Sciatica v Sacroiliac Joint Dysfunction

Do these symptoms sound familiar? “Hi Doc, I have been getting a dull achy pain that travels into my bottom and sometimes down the back of my leg. I think I have sciatica” What you might be describing is not sciatica at all but a referral pain from the muscles and/or joints in the low back and pelvis.

These structures include:

1. The sacroiliac joint (SIJ)
2. Lumbar Facet joint
3. The gluteal muscles
a. gluteus maximus
b. gluteus medius
c. gluteus minimus
4. Quadratus lumborum muscle
5. Iliolumbar ligament

These are just a few examples of structures around the low back and pelvis which can potentially cause the pain and discomfort that travels down the back of the leg. The difference from actual sciatica is that in most cases the pain normally won’t travel past the knee. There are some exceptions where the gluteals can refer past the knee but the path of the pain will be different from that of sciatic pain. Sciatica is a symptom of nerve entrapment specifically to the sciatic nerve which sits deep under the muscles in our buttocks. Sciatic pain will travel down the back of the leg past the knee into the lower limb and even the foot. This can also be accompanied by numbness, tingling and weakness in the leg or foot. With all neuromusculoskeletal conditions, it isn’t always so black and white and conditions may not present the same in every person. So, it is always best to have a qualified professional like a chiropractor assess and advise on the issue.

All the conditions listed above can benefit significantly with a combination of conservative treatment which involves dry needling, soft tissue therapy and gentle manual adjustments. On top of this conservative treatment approach, a specific rehabilitation program to complement is imperative. It is essential to have a qualified strength and conditioning coach that understands the body, its biomechanics and the way it can be injured for full rehabilitation.

Why is it important to have a good foundation of strength?

We are spoilt for choice when it comes to finding ways to improve our fitness and achieve our goals. We have 24/7 gyms, CrossFit gyms, F45, circuit training, Pilates and Yoga. So, it can all be a bit confusing as to which one to choose and why.
All these types of training can be a great option for you, however, if you don’t have a fundamental basis of movement you are likely to head down the road to pain and injury. Which can mean weeks to months off training and achieving your goals.

To perform any type of activity we must have a foundation of neuromuscular strength. If the task at hand is greater than what our tissues and nervous system can handle, we fatigue and reach a point of failure. This is when injuries occur and the frustrations that come with them. Let me give an example. Think of everything you do daily, this could include picking your young children up and down, carrying them on your hip all-day, doing groceries, washing clothes and other chores. Then at the end of the day you go and play a game of soccer or football or head to the gym for some ‘you’ time.

If your ability to move is compromised due to poor biomechanics and your movement health hasn’t been assessed correctly, then how do you know that your foundation of strength is able to withstand all this increase of load into your body and that it will not fail you at the time of most need?

Our movement patterns and base line of strength must be screened to assess whether we are “fit enough” to perform a certain task. This is no different to your yearly checkup at your medical doctor or GP that assesses your weight, blood pressure, cholesterol, heart rate etc. I see many people who can’t move well and don’t have any foundation of strength and yet they jump right into a CrossFit or F45 gym class and they come out injured because their movement capacity and strength is too low to withstand such a workout.

This is where a qualified experienced Strength and Conditioning movement specialist is necessary to help guide and build proper strength so that they can achieve their movement goals. Whether you are a novice athlete, elite athlete, anywhere in between or just looking to stay fit to play with your children it is important to have a proper individualized program in place. This will allow you to continue to do the activities you love.

If you are experiencing any of the above pain and discomfort or even would like to talk about improving your strength and having your movement assessed, contact Neurohealth and we will be more than happy to provide information to help.

If you would like more information or would like to book an appointment at Neurohealth Chiropractic – please call the clinic on 9905 9099 or email us admin@neurohealthchiro.com.au or fill in the contact form from our website www.neuro- healthchiro.com.au
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You can also head to http://joesbasecamp.com.au for further strength and conditioning information.

This article is written by Dr. Braeden Melmer, Chiropractor – Neurohealth Chiropractic