Sciatica Pain Gone through Military Experience Knowledge

5 02 2020

5 February 2020 by Marc Woodard

[Marc is the soldier in the featured image overlooking Camp San Louis Obispo, CA – during active duty training, 2002]

What is sciatica and what is the best way to manage, alleviate or remove it?

Through my military experience I found a treatment path which led to complete reversal of my sciatic pain problem. A pain problem that afflicted me throughout my 20 year military career. Below under “Sciatica Pain Experience During My Military Career,” I detail my experience and findings and treatment course once I connected all the dots. Possibly these pain alleviation modalities could work to relieve and/or reverse your sciatica problem without surgery.

Sciatica in short, refers to back pain caused by a problem with the sciatic nerve [webmd 2020]. Sciatica (nerve pain) can be caused through numerous factors: incorrect posture, genetic deformities, injury or overuse of back muscles, or when the vertebra discs become defective or inefficient at absorbing vertebrae structural stress, or the bone itself is compromised then impinge upon the sciatic nerve. Sciatica isn’t actually a condition, but instead a medical term used to describe symptoms, such as tingling, numbness, prickly sensation and shooting pain down the leg to foot. The cause of sciatica varies in pathology but can be effectively alleviated without surgery, or non-intrusive surgery in many cases… such as mine was the case.

Skeletal compression, or impingement often occurs at vertebra’s L4-5 (lumbar) to S1-2 (Sacrum).

Sciatica pain in the lower back and extremities are often caused by injury, over-stressed muscular skeletal system, poor postural alignment and bad genetics; whereas soft tissue and/or skeletal compression, or impingement often occurs at vertebra’s L4-5 (lumbar) to S1-2 (Sacrum). Pain and swelling events can be isolated in the lower back and/or felt anywhere down the lower extremities at various frequency, duration and intensity throughout the day once aggravated by any number of postural load imbalances.

The six most common spinal disorders that cause spinal nerve compression and sciatica lumbar radiculopathy (radiating pain) are

1) Bulging or herniated disc (The gel-like center of the disc mal-forms creating nerve compression and swelling around the sciatica nerve). 2) Spinal stenosis (nerve compression through narrowing or clogged nerve pathway – brought about by standing or walking and relieved by sitting down). 3) Spondylolisthesis (Characterized by slipping and displaced vertebrae – acquired at birth and developed through childhood, trauma or physical stress. 4) Trauma (accident injury, sports, weight lifting, etc.). 5) Piriformis syndrome (named for the low back piriformis muscle impinging and irritating the sciatic nerve. This condition is also very difficult to diagnose and treat due to lack of findings through x-ray and MRI findings). 6) Spinal tumors (although tumors are rare in the lumbar region, benign or cancerous (malignant) tumors can develop creating nerve compression. Fortunately, this is a rare.

Those who suffer from sciatica should also be aware of the term radiculopathy

Radiculopathy is a term often used to describe radiating pain from its origin. In the case of sciatic nerve and radiating pain problems, this pain origin occurs at L5-S1 vertebrae [refer to images above]. When there is a low back nerve impingement, or compression condition on the right side of the lower back for example, and it causes pain and/or numbness down one side of the buttocks and/or thigh-to-foot-to-toe… This is a radiating or radiculopathy neural pain symptom. The pain travels distant from the lower back pain origin. Many patients who experience radiculopathy symptoms absent of low back pain don’t relate the pain stemming from a low back problem. For others the low back symptoms may be a feeling of achenes and stiffness, but not produce radiating pain. At this point in time, the low back is likely stressed and requires early medical diagnosis and treatment to avoid future episodes and worsening a low back condition.

Although symptoms of radiculopathy pain in the low back may occur at the same time as a burning and/or prickly sensation down the leg and toes – patients “at first” rarely associate this pain originating from the low back. Unless pain in the low back occurs simultaneously at the same time it is felt in the lower extremities.

