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'''Original Editor ''' [[User:Daan Vandebriel|Daan Vandebriel]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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'''Original Editor ''' [[User:Daan Vandebriel|Daan Vandebriel]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== '''Definition'''<br> ==
== '''Definition'''<br> ==
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== '''Physical Therapy Management'''<br> ==
== '''Physical Therapy Management'''<br> ==
-
The physical therapy exercises consist of strengthening, stretching and low impact aerobic conditioning. When patient
follow
a physical therapy program the patient will not only recover more quickly but are also less likely to develop future episodes of sciatica. There are differences between the exercises due
tot
the cause of sciatica. There are specific exercises for sciatica that is caused by [http://www.physio-pedia.com/index.php/Thoracic_Disc_Syndrome herniated disc], [http://www.physio-pedia.com/index.php/Spinal_stenosis spinal stenosis], degenarative disc
decease
, [http://www.physio-pedia.com/index.php/Spondilolisthesis ithmic spondilolisthesis], [http://www.physio-pedia.com/index.php/Periformis_syndrome pereformis syndrome], [http://www.physio-pedia.com/index.php/Sacroiliac_joint_syndrome sacroiliac joint syndrome].<br>In general the strengthening exercises can help strengthen the spinal column and the supporting muscles, ligaments and tendons. These focus on the abdominal, lower back, gluteus and hip muscles. These core muscles support the spine keeping it in alignment and facilitating movements that extend or twist the spine with less chance of injury or damage.<br>The stretching exercises focus on the muscles
who
are
who
are tight and inflexible. These are frequently the hamstrings.<br>The low impact aerobic exercises such
al
walking and swimming encourage the exchange of fluids and nutrients to help create a better healing environment. During aerobic exercise there is also an increase in secretion of endorphins which are the
body
natural painkillers.
+
The physical therapy exercises consist of strengthening, stretching and low impact aerobic conditioning. When
a
patient
follows
a physical therapy program the patient will not only recover more quickly but are also less likely to develop future episodes of sciatica. There are differences between the exercises due
to
the cause of sciatica. There are specific exercises for sciatica that is caused by [http://www.physio-pedia.com/index.php/Thoracic_Disc_Syndrome herniated disc], [http://www.physio-pedia.com/index.php/Spinal_stenosis spinal stenosis], degenarative disc
disease
, [http://www.physio-pedia.com/index.php/Spondilolisthesis ithmic spondilolisthesis], [http://www.physio-pedia.com/index.php/Periformis_syndrome pereformis syndrome], [http://www.physio-pedia.com/index.php/Sacroiliac_joint_syndrome sacroiliac joint syndrome].<br>In general
,
the strengthening exercises can help strengthen the spinal column and the supporting muscles, ligaments and tendons. These focus on the abdominal, lower back, gluteus and hip muscles. These core muscles support the spine keeping it in alignment and facilitating movements that extend or twist the spine with less chance of injury or damage.<br>The stretching exercises focus on the muscles
which
are are tight and inflexible. These are frequently the hamstrings.<br>The low impact aerobic exercises such
as,
walking and swimming
,
encourage the exchange of fluids and nutrients to help create a better healing environment. During aerobic exercise there is also an increase in secretion of endorphins which are the
bodies
natural painkillers.
-
When
suffering from
sciatica due to
a herniated disc
they often prescribe
extension exercises
ore
press ups for example Upper Back Extension . <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatica-a-herniated-disc</ref> <ref>Stuart McGill.Low back disorders: evidence-based prevention and rehabilitation. Second edition. Human Kinetics. 2007.P222. (D)</ref>
+
With patients
suffering from
Sciatica caused by
a herniated disc
, <span style="line-height: 1.5em;">
extension exercises
or
press ups
</span><span style="line-height: 1.5em;"> are often prescribed;
for example
,
Upper Back Extension.
