An often-overlooked factor in sciatica is the alignment and support of the feet. The feet are the foundation for the whole body’s structure when standing upright, and as with a house, a faulty foundation can adversely effect the entire structure.
The video below explains how something as simple as fallen arches in the feet can translate to serious problems in the knee, hip, and low back, and can lead to or exacerbate sciatica, and what can be done to correct such problems.
165 Comments
Suzi Hanney
September 3, 2011Just posted a comment above= Have a swollen and puffy right pins and needly right foot and sciatic pain and lower back pain! help! x
Dr. George Best
September 3, 2011Hi Suzi,
I replied to your facebook comment, but I figured I’d reply here as well to make sure you receive it…
I suggest you start with the basic sciatica exercises shown on the video at:
http://www.sciaticaselfcare.com/sciaticaexercises/basic-sciatica-exercises/
In many cases, the basic McKenzie exercise will start relieving symptoms right away, although it can take several sessions to make a difference. Also, applying cold packs to the lower back for about 15 minutes every few hours will reduce inflammation and should also help reduce symptoms.
Sherry
July 16, 2019Hello
I was suffering from Morton’s neuroma and in the 5 months in the run up to surgery I was walking poorly and had a strained hamstring and calf as a result in my left leg. Two weeks after surgery during which I rested I ended up with severe pain in my leg at night. Physio did not resolve it and it soon turned to sciatic pain in buttocks, all the way down my leg and foot. Nights are extreme. . It’s now 10 weeks since surgery, 7 weeks of sciatic pain. There is real pain in my ham string and side of legs esp at night. Sitting is difficult for more than a few minutes at a time. MRI scan says no disc issue although I do have some wear and tear in L4/5. I don’t have any back pain and can bend, walk up stairs fine. Coming down stairs is v painful. I am trying cold packs now on legs and back. And doing mckenzie exercises. I don’t know what the source of problem is. I suspect it’s a hamstring issue which is causing sciatic pain.
Help!
Dr. George Best
July 16, 2019Hello,
I replied to your previous post a few days ago, but I guess you didn’t see it, so I’ll try again:
It sounds like it’s probably mostly a muscle reaction issue. In addition to the hamstrings and calf which may have been strained, there may be referred symptoms from the piriformis and/or gluteus minimus as well. Often such muscle reactions are associated with dysfunction in the sacroiliac and/or hip joint and problems in those joints would not be surprising with the months of altered gait associated with the neuroma. Stretching and massage of the piriformis and gluteus minimus (the basic piriformis stretch shown in my free ebook and the “figure 4” stretch – Google “supine figure 4 stretch” for directions) may be helpful, but you may need to have the joints corrected to get lasting improvement. I suggest seeing a chiropractor, preferably one who also offers massage therapy or works closely with a massage therapist. If you have further questions, let me know.
Good luck!
Dr. Best
Gelo
September 6, 2011Hi Doc,
I’m undergoing therapy, they put hot compress during the start of the session and then some devices after which they explain applies heat that deeply penetrates. After which, they put me on the traction. I’m not so sure if it helps, because i dont realy feel that it makes my condition better. I can hardly sit for a minute because of the pain. Thanks
Dr. George Best
September 7, 2011Hello,
There are differences of opinion on this, but when someone is in severe pain, that’s a sign of inflammation. In my opinion, you should NEVER apply heat or heating modalities like ultrasound (which is probably the deep heat therapy you described). Heat will temporarily sedate irritated nerves while it is being applied, but it will increase inflammation and overall make symptoms worse and often delay recovery. My suggestion is to ask them if you can forgo the heat and just do the traction and maybe electrical stimulation and either get them to use cold packs instead or start using cold packs on your own (about 15 minutes at a time up to every 2 hours – use a t-shirt or other thin cloth to separate the cold pack from the skin.
Besides getting off of heat and onto ice, I suggest you start with the basic McKenzie exercise (register with your email on my homepage to get access to the video and free ebook which demonstrate what to do).
Good luck!
Dr. Best
Tyler Pearson
September 29, 2011Dr. Best,
THANK YOU!!!!! sincerely from my heart! After watching this video I had a moment of clarity and realized that my sciatica is being caused by my flat feet!! I went and got a pair of custom orthotic inserts for my shoes to help give me that extra arch support, and tada!!! MY SCIATIC DISAPPEARED LITERALLY OVERNIGHT!!!!! The quality of my life is back to normal again and I truly have you to thank for it.