To get treatment for low back sciatica and radiculopathy pain, see your primary care physician and ask to be referred to a physiatrist. This is a medical doctor who specializes in Physical Medicine and Rehabilitation [also called PM&R physicians]. A Physiatrist is a pain specialist doctor who diagnoses and treats both acute and chronic pain in a wide variety of nonsurgical treatments for the Neuromusculoskeletal system” (google 2020); and can refer surgical intervention if determined the best treatment course. The sciatic problem can be diagnosed through use of x-rays, CAT Scan (Computerized Axial Tomography – 3 dimensional, multiple cross-sectional picture technology) and MRI (Magnetic Resonance Imaging – Magnetism produces images of body structure).

Sciatica Pain Experience During My Military Career

When I was younger, I associated the numbness in my right calf and foot with military issued boots at the beginning of my 20 year military service. Foot discomfort and back pain seemed to go along with the territory. There was much conversation between soldiers regarding military issued boots also suspected of causing knee, hip and lower back pain. Foot pain was a given in the military. Everyone I knew during basic and advanced soldier training had foot problems as a result of wearing those boots.

Military issued boots in the 80’s and 90’s had no posture corrective insoles. And the exterior leather required a lot of wear and tear treatment/ conditioning to make it comfortable to wear around the foot all day long. Although a pre-wear and tear treatment process helped condition to break in the boot… imbalanced pressures on the soul and side of foot and toes often caused painful hot spots, even after the boots were broke in.

I like many other soldiers began limping acutely during basic training… I also continued wearing those basic boots for the first 5 years of service limping at various times. I had no ideal through this time they were the cause of my low back pain. The postural imbalances were further aggravated by intense occupational work load [field training] on my body, which further compromised the lower back alignment and weakened the area – causing swelling around the sciatic nerve. In time, pain was felt from the lower back, buttocks, leg and foot [radiculopathy].

It only took 5 years of improper foot wear to permanently put me in a hurt locker. Ultimately my back problems became chronic for 3 years of my last years of service. I did purchase boots approved by the military with proper insoles… about my 6th year of service which alleviated the radiculopathy but not my back problems. Regardless I did complete 20 years of combined military service. However the damage was done and that was not the end of my physical pain challenge. My pain challenge is fully covered within Ageless MirrorAthlete “Overweight and Unfit No More.” The pain challenge is a continuing story at the end of each chapter that connects well with “how to live life to the fullest” regardless of mental, physical or spiritual pain challenges. Click on the link below to read the free preview at Amazon.com and please provide a rating review after you’ve read the book. Thank you for your support.

I’ve written articles on acupuncture and how it helped alleviate my sciatic pain. And ultimately led to complete remission of sciatica pain. Maybe it will work for you like it did for me. Just search under acupuncture in MirrorAthlete archives and you’ll find other articles.

I highly recommend if you are serving in the military or an avid hiker

Invest in a pair of Danner, or Bates boots of good thermal water resistant and good insole quality. Then throw those basic military issued, or over worn boots in the trash.

Basic Issued Military Boots were the the cause of my postural weight bearing load misalignment and cause of acute foot and back and neck pain for years. And thereafter chronic pain problems occurred in the lower back, worsened and radiated downward. I had no ideal in my twenties how important proper foot ware and customized and corrective insoles were to Neuromusculoskeletal health of the feet and the rest of my bodily alignment.

One would think with the science behind many foot related back and neck pain problems – the feet would be of great pain prevention interest and at a minimum the military would invest in proper weight bearing boots with foot analysis that custom fit proper insoles to be place within the boot. This foot pain prevention process would have a return on tax paid investment – i.e., reduced sick call incidents, higher soldier productivity and fewer disability claims that retire trained soldiers early on…, etc. Until any boot or “almost any” shoe is broken in, or has bad insoles, or none at all… this creates hot spots and/or blisters everyone can relate too. And when the feet don’t get relief, limping occurs. If something doesn’t change, pain can be felt in other weight bearing joints. I believe military issued boots should be of the highest postural and corrective weight load bearing quality, Solders work their bodies hard in the field and put their lives on the line and deserve the best gear money can buy and this includes foot wear. They also deserve to end their service commitment without pain and injury caused by inferior foot wear that also causes harm to other parts of the body.