</span>
<ref>http://www.spine-health.com/wellness/exercise/exercise-sciatica-a-herniated-disc</ref
><span style="line-height: 1.5em;"> </span
><ref>Stuart McGill.Low back disorders: evidence-based prevention and rehabilitation. Second edition. Human Kinetics. 2007.P222. (D)</ref>
-
When the cause of the
sciatica
is spinal stenosis flexion exercises of the lower back are suggested. Flexing the lower spine increases the size of these passageways and allows the irritation or impingement to resolve. The stretching exercises of the back are Back Flexion. For strengthening the abdominal muscles frequently used exercises are [http://www.physio-pedia.com/index.php/Hook-lying_March Hook-lying March ]and [http://www.physio-pedia.com/index.php/Curl-ups#Defenition Curl-Ups]. <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatica-spinal-stenosis (D)</ref>
+
When the cause of the
Sciatica
is spinal stenosis flexion exercises of the lower back are suggested. Flexing the lower spine increases the size of these passageways and allows the irritation or impingement to resolve. The stretching exercises of the back are Back Flexion. For strengthening the abdominal muscles frequently used exercises are [http://www.physio-pedia.com/index.php/Hook-lying_March Hook-lying March ]and [http://www.physio-pedia.com/index.php/Curl-ups#Defenition Curl-Ups]. <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatica-spinal-stenosis (D)</ref>
-
When suffering from sciatica due to degenerative disc disease a dynamic lumbar stabilization program is recommended. This program tries to find the most comfortable position for the lumbar spine and pelvis and training the body to maintain this position during activities. In doing this correctly, one can improve the proprioception of the lumbar spine and reduce the excess motion at the spinal segments. This will in turn reduce the amount of irritation at these segments, relieving pain and protecting the area from further damage. Examples of these exercises are [http://www.physio-pedia.com/index.php/Hook-lying_March Hook-lying March], [http://www.physio-pedia.com/index.php/Hook-lying_march_combination#Defenition Hook-lying March Combination ]and[http://www.physio-pedia.com/index.php/Bridging Bridging]. <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatica-degenerative-disc-disease (D)</ref> <ref>Stuart McGill. Low back disorders: evidence-based prevention and rehabilitation. Second edition. Human Kinetics. 2007.P226-229. (D)</ref>
+
When suffering from sciatica due to degenerative disc disease a dynamic lumbar stabilization program is recommended. This program tries to find the most comfortable position for the lumbar spine and pelvis and training the body to maintain this position during activities. In doing this correctly, one can improve the proprioception of the lumbar spine and reduce the excess motion at the spinal segments. This will in turn reduce the amount of irritation at these segments, relieving pain and protecting the area from further damage. Examples of these exercises are
;
[http://www.physio-pedia.com/index.php/Hook-lying_March Hook-lying March], [http://www.physio-pedia.com/index.php/Hook-lying_march_combination#Defenition Hook-lying March Combination ]and
[http://www.physio-pedia.com/index.php/Bridging Bridging]. <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatica-degenerative-disc-disease (D)</ref> <ref>Stuart McGill. Low back disorders: evidence-based prevention and rehabilitation. Second edition. Human Kinetics. 2007.P226-229. (D)</ref>
-
Sciatica can also be caused by
spondylolistesis
. In this case there are flexion based exercises and a stabilization program needed. The objective of this program is to teach the lumbar spine to remain stable in a flexed position. A few examples are [http://www.physio-pedia.com/index.php/Hooked-lying_march#Defenition Hooked-lying March]
,
[http://www.physio-pedia.com/index.php/Curl-ups Curl-Ups ]and [http://www.physio-pedia.com/index.php/Pelvic_Tilt#Defenition Pelvic Tilt]. <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatica-isthmic-spondylolisthesis(D)</ref> <ref>Donald W. Scheumann. The balanced body: a guide to deep tissue and neuromuscular therapy. Third edition. Lippincott Williams &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Wilkins.p176.(D)</ref>
+
Sciatica can also be caused by
spondylolisthesis
. In this case there are flexion based exercises and a stabilization program needed. The objective of this program is to teach the lumbar spine to remain stable in a flexed position. A few examples are
:
[http://www.physio-pedia.com/index.php/Hooked-lying_march#Defenition Hooked-lying
;
March]
;
[http://www.physio-pedia.com/index.php/Curl-ups Curl-Ups ]and [http://www.physio-pedia.com/index.php/Pelvic_Tilt#Defenition Pelvic Tilt]. <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatica-isthmic-spondylolisthesis(D)</ref> <ref>Donald W. Scheumann. The balanced body: a guide to deep tissue and neuromuscular therapy. Third edition. Lippincott Williams &
amp;amp;
amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Wilkins.p176.(D)</ref>
-
In cases of sciatica caused by a
piriformis syndrome
stretching of the piriformis muscle,
hamstrings muscle
and hip extensor muscles may be used to decrease the pain of the patient and regain his range of motion. <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatic-pain-piriformis-syndrome (D)</ref>
+
In cases of sciatica caused by a
Piriformis Syndrome,
stretching of the piriformis muscle,
hamstring muscles
and hip extensor muscles may be used to decrease the pain of the patient and
help to
regain his
/her
range of motion. <ref>http://www.spine-health.com/wellness/exercise/exercise-sciatic-pain-piriformis-syndrome (D)</ref>
-
When
the sciatica
is caused by a [http://www.physio-pedia.com/index.php/Sacroiliac_joint_dysfunction Sacroiliac Joint Dysfunction ]the treatment consists of range of motion exercises directed at the SI joint this can often restore normal movement and alleviate the irritation of the sciatic nerve. The 3 most important exercises are [http://www.physio-pedia.com/index.php/Single_Knee_to_chest_Stretch#Defenition Single Knee to Chest Stretch]<ref>Marcia K. Anderson. Fundamentals of sports injury management. Second edition. Lippincott Williams &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Wilkins .1997.p100. (D)</ref>
,
[http://www.physio-pedia.com/index.php/Press-Up Press-Up ]and [http://www.physio-pedia.com/index.php/Lumbar_Rotation#Defenition Lumbar Rotation]<ref>American Academy of Orthopaedic Surgeons .Athletic training and sports medicine.Jones and Bartlett Publishers.2006.P552-553.(D)</ref>(non-weight bearing).