Dr. George Best
September 30, 2011You’re welcome!
Challese Shelby
May 10, 2018I just got diagnosed with Siatica. I can’t hardly walk because of the pain in my left leg. I have a walking moon boot from when I broke my toe. Can I wear that for support for a while. I can’t use crutches. And this has been going on for two weeks now even with the pain meds I’m taking.
Dr. George Best
May 10, 2018I do NOT recommend using a walking boot with sciatica as the unleveling of the legs from wearing it may only irritate things further. The boot won’t really give you support where you need it anyway, because the leg itself is probably not the problem. Most cases of sciatica stem from the low back and/or buttock area. I suggest you try the methods in my free ebook. If you have not already downloaded it, you may do so from the link on the right side of this page.
Dr. Best
Cassandra
June 19, 2019I can’t hardly walk or use my right leg. I had CAT and MRI it came back negative.the pains are like contractions from my buttocks thigh,Calf and my tip of my toes are being numb. That causes severe pain. I put hot cream on it so I can sleep. You m not able to lay flat on my back bend or stretch my right leg
Dr. George Best
June 19, 2019Your symptoms sound like they’re disc related even though the CT and MRI scans were supposedly negative. I say supposedly because I have seen several cases over the years in which people were told their scans were normal but when I saw the actual imaging it was clear they had a significant problem. In some cases, I think it may be a case of error in reporting the results or incompetence in reading the scans, and in other cases (in situations where government-run healthcare was in effect) it appears that there was a deliberate attempt to delay or avoid providing treatment in an overloaded system. There are also cases in which standard scans (done lying down) may not show a problem, but a scan done in an upright position does (pressure on the discs due to gravity may cause them to bulge when upright even if they look normal when lying down).
You may be able to get relief with the self-treatment methods in the free ebook, which you may download from the link on the right sidebar of this page. Since it seems like it’s probably a disc-related problem, I suggest you focus on the McKenzie Method and application of cold packs as discussed in the ebook. The stretch for the piriformis is worth a try if and when you are able to really stretch the leg, but the disc treatments will likely be more useful.
If you have further questions, let me know.
Good luck!
Dr. Best
Doug Bone
October 5, 2011An unrelated question – I’ve been diagnosed with a benign tumour in my colon, which is to be removed next week.
Is there any remote possibility that this will also ‘FIX’ my sciatica?
Thanks for very informative videos!
Dr. George Best
October 5, 2011Hi Doug,
I responded via email, but for the benefit of others who might have an interest, the answer is that it is unlikely, but possible. Small to moderate-sized tumors outside the spine itself usually don’t cause significant nerve compression, but they can sometimes trigger muscle reactions that in turn might cause sciatic nerve irritation and/or muscle referral symptoms that mimic sciatica.
Good luck with the surgery!
Dr. Best
Robert T. Anselmi
October 6, 2011I am not aware that I may have fallen arches, or that it is the reason for my sciatica. But there is a former Denver Bronco football player that advertises for a company that makes foot support inserts. Do you think going to them, and checking out their recommendation for foot support may be advisable?
Thaks
Dr. George Best
October 7, 2011Hello Robert,
Custom shoe inserts that provide good arch support and shock absorption are usually a good investment with or without sciatica. They may or may not alleviate your sciatica specifically, but most people find that they make their feet more comfortable and usually reduce low back pain. Custom shoe inserts typically cost a few hundred dollars depending on the brand and features. If that’s comfortably within your budget, I encourage you to give them a try. If you’re hesitant to spend that much money, I suggest trying generic arch supports (available at most drug stores and some sports equipment stores) first, and see how it goes. If the generics help some, you’ll probably get even better results with the custom inserts, so that can help you determine whether or not they are a good investment for you.
Good luck!
