What's Causing My Sciatica? Simple Tests You Can Do At Home

what's up guys hey Jer dextran here doctor of physical therapy tone and tighten calm do you have sciatic nerve pain today I wanted to discuss with you three of the most common reasons why you get sciatic nerve pain and how to tell exactly where yours might be coming from let's get into it right now [Music] all right you guys so what is sciatica and how can we tell exactly where yours is coming from so we've got nerves that come down our back and they exit at each individual vertebral level and so represented here in the yellow would be our nerves so again they come down our spinal column and then they're going to exit out of our spinal cord out at each kind of individual vertebral level now the bottom most nerves so you've got a few of them right here on this side and you've got a few of them I don't know you guys but I can't see that very well on the inside part right here those bottom most nerves they actually come together to form three nerves and then they in turn are going to be wrapped in one kind of big sheath and so three nerves wrapped together forms kind of one big ol nerve that comes out again kind of down on that lower level and then travels right down your leg it's that combination of those three nerves and then again in that common sheath they travel down your leg that we refer to as the sciatic nerve now sciatica simply refers to an irritation of the sciatic nerve and so I point out to people all the time sciatica is not a diagnosis it's not telling us anything about where your pain is coming from sciatica is a symptom it's simply referring to pain that radiates down in your leg and so in order to treat your sciatica effectively you have to be able to come to the right diagnosis because not all back pain and not all kind of radiating pain down your leg is going to be created equally depending on the cause that I'm going to recommend different treatment options and different kind of plan of care for each of those different causes and so the three most common causes of sciatica that I see in my physical therapy clinic are going to be a bulged disc or a herniated disc stenosis or degenerative disc disease or DDD as number two and then number three is going to be what we call a piriformis syndrome tightness of the piriformis muscle that actually pinches down on that nerve and so what I wanted to show you guys what I wanted to demonstrate in the video today are just some simple tests that you can do at home to determine exact we wear your sciatic nerve pain is coming from or where that sciatica is originating from that you can then kind of troubleshoot it a little bit better and figure out what is the best treatment plan how we can best take care of your pain and so let's get into those right now all right so let's first talk about a bulged disc or a herniated disc and some common signs and symptoms that I see in that condition I'd say for the most part this is pain that is unilateral so it only happens down one side as opposed to both starts in your back or in your butt and can travel down your leg either into your butt into the back of your knee sometimes it's even all the way down into the foot can fill some numbness or some tingling kind of in places throughout your leg depending on which nerves affected and how badly it's affected these are people who a lot of times bending forward really aggravates that that disc as it puts more pressure on the front of the disc causes more bolds towards the back side more pressure on the nerve so bending forward especially bending forward to like pick something up to do that against a load is really painful if you have a bulged disc a lot of times standing upright and walking around is really helpful to these people so if you can kind of get up into this position walk around is really gonna alleviate some of your symptoms I'm actually gonna go grab my wife let me show you a couple more tests that we use in my PT clinic for this bulged disc condition all right so I brought my wife in to demonstrate two of our most common tests that we use to diagnose a bulged disc or a herniated disc now again the anatomy here is that the nerves go from her brain all the way down her back exit out her leg and basically go all the way down to her big toe somewhere along that line they're being bugged if it is in her lower back and if it is a disc we can actually reproduce those symptoms by increasing tension in that nerve basically stretching that nerve making that nerve long so what she's gonna do is get into a slumped position so she's gonna round her back she's gonna tuck her chin down into her chest if it was her left leg that's aggravated now what I want her to do is slowly extend that left knee until you start to feel maybe some of that production of those nerve symptoms and so not a lot of people will even be able to go this high they might even lis make it to kind of right here when they start to feel stress in the back of her leg now what else she can do is she can actually bring her toe and pull it up towards her knee to add even a little more stress to that test if that's positive you're gonna feel that reproduction of those sciatica symptoms down your leg that would be