Tag Archive for: sciatica

Got a Pain in Your Butt? Here’s what to do first.

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Nobody likes a “pain in the butt.” But what do you do when you’re dealing with literal pain in your butt versus the figurative kind?

It starts with figuring out where it’s coming from. Understanding the origin of your pain is necessary if you really want to solve it! One of our Pilates regulars (“Stacy”) has a story that illustrates this concept perfectly.

Stacy had been doing all the right things. She keeps active, does Pilates with us, and walks regularly. But still, she ended up with that dreaded pain in her butt that so many of us deal with on a regular basis. She tried to work through it herself by foam rolling and stretching – but none of that worked to completely eliminate her pain. Plus, her symptoms were starting to limit her Pilates and walking. This made her nervous because staying active and mobile is one of the most important things to Stacy, and the idea of being stuck at home and in pain this winter season made her want to take action now. She did the right thing by going to see our PT team.

Their first course of action was to accurately determine the root cause of Stacy’s butt pain. It could be a few different things.

Most often, symptoms like Stacy’s will get “labeled” generically as any one of the following:

1. Bursitis

They’ll call it this if you’re feeling the pain more in the side of your hip versus center of your butt.

2. Piriformis syndrome

This refers to a pain in the center of your butt. You might feel some tightness as well.

3. Back problem/Sciatica

They’ll call it this if your pain is more diffuse and achy, and perhaps even running into your thigh. This last diagnosis will be more common if you’ve got back pain along with the hip or butt pain.

As I mentioned, any one of these things could be the source of Stacy’s symptoms, and getting it right is critical. The correct diagnosis is the determining factor of whether Stacy’s problem gets resolved for good, or becomes something she deals with for the rest of her life. The problem with diagnosing your butt pain (or any problem for that matter) based on the location of your symptoms alone is that it’s not a reliable diagnosis.

The location of your pain alone does not tell you where your problem is really coming from.

For example, I’ve seen people with pain in their hip and butt that is actually coming from their back – even when they’ve never had a back problem. If your butt pain is coming from your back, and you think it’s “piriformis syndrome,” you’re going to be really disappointed in a few weeks when your pain is still there (or perhaps even worse) because you’ve been going about treating it the wrong way. In order to accurately determine what was really going on with Stacy’s butt pain, we needed to do some specialized movement screens and tests.

Research has shown that your pain’s response to movement, and how it behaves, is a much more reliable way to figure out the source of your problem versus relying on the symptom location alone.

In Stacy’s case, some quick movement tests revealed that her butt pain was indeed coming from her back – even though she did not have any back pain. How did we know? Pretty simple actually. When we asked Stacy to move and bend her back in specific directions, it triggered her butt pain! Her piriformis muscle was also tight – and may still need to be stretched – but it’s very possible that the tightness she is experiencing is also being caused by whatever is going on in her back. It’s possible for nerves to refer both pain and a feeling of “tightness.” We’ll know for sure in a few weeks, because we prescribed Stacy a corrective exercise designed to target the problem in her back and take pressure off the nerve that was triggering her butt pain. In fact, if she had not come to see us and kept stretching what she thought was a tight piriformis, she likely would have aggravated her nerve and made her condition worse. Nerves don’t like to be stretched. This is a great example of why it’s critical to know the true source of your problem before you start treating it.

Hopefully Stacy’s story helped you understand that the first step in getting rid of a pain in your butt, is to accurately determine where it’s coming from! If you’re experiencing unexplained pain in your butt that isn’t going away with stretching or general exercise, perhaps you’re going after the wrong problem. Try paying closer attention to how your symptoms behave. Do you notice they get worse after you’ve been sitting for a while, raking leaves, or driving? Do they move around on you – and go from your butt, to your hip, to the back of your thigh?

Signs like this could mean you’re dealing with a back problem, not a butt problem. Click here for access to our FREE back pain guide! This guide contains our best tips and advice on how to start easing back pain and stiffness right away — and get on the road to pain-free movement just like Stacy did.