Dr. Best
Bonnie
April 1, 2019Please help me been down going on 4 weeks can’t get rid of sciatica pain all the way to my feet. Can’t sleep
Dr. George Best
April 1, 2019Since you didn’t mention it, I’m going to assume you have not been to a doctor or at least have not had an MRI or CT scan to diagnose the cause of your symptoms. In that case, I suggest you start with the basics in my free ebook. If you have not already downloaded it, you may do so from the link on the right sidebar of this page: . Be sure to follow all of the instructions for testing the positions for the McKenzie exercises so you can choose the ONE position that is best for your situation (if you have doubts as to which position to use, go with the straight extension). Use of cold packs as discussed in the ebook is probably going to be the way to go (instead of heat) as well. If you don’t get much improvement with the self-treatment methods within another week or so, I’d recommend seeing a doctor to have things checked out and find out what the best treatment options are. If you have further questions, let me know. Good luck!
Dr. Best
Marge
November 8, 2011Dr; I had X-rays and was told that I have arthritis in both hips and my back. The left hip is the worst and I got exercises off the internet and was doing very well with them until sciatica hit me on the opposite leg. I know it comes from my lower back. I am afraid to do any exercises for fear that I might do more harm than good. Both my legs cramp up on me if I sit for long and it is really difficult to walk. It feels as though I need to stretch out both legs but not sure that it would be a good idea. I have been to a chiropractor and he helped me somewhat but I don’t think I will go back. I have had this sciatica for a week now. What do you think about exercises??
Dr. George Best
November 8, 2011There are many different exercises, and it’s important to find exercises that are appropriate for your specific problems. Arthritis varies considerably in its presentation and severity, so with the general information you’ve provided it is difficult to give you definite recommendations. Most people will benefit from at least some kind of exercise, it just depends on the specific location and severity of your arthritis as well as any other underlying causes there may be for your symptoms.
With regards to sciatica and stretching the legs, you need to be careful with how you do the stretches. Most cases of sciatica are due at least in part to bulging discs in the low back. Bending forward at the waist when in the seated or standing position can place pressure on bulging discs and cause increased bulging and/or inflame the discs, thereby causing increased pressure on the spinal nerves that produce sciatica. Straight leg stretching of the hamstrings will also create tension on the sciatic nerve, so I don’t recommend doing hamstring stretches while there are significant sciatica symptoms present.
If you have further questions, feel free to email me at info@sciaticaselfcare.com
Dr. Best
Manuel Spiteri
November 24, 2011I am a long distance runner and have been suffering sciatica for a long time.To day an x ray showed that the cartilage between the vertebra in the lower back has totally worn off.Doctor referred me to physiotherapy and after 6 months,if still in pain an MRI test and operation has to be done.I was advised to stop RUNNING which I did not agree at all,[I am passionate for running].ANY ADVISE PLEASE.
Dr. George Best
November 25, 2011From what you’ve described, you have severe disc degeneration in the lumbar spine. Unfortunately, running places pretty significant compressive force on the lumbar discs, and with the degeneration you have, it is going to tend to keep things pretty inflamed in that area and will make it very difficult to recover. It is quite possible that you can get some relief with exercises, physical therapy, and possibly treatments like spinal decompression, but continued running is likely to continue to cause problems for you. Even with a successful surgery, there is a strong likelihood that distance running would cause symptoms to return within a few years.
You could probably continue to run with the pain for some time, but the problem is that eventually the nerve compression will likely become more severe and start to interfere with muscle function. Diminished nerve function in the lower lumbar spine could lead to weakness in the lower leg and produce foot drop or weakness in toe-off, either of which would dramatically reduce your ability to run – or walk – normally.
I wish I could tell you what you want to hear, but I have to agree with your doctor that it would be best for you to stop running. That being said, there are other activities you can do without putting nearly as much stress on the lumbar discs and you might want to consider switching to something different. I know some runners scoff at it, but power walking is a good type of endurance exercise that is usually well-tolerated by people with low back problems. I know a few people who switched to power walking from running and they’ve all commented on how much more difficult power walking is than running. Activities like swimming and cycling (I recommend a recumbent bike for long distance cyling) are also good conditioning exercises that are much easier on the low back than running.
Good luck!
Dr. Best
Xavier Goh
December 3, 2011Hi Doc,
I am 23, I have been suffering aching pain at the butt area whenever I am sitting down. Its been for a year, I tried your stretching exercises on your informative website, after a week, the aching pain start to shift upwards, towards the lower back. Is this a good sign? Also does chiropractic treatment serves any effective or essential results?
Thanks.