+
When
Sciatica
is caused by a [http://www.physio-pedia.com/index.php/Sacroiliac_joint_dysfunction Sacroiliac Joint Dysfunction ]the treatment consists of
a
range of motion exercises directed at the SI joint
;
this can often restore normal movement and alleviate the irritation of the sciatic nerve. The 3 most important exercises are
:
[http://www.physio-pedia.com/index.php/Single_Knee_to_chest_Stretch#Defenition Single Knee to Chest Stretch]<ref>Marcia K. Anderson. Fundamentals of sports injury management. Second edition. Lippincott Williams &
amp;amp;
amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Wilkins .1997.p100. (D)</ref>
;
[http://www.physio-pedia.com/index.php/Press-Up Press-Up ]and [http://www.physio-pedia.com/index.php/Lumbar_Rotation#Defenition Lumbar Rotation]<ref>American Academy of Orthopaedic Surgeons .Athletic training and sports medicine.Jones and Bartlett Publishers.2006.P552-553.(D)</ref>(non-weight bearing).
-
The use of spinal manipulation or chiropractic
tries
to create a better healing environment. Research suggests that spinal manipulation is affective for acute cases of sciatica but hasn’t proven useful
witch
chronic cases
of sciatica
.<ref>http://linkinghub.elsevier.com/retrieve/pii/S1047965110000938 (D)</ref>Chiropractic treatment is based on the
hupothesis
that vertebral
decompresion
can be prevented by a flexion distraction procedure.
Due to
this procedure there is
a
greater intervertebral space
ans les
compression on the vertebral elements
. For
example the patient lies on
its
stomach
witch
a little flexion in the spine
.Due
to
a dawnward
flexion a
destraction
occurs. It has been proven that this treatment decreases the interdiscal pressure.<ref>http://scriptiesonline.bib.hva.nl/document/44239</ref> <ref>Larry P. Credit,Sharon G. Hartunian,Margaret J. Nowak .Relieving sciatica. Old Broadway.2000.p 42-46.(D)</ref>
+
The use of spinal manipulation or chiropractic
treatments try
to create a better healing environment. Research suggests that spinal manipulation is affective for acute cases of sciatica but hasn’t proven useful
with
chronic cases.<ref>http://linkinghub.elsevier.com/retrieve/pii/S1047965110000938 (D)</ref>Chiropractic treatment is based on the
hypothesis
that vertebral
decompression
can be prevented by a flexion
-
distraction procedure.
During
this procedure
,
there is greater intervertebral space
and less
compression on the vertebral elements
: for
example
,
the patient lies on
his/her
stomach
with
a little flexion in the spine
and due
to
downward
flexion a
distraction
occurs. It has been proven that this treatment decreases the interdiscal pressure.<ref>http://scriptiesonline.bib.hva.nl/document/44239</ref> <ref>Larry P. Credit,Sharon G. Hartunian,Margaret J. Nowak .Relieving sciatica. Old Broadway.2000.p 42-46.(D)</ref>
== '''Differential Diagnosis'''<br> ==
== '''Differential Diagnosis'''<br> ==
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Erginousakis D, Filippiadis DK, Malagari A, Kostakos A, Brountzos E, Kelekis NL, Kelekis A. Comparative prospective randomized study comparing conservative treatment and percutaneous disk decompression for treatment of intervertebral disk herniation. 2011 Aug.(B)<br>
Erginousakis D, Filippiadis DK, Malagari A, Kostakos A, Brountzos E, Kelekis NL, Kelekis A. Comparative prospective randomized study comparing conservative treatment and percutaneous disk decompression for treatment of intervertebral disk herniation. 2011 Aug.(B)<br>
+
<br>
+
+
== '''Recent Related Research''' ==
+
<div class="researchbox"><rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1FYSEY2m9I7_sB43mJKBFys-qNH8mnMtAosYLehw9mGq-9GkEi|charset=UTF-8|short|max=10</rss></div>
== '''Resources '''<br> ==
== '''Resources '''<br> ==