

    Dear Dr Best, Many thanks for your very informative videos & website contents. Also your replies to many comments are invaluable, providing enormous insights! My case a lot like Jose & Stan Kozar 20Feb2015. Problem started after a visit to a chiropractor over 30 years ago – immediate pain deep in left buttock around hip joint but alleviated by deep massage. Painkillers ~ aspirin & paracetamol~ worked very well for a long time, but now getting habituated. Also omega3 fish oil excellent with no side effects. However this physical pain problem increased over the years, and despite MRI, X-rays etc no real answer: but they all speculated: growing osteoporosis! Pain started shooting down outside of the upper leg as well & sneaking downwards, affecting my walk. Also pain peaks around 2-4 am during sleep, especially if I eat concentrated proteins for supper, so now I stop eating about 5 pm and it helps.But then recently my research online indicated its much more likely a Piriformis Syndrome + sciatica issue, and muscular contraction with inflammation. Perhaps gluteus min too? So I have started doing your exercises: helping a bit. And Mg mineral doses for muscle relaxation. Also some NLP applications to ‘turn down the volume’ of the pain so I can decrease the painkiller medication. This management protocol is the most positive in years. So grateful for all your advice – can avoid surgery now and be able to deal with the pain better.

    • Dr. George Best

      Reply Reply January 11, 2016

      Hello Marigold,

      I’m happy to hear that you’ve found my exercises to be helpful and that you’re getting some positive results from your current regimen. Pain in the side of the thigh is usually referred from the gluteus minimus, so I’d suggest focusing efforts on stretching and massage there. With no particular findings on imaging, I highly doubt that your symptoms are from osteoporosis. I think you are on the right track that it’s more likely to be piriformis and gluteus minimus related.

      Although your symptoms started with chiropractic treatment, I actually think you would benefit from chiropractic treatment in this situation. Gluteus minimus and piriformis issues are usually secondary to something else. Sometimes that’s nerve irritation from a disc protrusion or other lesion, but most often it is a functional biomechanical issue. The lack of imaging findings suggests a functional problem and I suspect what happened is that the initiating chiropractic visit caused some sort of sacroiliac and/or hip joint dysfunction. As odd as it may seem, sometimes an adjustment provides a partial correction of joint alignment, but the partial correction results in worse biomechanical function and increased symptoms. In other words, the joint corrects part way from point A (misalignment) to B (correct alignment), but the midway point is actually worse for the body than the original state of misalignment. I’ve seen that a few times over the years with my patients (and the patients of other chiropractors who come to see me) and it’s really just a matter of persistence and perhaps switching techniques to get things corrected all the way. I’m sure you’re not anxious to see a chiropractor again after the bad experience, but I really think it could be the key to getting good long-term resolution of your symptoms. If you are open to at least considering it, I would suggest seeing a chiropractor who uses a variety of adjusting techniques, ranging from low force methods like Activator, Arthrostim, or Sacro-Occipital Technique on up to manual manipulations.

      Good luck!

      Dr. Best

  • Marie Gobuyan

    Reply Reply January 19, 2016

    Thank you Dr. Best for your quick feed back to my Email. I fully understand that I cannot really expect a cure. I am a retired nurse ,84 yrs.old and osteoporotic ,…so what can I really ask for. I think all I need is some relief from pain because I don’t yet feel that old at my age and I can still enjoy life. I am soon scheduled for CT. Scan. When I get my result I will get back to you and enlist tin your exercise and maintainable program. Thank you again for your immediate attention . Marie G

  • Dilip

    Reply Reply September 11, 2016

    Sir,
    How much epidural injections usefull.

    Dilip

    • Dr. George Best

      Reply Reply September 22, 2016

      Epidural injections act by reducing inflammatory swelling that may be contributing to nerve compression. The amount that inflammatory swelling contributes to symptoms varies greatly from case to case, so the usefulness of epidural injections varies accordingly. In any case, the effects of epidural injections are usually temporary, lasting anywhere from a few days to a few months in most situations and in my opinion they are not a reliable stand-alone treatment. They can be useful in some cases for reducing symptoms enough to allow a person to more comfortably participate in exercises and rehabilitative care that will usually provide long term results or as a symptom control measure to help with sleep or tolerance to activities while other treatments are considered or employed.

      Dr. Best

  • david selkirk

    Reply Reply September 28, 2017

    Thank you so much for your info, i,m starting to feel better after 1 day of your info, i will subscribe to your site asap but the boss (her indoors )had my credit card. Once again you given me so much info, i have complete trust in you. 20 Years ago i was at hostpital and had all the tests for a bad back blue dye and all that stuff and asked to sign a form which was a waver for them because there was a 30% chance i would never walk again.No not happening Been fine for years with the odd 3-4 Days of pain every 3-4 years but i am a carpet installer so its tuff gig, once again Thank you so much.

    Dave

    • Dr. George Best

      Reply Reply September 28, 2017

      You’re welcome, Dave. I’m glad you’ve found my information helpful. As you say, carpet installation is tough on the back, so being proactive and taking preventive measures is especially important for someone in that line of work.

      Dr. Best

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