Dr. George Best
December 3, 2011Hello Xavier,
Yes, the shift of the pain towards the low back is a good sign. This is what is referred to as “centralization” in the McKenzie method and is an indicator that nerve irritation is decreasing. In some cases, as symptoms centralize, they may feel more intense, but as long as they are moving closer to the spine, it is a positive sign. In most cases, over a period of a few days to a few weeks, the symptoms will continue to shift closer to the spine, and then will go away altogether.
Chiropractic treatment can be helpful in speeding up recovery in many cases, but there is also a chance that forceful manipulation may temporarily increase symptoms. There is a wide variety of chiropractic treatment methods and of course the skill and experience of individual chiropractors varies as well. I suggest trying to find a chiropractor who uses more than one style of manipulation as this alows for customizing the treatment to your condition and level of comfort. If you can get a referral to a chiropractor from someone who has had a good experience, that is always the best way to go about finding a good one. Failing that, I suggest looking for one on Google or another search engine who has at least a few good reviews on their business listing (search using a term like chiropractor with your town name to get the business listings). You can also look in the yellow pages for one with just a regular listing – avoid ones with large display ads because the more advertising they are doing, usually the fewer referrals they get.
Good luck!
Dr. Best
Sally Wing
December 12, 2011Dear Dr Best, I have benefitted from Chiro care MANY times over the past 30+ years; I truly believe in its therapeutic value. I have extremely high arches, wear supports and get regular exercise. The pain in my feet is reletively recent campared to a lifetime of low-back issues. X-ray showed no problem structurally (bones, position) but the pain I experience in my heels and rolling off the balls of my feet has me “grounded” (middle toes). I miss my aerobic dance and fitness walking but the pain is not worth it. Could this be sciatica? Is there something specific to address the foot pain? It does not travel up my leg; it’s isolated in my feet.
Dr. George Best
December 13, 2011Hello Sally,
Since the pain is isolated in the feet, it’s probably not sciatica. My guess is that there’s probably some jamming in one or more of the joints of the feet and ankles and possibly some plantar fasciitis (inflammation of the connective tissue that runs the length of the foot). My suggestion is to see a chiropractor who evaluates and adjusts the feet and ankles (not all do). Depending on how old your arch supports are, it may also be time to get re-casted or re-scanned for new ones.
Good luck!
Dr. Best
jack albee
December 28, 2011ahh. relief! Decided to wear my tennis shoes exclusively when I went to Austin for T’giving. By the time I got to our airport, they had to wheel me to the gate; at Austin coming and going I was also wheeled. Went to two doctors there and an acupuncturist; returned home and went to two more doctors, physical therapist, another acupuncturist, pharmacy, and chiropractor, each time going to their respective offices, bent from the waist to reduce the pain and they all said the big S. They gave me pain killers, narcotics, muscle relaxers, steroids, poked holes in me, pushed my body around, gave me stretches and still the pain went on ; even your stretches kept me in pain—but no one asked me to take off my shoes so that they could look inside! After the above video, this morning at 3am, I awoke and looked into the tennis shoe and found no arch supports! Have worn shoes with such all day today and….. ahhh, relief!
Dr. George Best
December 28, 2011Hello Jack,
I’m glad you figured out the problem. It’s amazing how much of a difference some arch support can make!
Dr. Best
Owen
December 31, 2011Hi Doc,
I suffer from Sciatica and have now started on the exercises as suggested by you. It has brought me relief. I do have a problem with my feet as well and I’m now wondering if that has something to do with Sciataca. Thanks heaps for the help.
Dr. George Best
December 31, 2011You’re welcome. Good luck for further recovery and have a great New Year!
Dr. Best
jack albee
January 1, 2012per my comment last week. Perhaps it wasn’t the insole that helped. I was a lot better the first day but then it slowly went down hill. Last night I was really hurting again. Did the McKensie and others, used a heating pad, still hurt. This morning I did the massage and the acupressure. Don’t know which one did it for me, but I guess I will on with both of them because something helped.
You haven’t mentioned heat pads, dry & moist, or cold packs. What are you thoughts on those?
jack.
Dr. George Best
January 2, 2012Hello Jack,
In most cases, sciatica is caused by a combination of nerve compression and irritation directly by various structures such as bulging discs, and indirectly from inflammatory swelling.