If your feet have little to no arch, it would be wise to invest in good foot insole orthodics to provide a supportive arch and alleviate foot pain and calf cramps. Improper foot ware “when not corrected” will cause further breakdown of the foots mechanical-muscular structural integrity and then work that aggravation upward – putting pressure on other weight bearing joints. The bodies posture works to re-align itself around an articulating joint pain center. Better known as guarding. This is why you see people limping. E.g., the compromised [pain problem] side is guarded by the side not experiencing pain. Therefore it takes on an additional load burden moving the body forward, putting additional stress on the non-compromised side.

I have corrective insole in every shoe I wear. Simply rip out the manufacturers flat insole and replace it with a corrective insole – purchase them in pharmacies with free foot analysis equipment. Stand on the foot analysis machine. It analysis foot pressure points and refers an insole for less than 1/2 price of podiatrist prescribed orthodic.

When limping continues too long without correction the body adapts to compensate and create a new gait norm to alleviate pain. Realignment during guarding puts more stress on other weight bearing joints and causes an imbalanced mechanical disadvantage during the gait. When this is the case the weight bearing joints are susceptible to aggravation and injury because the anatomical posture is imbalanced and eventually becomes compromised.

Dr. Bernard Filner, MD, says, a significant number of people, including many of his patients, contemplate surgery because they hurt so badly – but most of the time, by using a Posture Control Insole can alleviate the pain and avoid surgery. … Your feet play an integral role in maintaining a pain free posture, including proper curvature of the spine. Modest changes in your posture provide the potential for complete relief of low-back pain. If you are in pain, even if you have tried custom orthotics without success, please try Posture Control Insoles before you try surgery, said Dr. Filner.

As previously mentioned – most who suffer acute to chronic sciatic symptoms experience numbness, tingly to prickly sensation to excruciating sharp – jolting pain from the buttocks down the leg and foot. … I experienced radiating pain at times as an achy to chronic electrical pain sensation which was horrible and nearly knocked my off my feet at times when it struck.

For me acute sciatica feels like short bouts of being zapped by electricity and a burning , or tingling/prickly sensation when it occurred. One way to know when the worse case pain scenario will occur… you’ll experience a numbness and swelling in your lower back and loss of sensation in parts of your leg/calf/big toe with prickly sensations. At least for me that’s how my acute converted to chronic pain episodes. When a chronic episode occurred, the pain and swelling afterwords was so severe, I stayed off my feet for a couple of days. Only anti-inflammatory, ice, physical therapy and bed rest helped get back on my feet.

I’ve known many people – including myself go years suffering with low back sciatic pain and use prescription pain killers, muscle relaxants and anti-inflammatory to treat the symptoms with rest. Other outpatient treatments include steroid injections, chiropractic and physical therapy sessions and acupuncture, etc., that work temporarily, or permanently but may/may not fix the underlying weight bearing integrity problems without surgery. Patients who ignore infrequent episodes of back pain, or sciatic symptoms… without proper diagnosis can unknowingly create an irreversible pain condition that may have been preventable and without need of surgical intervention.

Foot insoles may be the cure to remove a sciatic Pain Problem

I chose not to go through surgery. After years of working with specialists, I learned what worked for me. It was a combination of acupuncture and corrective insoles that abated my sciatic pain. I only wish I could have had someone tell me the exact treatment course that would work for me after experiencing 20 years of sciatic and radiating pain. Will this treatment course work for you? That’s hard to say. Everyone is so different. But until you make the time to get a physiatrist referral from your primary care physician you’ll likely continue the fast track pain alleviation plan like I did… pain pills, anti-inflammatory and muscle relaxants… “which won’t fix you, and your pain episodes and weight bearing bodily damage will likely worsen.”

Correcting posture at the feet first – in “most cases” when foot, knee and back problems first occur, including sciatic pain … corrective insoles are often the pain relief solution! However with this being said, there is no guarantee as you age a sciatic problem with radiating symptoms “will not” become worse. We are talking about pain alleviation through proper anatomical foot insole alignment that will not worsen a back-pain condition. But its good to know nearly all back problems can be corrected and/or alleviated without surgery when proper postural foot alignment “at the sole” is made in a timely manner.

