Saturday, May 11, 2013

Patients reported outcome: Not all cases of sciatica are alike.


Six weeks ago I received a 48 years old woman who suffered from sharp pain in lower back, buttocks area, including a high intensity irradiation pain to right lower extremity for the last seven months.

Actually she had sciatica condition since the age of sixteen. According to her these pains of some intensity were constant.  At least, once a year she had episodes of very sharp pain, that disabled her for few weeks.

All possible tests were done, including repeated MRIs. In the age of 36 MRI shows 4mm disc bulging on L4/L5 level. This time she have gotten a terrible attack for seven months and couldn't function at all, consuming lots of pain killers, undergoing three epidural injections, during six physical therapy procedures, including exercise, the condition have aggravated to the  point of being not able to function at all.

Listening to her, I was pondering that piriformis muscle syndrome often is the main cause of sciatic nerve neuralgia, and other related syndromes.  So I planned to investigate the presence of piriformis muscle syndrome and then apply the piriformis muscle syndrome protocol since it is very effective in most difficult cases of sciatic nerve neuralgia.

I started by carefully palpating all areas of lower back, buttocks and extremities and have discovered much fascia and muscle tension as well as many trigger points practically everywhere in these regions, but especially within  quadrates lumbarum, gluteal muscles group and hamstring.

Having been aware of similar cases, first few treatments a therapist should advance slowly, expecting to palpate additional abnormalities within soft tissue.  Considering the long history of her disorder and the fact that the exercise programs significantly aggravated her condition, I suspected that she was born with an unusual condition where sciatic nerve fibers intergrew through fibers of piriformis muscle. Due to chronic inflammatory conditions, people develop region adhesions, especially within neighboring muscles and other soft tissues. With age the condition gets much worse exacerbated by soft tissue calcifications.

During my career I have treated people with this condition.  So I carefully  went ahead, following the piriformis muscle syndrome protocol.  I was extra careful while addressing buttocks and shifting gluteal muscles since my goal was to transmit pressure to piriformis muscle.

Because of the intergrowth of sciatic nerve fibers in the fibers of piriformis muscle and neighboring soft tissues, in addition to normalization of aforementioned muscles resting tone, reduction of fascia tension and elimination of all trigger points within region, the main goal of the treatment was to carefully address all adhesions.

Again one has to be very careful tackling this problem and progress slowly. Otherwise it would be easy to significantly aggravate the condition, causing the client additional pain and sufferings.  By the way, this is why cases of sciatic nerve neuralgia/piriformis muscle syndrome, where sciatic nerve fibers intergrew through fibers of piriformis muscle. take many more treatments, then just usual cases.

Usually in case of piriphormis muscle syndrome improvements are evident in a frame of five treatment.  Yet in aforementioned case of intergrowth the progress comes even slower.  My professor Dembo believed that massage therapists  doesn’t necessary have to be very strong , but sensitive.  His view is  especially applicable in this case.

Considering that my client was unlucky enough to be born with the aforementioned intergrowth condition, her timing appearing in my office was perfect.

I just finalized development of silicone jars massage techniques, which proved to be very powerful but gentle in case of adhesions elimination. So I, naturally, have proposed my client to try applying this technique for her condition. 

It so happened that her husband, who is a medical doctor, asked me to demonstrate this technique on him.  After being subjected to silicone jars techniques, he come to the conclusion that these techniques are safe, effective and especially was impressed with my approach to introductory part, where I activated pain gate control.  In our collaborative opinion the worst case scenario was that application of these techniques could do nothing.  As for my client, she admitted that had nothing to lose since she already scheduled a  surgery.

After first gentle application of silicone jars techniques, she reported a relief in first time during the last seven months.  For the three days she received treatment while I gradually increased suction.  She improved to the point of coming back to normal life and having no pain.  In total I have provided sixteen treatments.   The surgery was canceled.

In two weeks I recommended to come back for some additional treatments  even if she was free of pain. Of course I asked her to be very careful in all functional activities, avoiding challenging the improvements and proposed her the home program.

By the way, the surgery would have done her nothing good but to add suffering.  In her case changes within L/spine didn't play the main role in terrible clinical picture she had suffered all her life.

From MedicalMassage–edu.com, LLC support team.

Dear friends,

Soon the release of Boris’ DVD “Prilutsky’s Method of Silicone Massage. Upper & Lower back disorders” is going to take place.

The DVD is going to cover incorporation of silicone jar massage for the Lower Back disorders, including:
  • ·         Sciatic Nerve Neuralgia/ Piriformis Muscle syndrome
  • ·         Hamstring
  • ·         Quadriceps
  • ·         Knee
  • ·         Calf
  • ·         Plantar fasciitis


and Upper Back Disorders including:
  • ·         Thoracic outlet syndrome
  • ·         Rotator Calf syndrome
  • ·         Golf & Tennis Elbow
  • ·         Carpal Tunnel Syndrome



The suggested retail price of this DVD will be 49.95 +7 dollars shipping and handling.
However, as and promotional effort, the first 200 DVDs, just to cover production cost, will be sold for $15 + $7 shipping and handling on first come first served bases.

If you would have an interest in learning from this DVD please write us to support@medicalmassage-edu.com


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