It sounds like you may be having fluctuations in the amount of inflammatory swelling present, and that’s resulting in changes in your symptoms. Inflammation varies in response to a number of factors, including diet, activity, emotional stress, barometric pressure changes, and the use of anti-inflammatory measures such as cold packs, acupressure, and medication.
I discuss the use of cold and hot packs in detail in my ebook, but the basic idea is when there is sharp or intense pain, use cold and when things are just stiff and achy, use heat. Heat may feel better while it is on than cold, but heat increases inflammation so it tends to prolong recovery from pain related to inflammation in most cases.
If you have further questions, let me know.
Good luck!
Dr. Best
laskesha
January 14, 2012Have ms and having unbareable pain in lower back and hip and leg and feet goes nomb cant tell if its ms or compression on my sciatic nerve cant bend and cant sit long nor stand long is it anyone else experiancing the same symptoms .
Dr. George Best
January 14, 2012Hello Laskesha,
Your symptoms could be related to MS, but they could also be due to sciatic nerve irritation. I suggest you give the sciatica self-treatment methods a try, and see if they help. I suggest you start with the basics in the video and ebook that are found at: http://www.sciaticaselfcare.com/basic-sciatica-exercises/ . If those methods do not help, then I recommend you consult with your doctor about possible treatments.
Good luck!
Dr. Best
Mike
January 25, 2012I was watching the foot support and I was born with flat feet. No wonder why I have Sciatica.
I have been doing the excersies and they are beginning to work.
Dr. George Best
January 25, 2012Hello Mike,
Having flat feet doesn’t always result in sciatica, but is certainly can be a contributing factor. I’m glad to hear that the exercises are already bringing about some improvement. Good luck for continued improvement!
Dr. Best
Orabi
May 10, 2012How do I know that I have a fallen arch, my foot looks flat and fat
Dr. George Best
May 11, 2012One simple test is to rub water or lotion on the bottom of your feet and then stand on some paper. The outline of the foot mark on the paper should curve inward where the arch is. If the outline is more like a straight line or outward curved line running from the big toe to the heel, you’ve probably got fallen arches.
Dr. Best
Rama
June 14, 2012i am getting lots of pain in my leg area starting from calf muscles to ankle and can’t put whole wt on the left foot.
Would u suggest something for me Dr Best’
I am 55 yr old and having 80 kg body wt.
With thanks and regards. I sweat a lot due to leg pain.
Rama
Dr. George Best
June 15, 2012Hello Rama,
If the symptoms are only from the calf down, the problem may or may not be sciatica. If you have not already, I suggest you try the treatments in my ebook available at: http://www.sciaticaselfcare.com/basic-sciatica-exercises/. If you don’t get any relief, I’d recommend you see a doctor to get checked out to determine what is causing your symptoms.
Good luck!
Dr. Best
Tricia
June 19, 2012Hi
All of the info I have read is very informative, but not sure if I have sciatica, I have discomfort in my right hip when turning in bed but not walking, when standing still i get pins and needles in the outside of my lower right leg radiating around the ankle and into my toes, this pain builds the longer I stand. This all started after a bout of lower back pain but might not be related,can you help with any advise. x
Dr. George Best
June 20, 2012Hi Tricia,
What you described could be true sciatic nerve irritation, but the description is more consistent with muscle trigger point referral symptoms. The most likely suspect is the piriformis, but the gluteus minimus muscle might also be contributing. Since the symptoms started after having low back pain, my guess is that the sacroiliac joint is probably involved. My suggestion is to start with the piriformis stretch shown on the video at: http://www.sciaticaselfcare.com/basic-sciatica-exercises/. If it seems to help, try doing it frequently throughout the day for a few days (it’s a good idea to stretch both sides). If you can’t get lasting improvement, you may need some work on the sacroiliac joint to get things resolved. There is a technique in my members area for this (the pelvic repositioning technique), but you might need to see a chiropractor or osteopath for manipulation treatment.
Good luck!
Dr. Best
Gail Ramirez
September 27, 2012Hello Dr. Best,
I need either an article or research written by you that explains the fallen arches theory leading to knee problems and Sciatica. Your Video, “The Feet and Sciatica” perfectly explains my medical conditions of Fallen Arches, degenerative knees, Scoliosis, and Sciatica. I’m presenting a medical case to the Veterans Administration for these conditions they failed to diagnose during my service years. Can you email a written version of the video, “The Feet and Sciatica?” Thanks.
