FIIX

  • How Do You Know If It’s REALLY Sciatica?

    You bend over to pick something up, your back goes out and you feel that shooting pain down your leg. Your mother, neighbour, and massage therapist all tell you “It’s sciatica”. But is it? Or is it something else?

    Did you know that the SI joint can refer pain down the leg very similarly to sciatica? At The Movement Boutique, many of our patients come in already “diagnosed” with sciatica by a friend or family member (or Dr. Google!) and are surprised to learn that they are actually experiencing SI joint dysfunction. With so many causes of back pain, and sciatica leading the way on the internet, it can be difficult to decode on your own. Especially when the search term includes back pain that ‘goes down the leg’. Because of things like the start of ski season, snow shoveling, high heels at Christmas parties and carting around those holiday shopping bags, these types of injuries are especially common during the winter months

    So, what’s the difference and what do they have in common?

    Our SI joints are located under your thumbs when you put your hands on your hips. They serve both a stabilizing and shock absorbing function. The SI joint’s main purpose is to connect our sacrum (which is the bone at the base of our spine) to our iliac crest (aka our pelvic bone) and support our upper body weight. Since it serves a weight bearing function, the joint is generally quite stable with minimal, but necessary range of motion. SI joint dysfunction can be caused by a variety of things such as pregnancy, weight gain, or repeated movements that put stress on the joint and muscles. Sciatica, on the other hand, is often more serious and caused by irritation of the sciatic nerve (a long nerve that runs from lower lumbar spine all the way down the back of the leg. It’s common for people with bulging or herniated discs (more common under age 45) or an encroachment due to degeneration (more common over 45) to experience sciatica.

    Many times, sciatica symptoms and SI joint dysfunction can mimic each other, so one can easily be mistaken for the other. Both types of injuries can be experienced as an intense sensation (sometimes described as an “electrical shock”) starting in the lower back and travelling down the back of the leg. That’s why in many cases, when you go to your GP and describe the pain, they will assume it’s the sciatic nerve, but the truth is, not all pain that travels down the back of the leg is necessarily sciatica.

    To get it properly assessed and diagnosed, we recommend seeing a qualified practitioner and if you’re local, this is something we see on the regular at TMB. In the meantime, we wanted to give you some tips to help you differentiate the two. Please note that everyone is different and these factors can sometimes overlap when it comes to sciatica and SI joint dysfunction, but it should serve as a helpful starting point to paint a clearer picture for you!

    1. Imaging

    While neither will technically show up on an x-ray, the signs of sciatica will show up on an MRI.

    vs.

    If the MRI imaging is negative, then it might be a clue that you have SI joint dysfunction.

    **Keep in mind that imaging does not always correlate with functional problems. One of Dr. Bhat’s favourite analogies to illustrate this is to picture a photograph of a car parked in an auto body shop. Can you tell if the car has just been dropped off or ready for pick-up just by looking at the photo? NO! Similarly, you can’t tell just by looking at an image if there’s a functional injury. It needs to be properly assessed by a professional.**

    2. Referred Pain vs. Radiating Pain

    Radiating pain is pain with which a nerve is the actual source, forming a direct line from the sciatic nerve (in this case, the source) to other areas of the body. This is more so the type of pain you’d experience with sciatica.

    vs.

    Referred pain can be felt in other parts of the body other than the actual source. The source can be the SI joint, but you feel it in the low back and/or down the outside of the leg to the knee.

    3. Trigger Points

    Sciatica – Trigger point release (pressing down on the area) worsens the pain. If you press down on the part that hurts and you continue to feel an “electric shock” type of feeling, then it’s more likely sciatica from nerve irritation.

    vs.

    SI joint – Trigger point release will help the pain subside. The soleus muscle can play a big part in SI joint problems. In fact, a trigger point in the soleus muscle and the posterior fascia sleeve goes all the way up the back of the legs and into the SI joint. Other trigger points here include the glutes, hips and right below the lower ribs. If you press down on any of these trigger points and you notice pain relief or more mobility, then it’s more likely you have SI joint dysfunction.

    4. Aggravating & Relieving Positions

    Sciatica – Bending over, twisting, carrying heavy loads etc. would aggravate the injury. Lying on your tummy on your elbows with your chest lifted (this is known as the “McKenzie stretch”) or lying on your back with your knees bent on a chair would relieve the pain.

    vs.

    SI joint – Driving or sitting with your pelvis slouched (or body slightly rotated) with your legs above the rest of your body (think lying on a hammock) for prolonged periods of time would aggravate the injury. Pregnancy can also cause it.

    5. Pain Location

    Sciatica – Very sharp “electric shock” like pain that can easily be traced deep in the glutes, down the back of the leg, most frequently into the foot.

    vs.

    SI joint – Diffuse pain that is typically felt in the lower back, hip, leg, and/or groin and the patient might have a tough time narrowing down exactly where they feel the pain.

    At TMB, if a patient points the pain using their hand, it’s likely diffuse pain (SI joint), whereas if they use their finger to trace the exact path of their pain, it’s more likely nerve irritation (sciatica).

    6. Character of Pain

    Sciatica – An “electric shock feeling” that you can trace with your finger and your sensory might also be off (numb, tingly “pins & needles” feeling on the bottom or side of foot).

    vs.