Tight Hamstrings: a Case Study

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If you’ve ever felt tightness in your hamstrings, the typical advice you get from friends, family, and even well-meaning health and wellness professionals is to stretch them.

Well… if it’s just your hamstring that’s actually tight then this might be good advice to follow.

But what if it’s something else?

If you accidentally stretch a hamstring that feels “tight” due to a back problem – there is a very good chance you’ll make your condition worse.

This exact scenario happened to a recent client of ours (we’ll call him “Jack”) who came to us with what he thought was a “hamstring strain.”

Jack had been stretching and stretching his hamstrings – which he had been told to do by his chiropractor – but he wasn’t feeling any looser. In fact, his hamstring even started to hurt the more he stretched, so he thought maybe he caused himself a strain.

Was he doing too many stretches? Or perhaps doing them incorrectly?

He made the smart decision to call us for help and came in for an examination.

And the first thing we asked him was…

“Where is your pain?”

Jack pointed to the back of his leg, but when he started describing his symptoms… it turned out they actually started in his butt, traveled down the back of his thigh, and stopped at his knee. But on occasion he’d also feel the tightness in his calf. And since doing all that hamstring stretching, he was even starting to feel pain!

Lesson number 1:

Your hamstring starts at your ischial tuberosity – otherwise known as your “sit bone” – and extends down to just below your knee. Since muscles and joints can’t actually refer symptoms (only nerves and sometimes fascia can do that), feeling pain or tightness anywhere other than your actual hamstring is the very first clue you could be dealing with something other than a hamstring problem.

Since Jack was feeling symptoms in his butt and also down into his calf, we knew immediately that “hamstring strain” was NOT Jack’s problem.

The next step was to figure out where his tightness was coming from.

Lesson number 2:

Since he’d been stretching for several weeks already and was starting to feel more problems in his leg – the likely explanation was that it was coming from his back.

While yesm over-stretching can make you sore, and yes, stretching incorrectly can cause you discomfort… that wasn’t the case with Jack. He was still feeling tight, and now on top of that he was dealing with pain.

All signs were pointing to a problem in his back.

Well now that we had our theory – it was time to test it!

After performing several movement tests with Jack’s back, we were able to produce the exact same tightness AND pain he had been feeling in his leg. And with some different movement tests we were actually able to ELIMINATE his symptoms temporarily.

Since moving his spine in certain directions was responsible for both turning “on” AND turning “off” his leg symptoms, we were able to confirm that he had a back problem – not a hamstring problem.

Pretty cool – right?

Jack thought so… but more importantly… he was glad to finally have some answers! Finally, he had a plan to move forward.

  1. He stopped stretching his hamstring.
  2. He started doing a different – and properly prescribed movement instead – that was designed to eliminate the symptoms in his leg.

We’ll of course need to continue working with Jack to make sure that his leg symptoms not only go away – but that they stay gone. Part of the process will be teaching Jack how to do this on his own in case the problem ever comes back again.

Sadly, I can’t tell you how many times I’ve seen a case like Jack’s in my office.

Lucky for Jack, he came to us early on – when his symptoms were mild. Basically, the nerves in Jack’s spine were starting to get irritated, and the result was a “tight” feeling in his hamstring. Nerves don’t like to be stretched, so Jack was actually making his problem worse by stretching and he didn’t even know it. Had he not gotten this addressed – the tightness in his leg could have progressed into full blown sciatica!

If you have any kind of ache or pain that isn’t going away on it’s own with natural movement or stretching – don’t try to figure it out on your own.

And as you learned from Jack’s case – not all movements are created equal. It’s possible you could look up a stretch on Google or YouTube and actually make yourself worse!

Don’t guess… TEST 🙂

And when it comes to pain during movement or certain activities – let the movement experts be the ones to test you and figure it out. All you have to do is click here to schedule a FREE, no-obligation consultation with one of our specialists! These Discovery Sessions are your chance to determine where your pain, tightness, or stiffness may be coming from and if we’re the right people to help fix it.

Is Quarantine Turning Into a (Literal) Pain in Your Butt?

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We are about 5 weeks into social distancing and doing our best to flatten the curve. Although we are all coming together as a country to do our moral duty and fight the spread of Covid-19, it doesn’t come without consequences.