Dr. George Best
September 27, 2012Hello Gail,
I’ll reply via email.
annamarie
November 26, 2012I broke the bones in the arch of my right foot some 35 yrs ago and have now realized the plethora of imbalances between the left and right sides of my body it has caused. Pelvic rotation, short leg syndrome, sciatic pain.. and that is just the lower half. The upper half tilts to the right as well and the muscles do not know how to properly function. I am 54 yrs old and extremely fit having rode race horses for 25 years. I now own a gymnastic club so I am still active,but much more aware of my body. I never realized how imbalanced I was until I started jumping on the trampline. A sharp pain would radiate under my glutes and down my leg..since my job as a coach is too work on postural alignment with my students I figured I better start working on myself. Unfortunaley, I am finding it hard to spot the students on my right side ( I just don’t feel safe (for the kids sake) ) so I am always using my left side to do all the strength work. Would inserts ( I can’t afford to go to an orthopedic, so I use the generic ones help to raise my lower right hip, or do I have to consciously hike it up to stay level and balance. I do the exercises and don’t mind the pain but so much of the day I can’t remember to stay centered. At night I do alot of visualizing when I am laying down in bed..which makes me feel good but I don’t know if it really matters because when gravity takes over, I stand the same. bend over the same, reach for something the same way I’ve been doing for last 30 years..I would love to change the way I do everything.. Should I become right-handed to get my right side involved and give my left side a break..poor thing..the muscles are so tight and contracted.. Lots of questions I know but..you’re the expert.. Sometimes I feel like I should double up the inserts in my right foot to level out the hip but my foot won’t fit in the shoe..lol..thanks for thinking about it for me… anna
Dr. George Best
November 26, 2012Hello,
First, it is important to understand that there are two main types of short leg syndrome. A structural short leg is one in which one or more of the bones in the legs vary in length from left to right. The other type, which is far more common with significant leg length differences is a functional leg length inequality in which the difference comes from unleveling of the pelvis due to any of a number of biomechanical issues (fallen arches, knee issues, hip issues, sacroiliac issues, and cervical spine issues, just to name the most common areas of involvement). While using a lift to compensate for an actual bone length difference is usually helpful, compensating for a functional short leg with a lift will often make things even worse. Since I don’t know what the cause of your leg length inequality is, my recommendation is to have a doctor, chiropractor, or physical therapist evaluate you to determine what the source of the leg length difference is so it can be properly addressed. Most chiropractors I know will work with you to make your care affordable, so my suggestion is to talk to some and try to find someone who you can work with
With regards to trying to switch to being right-handed, that’s no easy task, and if you have mechanical issues on the right side, that mightonly serve to move the problems not really fix them. So, before you go to the effort, I’d definitely get things checked out first and find out what the recommended course of action is.
If you have further questions, let me know.
Good luck!
Dr. Best
Rajkumar
November 26, 2012Hi Dr. Best,
I had accident 2 years ago, i have taken treatment from different hospital in India but no relief in back pain. In MRI it show the second disc from the bottom bend toward right. I got your reference for the same.
I can not sit or walk for long time. Dr. i want to know is it possible of treatment without surgery.
prince.2007g@gmail.com
Thanks and Regards.
Raj
Dr. George Best
November 26, 2012Hello Raj,
Depending on the severity of the disc problem, it usually can be treated without surgery. Most disc bulges/herniations/protrusions can be treated with the methods in my ebook. If you don’t already have it, it can be downloaded from the right sidebar of this page:
http://www.sciaticaselfcare.com/basic-sciatica-exercises/
Severe disc protrusions and disc extrusions (discs that are actually ruptured) do often require surgery, but even in these cases, the self-treatment methods are sometimes effective, so they are worth a try.
Good luck!
Dr. Best
Ron
December 19, 2012Thank you for giving me clear answers about what sciatica pain is. I have a L4L5 disc extrusion and L5S1 protrusion that has caused me much pain for about 2-3 months. You have given me more hope that I can get myself back to being somewhat healthy. I feel like I didn’t receive enough imformation from my Doctors about what I could do other than have a shot, take some pills, and let me adjust you to fix your spine. I feel like just a number when I go to see a Doctor. It is not a conforting feeling.
Thanks again!