Most back pain can be resolved without surgery if both doctors and patients are willing to try other treatments that basically help the back to heal itself (Dr. Richard Deyo, University of Washington, and Consumer Health Interactive Magazine).

Author:  Marc T. Woodard, MBA, BS Exercise Science, Captain ARNG Retired. 2009-2020 Copyright.  All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com, Sign up for your Free eNewsletter.





Back Pain Relief Wisdom

24 01 2016

Don't let back pain prevent you from places you want to be.

Don’t let back pain prevent you from exploration and activities you enjoy.

Last Updated:  24 Jan 2016

The most common muscular skeletal weight bearing pain typically occur within the lower back for many.  Whereas soft tissue and bone, or musculoskeletal tissue becomes compromised.  Which include nerves, cartilage, disc, ligaments and tendons where localized swelling, soreness and aggravating and radiating pain occur.

Human studies and statistics have shown low back pain will account for more sick leave and disability time than any other single medical condition.  Nearly 80% of all adults will experience back pain some time in their lives.  It is for this reason it is important to understand how to take preventative and corrective measures to avoid, alleviate and timely treat weight bearing joint pain.  Also recognize the difference between common causes of back pain, severity of condition and treatment course options.

Weight bearing and repetitive physical work pain is often medically defined as an acute or chronic pain condition that may be caused by injury, postural imbalance, repeated physical activity and diagnosed as a strain or sprain, or compression injury, or Repetitive Strain Injury (RSI).  A Repetitive Strain Injury is also known as Cumulative Trauma Disorder (CTD).  Which has a compromised muscle-tendon relationship.  Some cause examples of these pain disorders may be a result of the following activities: administrative work, gardening, biking, walking, jogging, running, sports, commercial painting, plumbing, electrical and other laborious work etc.

“There are also chronic nerve compression injuries such as carpal tunnel syndrome, radial tunnel syndrome and cubital tunnel syndrome. In these cases, the spaces through which the nerves run are narrowed due to inflammation or fluids putting pressure on the nerves (Kriskarr 2012).”

Of course there are many pathological musculoskeletal compromise possibilities which could cause weight bearing or low back pain in vertebra joints.  Some of the more familiar diseases of the back are: degenerative discs [wear & tear on between vertebra space], herniated discs, [swollen, and irritated “overblown” discs], spinal stenosis [narrowing of vertebrae canal presenting sciatica radiating numbness and pain down the leg].

Off Road Trail Hiking Exercise.

Remove back pain and experience off road trail hikes, enjoy nature and get more daily exercise.

Regardless, our focus is not to play doctor or learn all the possible causes of back pain.  But instead to understand how to recognize and prevent unnecessary pain through prevention and seek corrective medical treatment when needed.

Poor ergonomic posture or laborious repetitive work or sedentary lifestyle combined with weight gain almost always put undue stress immediately on the low back.  And when poor work and activity posture, footwear and overweight conditions are not addressed, it’s just a matter of time before weight bearing joints begin to ache, strain and become painful.  If left uncorrected that pain will worsen, slow you down and increase risk of injury and put you out of commission.

The biggest difference between strains vs. “sprain” is the severity of injury and healing time.  For instance sprains are typically long-term injuries which may or may not require surgery and almost always require physical therapy and rest to alleviate the compromised soft tissue condition.

Most of us are familiar, or have experienced a strained [overstretched] or sprained tendon, ligament or muscle.  Sprains are often verified and substantiated using MRI (Magnetic Resonance Imaging) equipment to determine exact locality, severity and corrective treatment for tissue damage.  The technology can see the degree of partial or full tear of soft tissue sprain often associated with significant swelling and bruising of injury site.  Whereas x-ray typically cannot and is mostly used to confirm broken and fractured bone and observe bone density health.

