Your Sciatica-is it from Piriformis Syndrome or a Herniated Disc? How to Tell.

Bob and Brad, the two most famous physical therapists on the Internet. Hi, I'm Bob Shu, physical therapist. Brad H. physical therapist. Together we have the most fabulous physical therapists on the Internet. Well, in our opinion, of course, Bob, that's something new. Brad, it's okay. Today we are going to talk about sciatic pain and it is very important to know where it comes from, right Brad? and what the cause is, but I think one thing about sciatic pain or

sciatica

is that people don't know what that term is. means let's define that first it's just a general term that says I want you to get up Bob once yes turn around show them everything you have there is a leg it's almost always a leg it has pain numbness tingling burning in one leg it's

sciatica

where it comes from could There are several things, many things and that is what we are going to cover today.

Some of the things that you could possibly be right about and the two most important are the

herniated

disc

, the

herniated

disc

, which is large and the other one. one in P, P

syndrome

right now. I have some numbers on this that make it interesting about P Syndrome Form 300 or 200,000 PES, but let's go back in time, there are an estimated 3 million cases of that and this is in the United States, that is very true. per year, but only 200,100,000 of them are pure forum

syndrome

, which

tell

s you that a fairly small percentage is more likely than not, if you are a betting man, it will probably be more from a herniated disc, but come on to show We present to you some things today to try to distinguish between them because if you try to treat a p foris or a Herer disc as you would with pform syndrome, you will not have any success, exactly, and I think this model that we have explains it quite a bit good. very clearly in a couple of simple tests, okay, so this is for pure performance, right, I'm G, just get this out of the way so the red bureaucracy here represents the pform muscle.

The pform muscle is a wide, flat muscle that runs from the orri major. cantra to the sacrum here the blue elastic band here represents the sciatic nerve and it passes directly through this area when this muscle becomes tight for any reason it pushes down on that stiff nerve and anything that interferes with the nerve at this point will send that pain symptom , uh, pain, numbness, tingling in the leg and as an intermediate extension point, by the way, sometimes it cuts through, it actually goes through the muscle to the right and sometimes above the muscle, it just depends anatomically where Unfortunately, not all of us are anatomically perfect.

That's right, by looking at this you can

tell

where

your

symptoms will be. However, if you have Purform syndrome, you're going to have a Can I jump to this jump on the jump on Bob? pain in

your

butt and down your leg, but you probably won't have pain in your back at all, so that's a big sign, you know, maybe it could be referred to that way, but this is where you have to do some work, but we will show you some tests that can help eliminate that difference, because I must also say that you couldn't have a herniated disc that hurts down here and doesn't hurt up here, yeah, it gets a little complicated, doesn't it?

That's why you have the therapist nearby, Bren, exactly, you want me to go to bed. Go ahead, go ahead, he takes a nap. Okay, I'll need you face down. Oh, prone position. Bob upside down. I'm prone to not listening to you, okay, what are we doing now? Lie down Bob, we need you, he stares into the camera. Some viewers have said that we are supposed to look at the camera. Okay, so I'm going to Here's a bag of that bony prominence and here's the hip. You don't have to do this, but I like to know where the two points are and then right here if you push in if they're shaped like This sends them through the roof, they're not happy with that at all and what you definitely want to do is compare sides.

Because you will usually find that one side is very different from the other, you can poke around for yourself. even also and I feel and uh the other thing is that quite often I found Brad, sometimes the muscle actually got torn too sure it could be and he has kind of a scar over the uh the piic nerve so yeah , so you go to look here and go in there, normally I go like this with my Knuckles and I'll go in there, I'll start slowly um and if it's hot, in other words, tender, it doesn't take much, but I'll go in there and push just to make sure and then I'll go to the other side and I will work that and there is always a clear difference from one side to the other very clear if you have tension and pure pain I thought you were going to invite me to dinner before you do it with this Brad but oh no, forget it Bob, it's okay, it's okay, if you keep talking smart, I'll take care of you, okay, next is if we bend the knee here to 90° and internally rotate the femur. in other words, all you do is take your knee and go in this direction, okay, that tightens the foris F and then you compare the sides, sorry, we have a bad angle here, but let's say this foot only comes out about 20°, maybe a little bit of pain in the buttock with that and this one drops down, let's get this foot out of the way.

Bob drops down painlessly, everything is very relaxed, that's another possible sign that you have pure ex, so if you have sensitivity here, do this. try it and it's tight with some pain, there's a good indication that it's pure performance, yeah if you even do this you might even feel more pain when you go this way because you're stretching it, didn't I say that Lonnie? Oh, maybe. she maybe already did it right, the last one presses up, Bob, okay and back off, if you can do this, keep going and it doesn't affect anything, that's an indicator that it's pure performance, but if you do this and suddenly The pain down your leg is getting a lot worse and all we are doing is working on your lower back, that is an indication that it is not pure performance and probably if it gets worse or better, oh yeah, it could be either direction, yeah Yes, if it really changes.

That's when you have to start thinking oh no, no, maybe it's the spinning disk, yeah, so these are tests that you can do yourself, you can lay down like this and do Brad like this, see how they do, you can do these and on and on. I mean, you can do all this, basically, you can feel your own butt, so oh feel, yeah, oh feel means touch, yeah, so forget that this is a family show, okay, let's move on to Hern's record, How will you know if it's A? Herniated disc, a simple test, well, some of what happens with herniated disc, it tends to get worse with any type of flexion or flexed position, so sitting, yes, sitting for a long time tends to get worse, although performance Pure can be bad if you sit on it, yes, yes.

This is where it gets a little touchy sometimes, how about this one when you stand up? There is often a herniated disc when you stand up. This movement from here to here. This is what the person will look like. Yes, and it rises slowly, but after you arrive. When you get up and start walking a little bit, it loosens up and then it can be much better, so I'm thinking, as we already alluded to Brad, if the flexion tends to occur when you bend your back forward, as if you were lying on your back. and you bend like you're doing repeated pushups like this double knees to the chest, yeah, and this starts to make your back and leg pain worse, there's a chance it could be a herniated disc, yeah, so the other one of the What you talked about is simply sensitivity in the Back to the right exactly like this and this you can check for yourself.

I think it works better if you're lying down and you have someone else, because then the muscles relax and you can go in and work and usually I'll feel it on one side or the other or some gentle pressure here will say "ow" and the person will know, um, so you have to be careful quite often, they are very sensitive, if it's a disk of hers, she doesn't need it. a lot, now that we've completely confused our right, I mean, you know, if you really have a lot of back symptoms, I'm leaning towards a herniated disc and if it's a lot, it's just a spot. the leg and I lean more towards pureformance and we have a good video on the artist stretch and you could do it.

I'll link it at the end here, so that won't make the album any worse, so yeah. Give it a try, yeah, you have nothing to lose, so that's okay, thanks for watching, have fun too.