Dr. George Best
December 19, 2012Hello Ron,
With a little luck, you can manage your condition effectively with self-treatment and perhaps medication during flare ups.
The problem with disc extrusions is that they are pretty unstable and unpredictable. Unlike a protrusion (a bulge), an extrusion (also called a rupture) means that the outer wall of the disc has been breached by the inner gel of the disc (although radiologically-speaking, the difference between a protrusion and extruson is a matter of size, so what the radiologist called an extrusion may not be a full rupture). This is a much more difficult situation to treat conservatively than a protrusion. My recommendation is to work with the methods here on the site and with your health care professionals to try to get the best results possible. If you are not much better within another 3 to 4 weeks, then I’d say your best bet is probably going to be a minimally invasive surgery. This is done through a scope using small incisions and they trim away the extruded and protruding disc material to open up space around the nerves. While it certainly would be preferable to avoid surgery altogether, most people do quite well with minimally invasive procedures. The recovery is pretty fast – most people can return to most normal activities within a week or so, and there are much fewer issues with post-surgical scar tissue development. It is very important to take good care of your back following such a surgery, but really that’s no different than for any other person with a history of back problems.
If you have questions, let me know.
Good luck!
Dr. Best
Gregor
February 14, 2013Dear dr. Best
First I would like to thank you for all the information and treatment directions about the sciatica that everybody who has the interest can get here. It`s very empowering and guides people to stop leaning so much on the doctors and physicians as most elected “contributors” in the process of treatment. Of course valid information, diagnose and good medical approaches are crucial and comes from specialists, but the most important factor of healing derives (and people should know that) from the patient who is the one who can really help him/her-self. That`s where the responsibility lies to get better as well. And that is the true beauty of your work and your website.
I found some interesting information; exercises and self-diagnosis tests that help me understand better my problem. But I still have a few questions that I would be very happy if you would answer. So let me tell you a bit more what the issue here is. I am 40 years old and I come from Slovenia. I am experiencing some of the problems you`re describing in your videos. It all began 4 months after a car accident that I had (December 2011). I didn`t need any emergency or medical help and a few days after the crash I didn’t feel much pain except some gentle feelings of tension in my back (between shoulder blades) and my neck. Later when I went to the examination the x-ray scans of my entire spine showed that my spine was not injured and my physician diagnosed me a whiplash injury (distorsio columnae vertebralis cervicalis). So the treatment was that my physio-therapist taught me some useful exercises and I was also included in electro-therapy sessions and after a month or two I was pretty much ok.
But a few months after I completed my treatment I was doing some physical work where my problems actually begin. While working (mostly lifting disabled people) I felt nasty pain in my more central then lower back, that several weeks later begun to move down. And in about 3 or 4 months after starting the initial pain, it went down to my lower back and was sometimes moving slightly to the right and sometimes more to the left side. Mostly I felt pain when I was sitting and wanted to get up and the pain got more intense while just sitting. Also while walking but less intense. This type of pain lasts about 4 or 5 months. At that time I did every day my exercises for my back (not for sciatica). But after that the pain vanished and I thought it was over. But instead the whole thing moved down to my buttock and to my right leg that sometimes go down all the way to the foot. Most nasty pain is in the morning or when I seat to long. Some days are better and some days are worse, but I can walk, I can do pretty much everything except sport activities and hard physical work. I feel I can control the pain quite well by doing sciatica exercises.
So now we finally got to my questions. And they go like this:
1. Regarding to the tests you showed us in video I consider my problem is more like “piriformis syndrome” than a “nerve compression” issue. In your video you recommend to begin with exercises that work on nerve compression first. I am doing both types of exercises, mostly because I feel that exercise that work on the piriformis muscle suit me better and make me feel a lot better. Beside your exercises I am doing the one I found on the web (from dr. Paula More – http://www.youtube.com/watch?v=_DkD_PNMnFk ) and I would like to know do you think is it ok if I do both types of exercises? Or is it better I don’t mix them together?
2. My second question is related to the feelings of coldness in my feet. As far as I am concerned I was never a person who was bothered with cold feet and that kind of problems. I am very rarely ill and I am used to tolerate quite extreme weather conditions. But now I find out that since this pain got in to my leg, that I feel more often coldness in my both feet. Can this be related to the sciatica and if so how to begin to solve the problem?