    SI joint – More of a diffuse, sharp or achy pain that can, depending on severity, travel down the leg (usually no further than the knee) and feels heavy and/or sore.

    7. Treatment

    Barring a traumatic fracture-causing case of either, requiring surgery, conservative care is recommended for both. This would include acupuncture, spinal mobilization, fascial release, low-inflammatory diet, rest from aggravating activities and icing. At TMB, we also suggest natural anti-inflammatory supplements like Curcumin and Inflammatone

    About The Movement Boutique in Toronto – Pilates, Chiropractic, Functional Medicine

    TMB The Movement Boutique Located on Yonge Street in Toronto, The Movement Boutique serves the areas of Summerhill, Rosedale and Yorkdale with Pilates classes and much more. Our philosophy is centred on a holistic, multimodal approach to health, grounded in the latest therapeutic techniques and clinical research. Our approach: Optimal health cannot be attained through a single therapeutic lens; injuries are often the result of a constellation of lifestyle issues, including dysfunctional movement patterns, trauma, nutritional deficiencies or destructive habits of mind.

     

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  • 7 Fun Fascia Facts to Help You Move Better

    Understanding what fascia is to help you look and move better

    “Mirror, mirror on the wall, who has the most gorgeous fascia of them all?” Wait a minute! What is fascia exactly? Don’t worry if you had to ask – it’s a common question and one that has a most intriguing answer!

    What is fascia exactly and why is it important?

    Fascia is a sheet of connective tissue, mainly collagen, located beneath the skin like an extra layer that encloses and separates all of our muscles and organs. Optimizing fascia through acupuncture, soft tissue techniques and facial release can drastically improve how we workout, how we approach injury prevention and how we address pain management.

    Understanding fascia in functional medicine

    Although fascia remains invisible to the naked eye, it is a pretty incredible part of the human body that when regarded from a functional medicine approach can increase mobility, strength, relieve stress and eliminate pain and discomfort.

    It’s not magic, it’s mechanics and here at TMB our treatments involve a thorough understanding of fascia and fascia release to address root causes of pain.

    Let’s get into some fun stuff though! Here are seven fun facts about fascia!

    1. FASCIA IS LIKE THE BODY’S FRAMEWORK

    Fascia is the system of connective, fibrous tissue fibers that lay just under the surface of our skin and is wrapped around every structure throughout our whole body. It’s role is to act as a framework of protection and support and to create a barrier between our deeper soft tissue and skin.

    2. FASCIA MAKES FOAM ROLLING FEEL GOOD

    We bet you’ve used a foam roller before, right? And we bet you know how good foam rolling feels. Foam rolling is actually a fascial release tool that helps keep you mobile and release any built up tension or “stickiness” in the body.

    3. FASCIA IS LIKE AN ORANGE’S INSIDES

    You heard us! Take a moment and think of an orange: the white, stringy rind that you see underneath the peel is like our fascia. The white layer surrounds the fruit, dividing it into various segments, just as your fascia encases your bones, muscles, nerves, blood vessels and organs.

    4. FASCIA CONNECTS EVERYTHING

    Fascia is connected to everything in our body – everything! This is why we always address the root cause when it comes to injury and dysfunction. You might feel pain in your knee, but the underlying issue could actually be somewhere in your shoulder! Fascia connects everything so pain can be felt in areas beyond where it originates.

    5. KEEPING FASCIA HEALTHY IS IMPORTANT

    Unaddressed injuries can create a domino effect in the body, which means that you can have subtle pain in your lower back that years later can spiral into your shoulder, your neck, even down to your feet! Wild, right? Myofascial release techniques and acupuncture help ensure your fascia stays healthy, so that you reduce your risk of an injury snowballing into something more severe.

    6. FASCIA IS YOUR LARGEST ORGAN

    Not only is fascia your largest organ, but it’s also the richest sensory organ in your body, with between six to ten times higher quantity of sensory nerve receptors than the muscles. Understanding this is important, because it goes to show why well-hydrated and supple fascia is essential to movement, alignment, proper function and injury prevention.

    7. MAINTAINING FASCIA MAKES A DIFFERENCE

    Ongoing support of your fascia through regular treatments will go a long way in preventing small problems and dysfunction from becoming chronic and decreasing your quality of life in the future. In short, making your fascia care a priority can help prevent other issues from developing.

    GOOD HEALTH AND GREAT MOVEMENT IS LINKED TO YOUR FASCIA

    And there you have it! Seven fun facts about fascia to help you move and feel better!

    Visit TMB to talk in more detail about your fascia care and see all of our treatment options! We provide tailored health improvement services that fit you better than designer couture!


    About The Movement Boutique in Toronto – Pilates, Chiropractic, Functional Medicine

    TMB The Movement Boutique

    Located on Yonge Street in Toronto, The Movement Boutique serves the areas of Summerhill, Rosedale and Yorkdale with Pilates classes and much more. Our philosophy is centred on a holistic, multimodal approach to health, grounded in the latest therapeutic techniques and clinical research. Our approach: Optimal health cannot be attained through a single therapeutic lens; injuries are often the result of a constellation of lifestyle issues, including dysfunctional movement patterns, trauma, nutritional deficiencies or destructive habits of mind.

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