Many who experience weight bearing pain of the foot, ankle, knee, hip, back or neck don’t make the pain origin or cause connection.  That pain cause is often the result of musculoskeletal postural misalignment.  Whereas misalignment of musculoskeletal weighted posture starting at the feet cause imbalance and joint instability while walking, working and during exercise activity.  And this condition often results in multiple radiating joint pain areas up the body’s trunk and can cause a painful limp.

Like pain free body posture, A tree is only as healthy as the foundation.

Like pain free body posture without compromised food mechanics… a tree is only as healthy as the root foundation system.

The sole of the foot is like a tree root system.  For instance, when the soil erodes from one side of a soil bank, the tree may begin to lean due to a breach of ground foundation stability.  Then the roots on the opposite side grow and strengthen and absorb the stress to keep the tree growing upright.

Through time the trunk grows slightly offset to relieve stress on the compromised root system, but may cause the mid-line tree trunk to crack or snap during a heavy wind storm.  Similar to upright walking posture, if walking with a painful lower back caused by a compromised foot foundation, if left uncorrected this condition will have an effect on an number of distal weight bearing joints [foot-to-knee-hip-back pain].      Whereas poor foot mechanics like the compromised tree root system make it likely to cause multiple joint pain and injury possibilities.

However it is possible with corrective insoles and supportive footwear to realign and balance body posture and completely alleviate stress and pain of other affected joints, even the neck and shoulders.  In this case the corrective lift at the insole, or bottom of foot may realign the low back and neck vertebrae simultaneously while removing a painful limp caused by sciatica for example.

If any type of acute joint pain condition appears more frequent and severe…. “Pay Attention!”  It is important to remember weight bearing pain is often a result of unconditioned physical body, sedentary lifestyle, overweight condition and improper footwear, or disease.  The good news is it can be corrected if timely action is taken.  Like a tire realignment, corrected foot mechanics can achieve the pain free goal.

Recommendations to treat weight bearing pain before it becomes chronic

  1. If experiencing acute weight bearing pain:  a) “Apply Ice right away.  Ice reduces inflammation and pain.  Be careful not to use ice for more than 15-20 minutes, every 2 hours.  Even though heat is used to ease tension & soreness, heat might cause more swelling in the first 2-3 days.  b) “Place the ice on the painful area in a fanny pack while you are up and moving around.  Apply ice consistently as long as you have swelling and pain.”  c) “If you have diabetes or circulatory problems, limit applying ice and heat to 8-10 minutes.”  d) “Take medication as directed.  Common medications are acetaminophen (such as Tylenol) and non-steroidal anti-inflammatory drugs, such as ibuprofen (such as Motrin) and naproxen sodium (such as Aleve).  In some cases, prescription pain medications may help.  It may take 10 to 14 days of taking it as prescribed to be fully effective.” 

Reference:  (Kaiser Permanente Brochure Recommendations, Items 1, a-d) 

Note: If you experience any abnormal pain seek medical advisement, diagnosis and treatment from your doctor immediately.

  1. Maintain Ideal Body Weight.  Simply enter into any Internet search engine, BMI (Body Mass Index) use free calculator, enter your height and weight.  This will give you an ideal of whether or not you’re underweight, normal or overweight for your current body mass stature.  If too heavy over normal body weight for height, you’re at increased risk for weight bearing pain.  Most specifically:  foot, ankle, knee, hip, back.

    IMG_1061

    Exercise comes in all fun forms and exciting playtime activities.

  2. Perform daily aerobic exercise to burn fat (e.g., bike, walk, aerobic dance exercise not less than 3/week @ 20-30min/day).  When heart rate is increased for extended periods of exercise, the body’s metabolism during aerobic activity burns more of the preferred fuel source from body fat.
  3. Balanced nutrition:  consume more fiber, drink more water and decrease total calorie intake daily.  Remove high processed fat and sugar foods and drinks.  Focus more on shopping and consuming fresh whole foods more in line with Mediterranean diet which contains plenty of fish, fruits and vegetables.  Avoid fried foods if possible.

    Catch it yourself it does a body good.