indicative of a herniated disc our second test go ahead and lay down on your back here BAE would be a straight leg race test so she's gonna scooch all the way up so that she can kind of lay out flat I want both your legs out straight and then in this position what she's gonna do you can do this on your owner you can have a helper is just someone who's gonna very slowly bring your leg up into this position now oftentimes when I find positive tests on this people will get to about this point about this 45 degree angle if we come up here I'm starting to get resistance there but that is just tight hamstrings that's I'm meeting her hamstring resistance right there if it's true nerve pain again increasing the length of that nerve and pulling on that nerve with that disk in the way she's gonna get to about right here and say okay yeah I'm starting to feel some electricity down the back of my leg with that one what I then asked her to do is pull that toe towards her or go ahead and relax if you have an assistant I can come in and I can push on that and all of a sudden zing wow yeah that really hurts those nerve pain that really reproduces that nerve pain down the back of my leg that's what we would call a positive straight leg raise test which would also be indicative of that bulge disk condition the last test that you can do a home to check and see whether or not you've got this bulged or herniated disk condition would be some simple muscle tests a lot of times the nerves that are affected are kind of the lower nerves in your back they're the ones that are primarily responsible for moving your foot up and down so one thing you can do is walk around on your heels and so you'll see here that I'm up on my heels I have good nerve activation I have good nerve signal and muscle activation to this muscle in the front right here if that nerve if one of those nerves is bugged if it's that l5 nerve it's going to actually affect your activation of that muscle and so for you to walk around on your heels like this that side that's affected you might be fine on one side but the other one you might not be able to hold it up because that nerve signal isn't getting to that muscle that muscle completely the other thing that you could do if it's that next disc down that might be affected is stand on one foot and then just do some heel raises and so here's my left leg I usually tell people to do about ten of those and if it's not affected you should be able to get through ten of these pretty easily however if it is that right side disc and if it is that right side nerve that's affected that's going to be a little more difficult for me to do these single leg heel raises I might get through four or five six of those and notice a significant asymmetry between those muscles between that muscle activation that would be another indication then you might have a bulge disk condition so if any of those are true you guys if you've got the straight leg raise test you've got the slump test and the muscle tests any of those other kind of signs and symptoms we talked about that would be indicative of a bulged or herniated disc I shot a video for you guys it's all about how to treat sciatica related to that bulge disk condition check out the link in the description to this video I've linked to that video from there you can also click on it read up here I'll leave the link up here you can click on that to go to again the best treatment for that bulged or herniated disc condition the second most common cause of sciatica that I see in my PT clinic would be a stenosis condition or degenerative disc or deteriorated disc or DB D all of these things are indicative of the same thing basically your disc should be this tall over time that disc loses its ability to retain fluid over time it shrinks and so the thing that we most commonly hear with a degenerative disc are maybe someone who's a little bit older and so a lot of times I'll see the degenerative disc condition in someone who's in their 40s and 50s and 60s as opposed to back pain and sciatica in your 20s and 30s and 40s and so a little bit older is the typical population that I see this one in these typical these this condition is tip aggravated by bending over backwards so standing up standing up straight bending over backwards a lot of times aggravates that pain in your back and down your leg conversely oftentimes it's alleviated by folding forward and so these are the people who walk around like this because that helps their back to feel better they prefer sitting to standing all of these things are going to alleviate pressure on that disc and then also this is back pain and sciatica nerve pain that can happen bilaterally meaning as that disc gets shorter a lot of times it pinches on the nerves on both sides of your back and causes those symptoms to radiate down both sides so those are the things that oftentimes we cue into with the degenerate degenerative disk condition now if you're experiencing the degenerative disc with the sciatica I shot a video about some of the best stretches and exercises that you can do at home to treat this stenosis or DDD condition look for that and a link below I'm also going to leave a link to that video right up here in this spot click on