Sciatic Pain

 

Sciatica is often the result of muscular spasm deep in the gluteal region where the piriformis muscle impinges the sciatic nerve exiting the spine anterior to the sacrum. This nerve is not a fine wire but a substantial structure the size of a little finger readily affected by surrounding muscle spasm. A primary contributing factor are Left and Right Lower Limb Mechanisms due to lumbro-sacral dysfunction and injury associated with structural leg length discrepancy. This is very treatable with the Remedial Therapy I practice. Another cause for sciatic pain is spinal degeneration and injury directly impinging nerve roots. This is not so readily treatable and in advanced cases may require surgical intervention.

 

A short right leg is a dominant genetic trait. Even or near even structural leg length is rare. I virtually never see short left legs. The vast majority of cases sighted in my clinical practice have a leg length discrepancy in the range of 15mm to 20mm. Discrepancies greater than or less than that are uncommon. While symptomatic effects down the backline of the lower limbs may appear similar side to side, very different things are going on at the hip.

 

The left side is primarily affected by anterior rotation of the hip about the Sacro-Iliac Joint in the Sagittal plane. Binding and straining the left SIJ. This is the First Cardinal Sign of Short Right Leg Syndrome and blocks energetic Qi flow down the backline of the lower limb from gluteal region through to the plantar fascia. When energetic Qi flow is blocked, a subtle thickening and tightening occurs through the connective tissue. Under loading and other influencing factors this can escalate to acute pain, dysfunction and injury. Due to the absence of notable biomechanical or neurological effects, conventional therapists do not connect the dots between the rotated hip and bound SIJ, and acute symptoms in the plantar fascia, for instance.

 

https://www.massageworksdandenongranges.com.au/left-lower-limb-mechanism

https://critsvcs.wixsite.com/shortrightleg/first-cardinal-sign

 

The story on the right side is rigidity due to gait effects generating unconscious holding patterns about the right hip, as well as, lumbar dysfunction due to geometric widening of the vertebral gaps from right leaning pelvic tilt encouraging mild disk bulging. Under the influence of loading or impact this can escalate to acute disk bulge injury in the lumbar spine. However, sub-acute effects are sufficient to create a blocking action to energetic Qi flow down the backline of the right lower limb. The most common presentation of Short Right Leg Syndrome includes tenderness and tightness palpating the right QL’s in the small of the back at the lumbar spine.

 

https://www.massageworksdandenongranges.com.au/right-lower-limb-mechanism

https://critsvcs.wixsite.com/shortrightleg/second-cardinal-sign

https://critsvcs.wixsite.com/shortrightleg/classic-presentation-of-srls

 

While bilateral cases are hypothetically possible, they are not often sighted. It is usually a left sided or right sided issue that we see. Left sided cases are more common than right sided cases. As a rule, left sided cases are less complex and easier to treat. Right sided cases are more difficult to treat and take longer owing to the fact the integrity of the lumbar spine may be compromised. Direct treatment of resulting lower limb symptoms from gluteal to plantar fascia results in limited and temporary effect if the lumbro-sacral and pelvic postural issues associated with the leg length discrepancy are not addressed.