  4. If your feet are in pain, the likelihood of sustaining daily aerobic exercise activity is greatly reduced.  Seek a referral from your Primary Physician to get a diagnosis and treatment from podiatrist (foot specialist).  See if your foot posture is the cause of your weight bearing pain.
  5. Realize:  a) In order to perform daily aerobic exercise activity will likely require good insoles and footwear to offset pain and lose weight.  b) Don’t pay $300-$1500/year for custom molded insoles out-of-pocket from your podiatrist if you don’t have to.  First try inexpensive insoles at a local pharmacy center if your health care situation is limited in services, deductions and co-pays are high.  Simply stand on a free foot analysis machine and receive corrective insole inventory selection based on the postural hot spot(s) imbalance foot imprint.  And if the insoles remove pain it is well worth the effort and cost.  However, do see your doctor to positively determine pain cause and origin.  If you do get a referral to podiatrist, decide if you want to try the inexpensive insoles before paying the cost of customized insoles, especially if you have to pay over $50.00.
  6. Do you need surgery or other treatment? Ask your doctor about Spinal Cord Stimulation (SCS).  “Electrical nerve stimulation is a procedure that uses an electrical current to treat chronic pain. Peripheral nerve stimulation (PNS) and spinal cord stimulation (SCS) are two types of electrical nerve stimulation. In either case a small pulse generator sends electrical stimuli that interfere nerve impulses to alleviate the pain (WebMD 2014). Reports show SCS use results in: 84% reported that their quality of life was improved or greatly improved, 77% had good or excellent pain relief, and 82% decreased their use of pain medications (St. Jude Medical 2016).

    Seek adventure, explore, get excited about life and move the body.

    Seek adventure, explore, get excited about life while moving and exercising the body.

  7. “Tens Therapy” electro muscular-stimulation can provide significant relief.  Ask your doctor about obtaining a Tens unit through health care coverage, or if covered to receive electro muscular-stimulation physical therapy sessions.  “Transcutaneous electrical nerve stimulation (TENS) is a therapy sometimes used to treat localized or regional pain. During TENS therapy, electrodes deliver electrical impulses to nearby nerve pathways — which can help control or relieve some types of pain. TENS is often used to treat osteoarthritis and chronic and postoperative pain (Thompson 2014).”
  8. Tens units can also be purchased on-line, or provided by HMO.
  9. Acupuncture – “May also reduce chances of chronic back pain from occurring.  “One of the largest studies to date on acupuncture and chronic pain — a meta-analysis of 29 well-conducted studies involving nearly 18,000 patients and published in October 2012 in the Archives of Internal Medicine — found that acupuncture is effective for treating chronic pain and therefore is a reasonable referral option (Palermo 2015).”

If acute back, or any joint pain seems abnormal or Intolerable, or you’ve recently experienced an injury consult your physician immediately for diagnosis and treatment.

Citations:

Kriskarr. “What Is a Compression Injury?” VACUPRACTOR. Vacupractor, 23 Oct. 2012. Web. 22 Jan. 2016.

Thompson, Jeffrey, M.D. “TENS Therapy: An Option for Fibromyalgia Treatment?” – Mayo Clinic. Mayo Foundation for Medical Education and Research, n.d. Web. 22 Jan. 2016.

Palermo, By Elizabeth. “What Is Acupuncture?” LiveScience. TechMedia Network, 05 Mar. 2015. Web. 22 Jan. 2016.

St. Jude Medical. “Power Over Your Pain.” Spinal Cord Stimulation: A Proven Therapy for Pain. St. Jude Medical, Inc., 2016. Web. 22 Jan. 2016.

WebMD. “Electrical Nerve Stimulation for Chronic Pain.” WebMD. WebMD, 12 Mar. 2014. Web. 22 Jan. 2016.

Author: Marc T. Woodard, MBA, BS Exercise Science, ARNG, CPT, RET. 2016 Copyright. All rights reserved, Mirror Athlete Inc., http://www.mirrorathlete.com, Sign up for your Free eNewsletter.