that to be taken to those videos alright so lastly let's talk for a second about piriformis syndrome as a cause for your sciatica brought my wife back in to help me demonstrate some of these however let's first talk about some some other causes that you might be experiencing I see a lot of piriformis syndrome in people who spend a lot of time sitting especially if you're sitting maybe on a wallet if you sit a lot with your leg crossed those are all things that kind of cue me into thinking okay maybe it's that piriformis muscle that's affected another thing that I key into is hip mobility and so to demonstrate especially rotational mobility so to demonstrate that Camille's going to get into let's cross your right leg over your left and you'll see that if you know straight up and down with zero degrees she can get about 90 degrees that's probably about eighty degrees of rotation in that hip with the right hand she can even push down on her right knee and you can see that we can add a few more degrees to it and so that would be indicative so I would expect about a seventy kind of 80 to 90 degrees of hip rotation let's say her right side was pain free now get out of that position now let's check the left side and let's say for example she's in this position so if you here zero we're looking at like 45 50 degrees there of hip rotation and if that's tight that can be indicative of tightness in that piriformis muscle if she even kind of pushes down on that and she's only getting kind of to here okay yeah we have an asymmetrical or we have an imbalance in that piriformis muscle if it's that left side that's painful that can be a pretty good indicator go ahead and uncross your legs the other thing that she can do is look at her internal rotation range of motion so seat it just like this if we have her pull her legs apart again as we look at that that should be pretty symmetrical if it's not most of the time it's probably on that side where you're experiencing those sciatic nerve symptoms and again that would be indicative of the piriformis Sentra's syndrome that'd be an indication that we need to treat that specifically and then the last thing that we the last the test that I use kind of for this piriformis syndrome would be pain with muscle activation so Camille's gonna lay down up here on her left side and let's say for example again that it was that right side that's affected and so she's laying on her side with her knees together and her feet together and now what she's going to do is separate her knees what that does is we call this a clamshell and the PT clinic again indicative of a clam opening up its mouth what that's doing is activating that piriformis muscle it's a hip external rotator activating it if it is a cause for your pain can actually cause some of those symptoms it can cause pain and can cause point tenderness in that area now if this is too easy you can have you know a friend or a helper actually come in and kind of give you a little push on that if we activate that muscle with a little bit more resistance on there and if it does reproduce that pain either in that spot or down your leg that could also be indicative of a positive piriformis syndrome so if you think that your pain might be due to that piriformis syndrome or if some one of those things that I just mentioned you know sounds like your pain sounds like your sciatic nerve pain I also shot a video for that the best exercises and stretches you can do to alleviate your piriformis related sciatica symptoms again check out the link in the description to this video check out this link right up here that will take you to the best exercises you can do for that condition and so that's it for me you guys hey again I just wanted to highlight the three major causes that I see for some of those sciatic nerve symptoms that you might be experiencing talked about how to diagnose them what could potentially be causing man and then again left you some links to some great video ideas on how you can best treat that pain treat those symptoms so I hope you guys found this beneficial if you did do me a favor hit that like button down below thank you so much for that in advance also if you haven't done so already please subscribe to tone and tighten here on YouTube my goal is to help you guys to become the fittest healthiest most pain-free versions of yourself I hope you take the chance to subscribe to this channel if you have any questions comments or suggestions for future videos leave those in a comment down below I'll get to those as soon as I can and until next time you guys hey we'll see you right back here on tone and tighten [Music]

Channel: Tone and Tighten

Views: 601,066

Keywords: how to diagnose sciatica, how to diagnose sciatica pain, how to diagnose sciatic nerve pain, sciatica, sciatic nerve, sciatica pain, sciatic pain, sciatic nerve pain, sciatica symptoms, sciatica pain relief, sciatica relief, sciatica relief exercises, sciatica diagnosis, sciatica treatment, sciatica treatment exercises, how to treat sciatica pain, how to treat sciatic nerve pain, diagnose sciatia, physical therapy, tone and tighten, sciatic exercise, leg nerve pain

Id: KhTDej-LKRM

Length: 14min 41sec (881 seconds)

Published: Thu Mar 28 2019