More screen time and more couch time are wreaking havoc on our bodies.

Most people I speak with are making a concerted effort to be as active as they can during the day. But even the best efforts are not combatting the extra bending and sitting that is happening. It’s almost impossible to avoid it. Due to social distancing and more people working from home than ever before, our primary way of “gathering,” seeing loved ones, and communicating with co-workers is now totally digital.

Whether we like it or not, we are hunched over and leaning forward more than ever — and it’s becoming a pain in the butt, quite literally.

In our last blog post I talked about the difference between “good pain” and “bad pain.” Since then, I’ve spoken to many of you over the phone about your concerns. One of the most common questions that came across this week was about pain in your butt, and not the figurative kind!

Yes, too much sitting can cause pain in your butt, but not for the reasons you might think…

One person I spoke with thought it might be due to the hard kitchen chair he was sitting on. Makes sense, right? But when he added a cushion, and then tried moving to the recliner to do his work and online social gatherings, the pain in his butt got worse.

So he did what most of us do, and went straight to Google.

He thought that maybe he had “piriformis syndrome” and started doing the recommended stretches. The pain in his butt started to subside a little, but then spread to the back of his thigh. He thought the pain in his thigh might be due to the stretches and that it was a good thing. But after about a week of this, he woke up one morning unable to move his back! That is when he called me.

I explained that the pain in his butt was NOT due to piriformis syndrome like “Dr. Google” told him. It was actually coming from his lower back. All the extra sitting was putting pressure on his disc, which was putting pressure on his nerve, and the result was pain in his butt. Without realizing the true cause of his problem, he accidentally started doing stretches that made his problem worse. It’s very common to have a back problem and not experience any back pain. Back problems can manifest in your butt, thigh, or lower leg, and very often get confused with tight muscles that just need to be stretched. If you do the wrong stretches, you will make your problems worse and you WILL end up with back pain – often severe and seemingly out of nowhere.

Luckily, we were able to hop on a Zoom session and give him the correct stretches to do. Within a few weeks, he no longer had pain in his butt, and he knew what to do to keep it from coming back.

If quarantining is giving you a (literal) pain in your butt right now, don’t rely on Google to figure out your pain — talk to us!

We’ve been opening up extra slots on our schedules just to talk to people and help them figure out anything new or strange that might be going on.

All you have to do is fill out this quick form to request a call with one of our specialists.

work from home, coronavirus, back pain, quarantine

Back Pain Doesn’t Go Away for the Coronavirus!

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The coronavirus (COVID-19) is forcing everyone to adapt to new routines — but many of us are still experiencing the same old chronic pain. In fact, your back pain may start acting up again now due to stress, decreased exercise, and more time spent at home on your computer. The important thing is that you don’t ignore it! Listen to your body and KEEP MOVING!  

Prior to seeing us, many of our clients who suffer from back pain were told that the best way to recover was to ice and lie down. They were advised to rest, relax, and limit their movement until the pain goes away. The problem with this model for treatment is that it goes against everything we know about the basic principles of joint and tissue healing.

Our modern health research suggests that early movement is actually the BEST way to head off chronic back pain!

Of course, if you’ve suffered a trauma like a car accident or a major fall, you should absolutely go get checked out by a medical professional and follow their advice based on your injuries. But if you are dealing with a chronically aching back or general soreness, stiffness, and pain, it turns out that movement is actually the best course of action!

But not ALL types of movement and exercise are safe or beneficial when you’ve hurt your back…

That’s where physical therapy comes in! A physical therapist is able to identify specific movements that actually work through and relieve that pain, based on your individual condition. We call these initial exercises “first aid movements” – and they are especially helpful because you can use them any time you might tweak your back in the future! If you’re experiencing acute back pain, of course it doesn’t make sense to continue with all of your activities as usual if they are just exacerbating your symptoms. But there is a middle ground between overdoing it and completely stopping the movement that your body craves. 

But how are we supposed to see a physical therapist, you ask, when everything is shutting down to contain this coronavirus?