Learn safe and effective exercises for alleviating sciatica pains. Hosted by Dr. George Best.
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Okay, now of the things that you need to be able to tell is whether you're having more of a true sciatica which I'll say it's a condition primarily it's caused by discs where the discs are bulging and pushing against the nerves or whether you have a condition know Piriformis syndrome or you have a combination of the two. There is a fairly simple way to tell which is which. Again you could have both of them at the same time. But let me just start with telling whether or not it looks like it's true sciatica and one way to do that is by sitting in a chair and again let's there is my left leg is the one where I'm having the symptoms. If I straight my leg out and it increases either pain up in the hip or buttock come little back or it causes pain to shift down the leg, then that is the indication usually of true sciatica where there is actual pressure against the nerve because when you stretch the leg like that, you're also stretching the sciatic nerve and if it's irritated it will definitely cause some increased pain. Now, the other condition that I mentioned before is called Piriformis syndrome and that's it refers to a muscle in the buttock area which is called the Piriformis and the Piriformis can closely mimic sciatica. Sometimes you can get referral pain from the muscle itself or sometimes Piriformis will tighten up and it'll actually contract around the sciatic nerve and some people with sciatic nerve actually goes right through middle of the Piriformis muscle. So if it's tight it can cause quite a bit of sciatica too. But it's not quite the same as the sciatica that you get from a disc type of problem. So with Piriformis syndrome, one way to check for that is, again sitting, you can do this lying down as well but basically what you do is you pull your knee towards your chest just to grow little stretch on the buttock first and then what you want to do is pull the knee toward your opposite shoulder. Now what this cause is increase in pain of the especially in the buttock and/or distribution of the pain down the leg, that's a good indication that the Piriformis muscle is tight and it's producing that pain. So that's when you want to start doing the Piriformis stretch that I'm about to show you. If you're showing more of the disc related type pain, then usually it's not so much helpful to stretch the Piriformis we're willing to stretch any muscle at that point you want to let things get settle down using the McKenzie exercise I showed you before but for Piriformis syndrome, you may get some benefit from things like the stretch I'm going to show you plus some yoga stretches like down facing dog and that kind of thing. If you have true sciatica, one important caution is I do not recommend downward facing dog even though lot of people recommended for sciatica because again if you stretch those muscles, you're also stretching the nerve and a lot of times you're just going to make things worst. So I would avoid downward facing dog if you have the disc type of sciatica as I just showed you do this thing works. So let me go ahead and show you what to do for Piriformis syndrome. Basically the stretch for Piriformis syndrome and again can be done sitting or it can be done lying on your back, is basically the same as test we just did. We're going to bring the leg up and then we're going to slowly pull them towards the opposite shoulder. You want to be gentle with this because if the Piriformis is irritated you don't want to force it to stretch. You want to be careful and gentle with it. You want to hold the stretch for about 10 seconds and then slowly relax, let it kind of go straight again towards the shin, shoulder and then again you go across towards the opposite shoulder and again you hold for about 10 seconds. Like with the McKenzie exercise, the Piriformis stretch is going to be most beneficial when it's done frequently. Unnecessarily when you do it for long periods of time at any one time but the more frequency that you

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