3. My next question is do you think it is possible that patients with sciatica issues can be involve in sport activities again such as jogging, soccer, skiing and mountaineering? If answer is yes, when it`s best to start practicing it?
4. And finally are certain exercises for general back problems helpful or maybe even harmful for patients with sciatica? If so, could you tell us what kind of exercises are not appropriate?
Thanks again for your answers and I hope my questions and my story didn`t take too much of your time.
All the best to you Dr. Best and thanks for your work 🙂
Gregor
Dr. George Best
February 15, 2013Hello Gregor,
In answer to your questions:
1. The exercise in the video link you sent is fine to do. It does essentially the same thing as the seated piriformis test/stretch shown in my video. You can do either version or both, whichever you prefer. While your major symptoms may be coming from the piriformis, the history you gave suggests a strong possibility that there is a disc protrusion causing some nerve compression / irritation as well (which in turn may be causing the piriformis tightness). For this reason I recommend you do the McKenzie exercise as well.
2. The coldness in your feet may very well be associated with the sciatica. In addition to the nerve compression itself giving the sensation of coldness even when the feet are in fact normal temperature, the nerve irritation can sometimes cause reactions in the autonomic nervous system which controls things like blood vessel dilation and constriction and thereby effect the circulation in the feet. If the coldness is related to the sciatica, resolving the sciatica will likely resolve the coldness as well.
3. People who have had sciatica can usually return to at least some sports. High-impact activities like running, jumping, or skiing moguls are less likely to be tolerated, but sometimes people can resume even those types of sports if they otherwise take very good care of their backs. With any heavy exercise or sport, it is best to wait until all of the symptoms are gone for at least a few weeks and then start back very slowly, doing only what seems very easy the first few times. If things go well then you can gradually build back up to your normal intensity, backing off as needed if symptoms develop.
4. Besides the high-impact activities discussed, powerlifting or other extremely heavy weightlifting is certainly not ideal, but with excellent form and control when lifting, even that can usually be tolerated in many cases. The main thing to watch out for is any exercise in which you bend the upper body forward at the waist while standing or sitting. For example, straight leg deadlifts, “good mornings”, and rows done without a chest support are very hard on the lower lumbar discs and tend to cause problems. The same thing goes for yoga and stretching exercises – avoid anything where you bend the upper body forward at the waist when sitting or standing. For example, the hamstring stretch in which you are standing and bend your upper body forward and try to pull your chest toward your legs is bad, but if you lie on your back and pull your legs toward your chest, that’s fine.
I hope this is helpful for you.
Dr. Best
Gregor
February 15, 2013Thanks for your quick response. It`s helpful.
G
Chris Soper
March 19, 2013Hello Dr. Best,
Over the years, I have been told by various medical professionals and even my tailor that I have one leg 1/4″ shorter than the other. None of them has ever shown any great concern about this but after watching your video, I wonder if this is causing or contributing to my low back, hip, leg and knee pain. The pain is worse in the knee but starts at the hip and extends to just above the ankle. The pain is in the front of the leg and at its worse is a burning sensation.The leg is also partially numb and somewhat weaker than the right leg. I also have pain between the hip and sacrum area. I have seen my family doctor, physio therapist and osteopath and I am to have an MRI in ten days time. They all believe it is sciatica but I think it is something else since I have had problems with my knee since high school. It often gives me pain and feels unstable frequently. I appreciate your comments.
Chris
Dr. George Best
March 20, 2013Hello Chris,
To start with, if the pain is in the front of the leg, it is not sciatica, since the sciatic nerve supplies the back of the leg. There could be some involvement of the femoral nerve due to causes similar to those of sciatica. It’s difficult to say without being able to examine you, but the description of your symptoms sounds to me more like muscle reaction to joint dysfunction in the sacroiliac, hip, and/or knee joints.
Your leg-length inequality is not severe, but over time it will result in uneven wear and tear on the supporting structures and could predispose you to the type of problems you are experiencing now. In most cases leg length inequality is “functional”, meaning that the bone lengths are equal, but due to mechanical dysfunction and uneven muscular contraction the pelvis tilts to give the appearance of a short leg, and this definitely goes along with issues in the sacroiliac joint. It is quite possible that you do have an actual bone-length difference, and if that is the case (best-determined by X-ray measurements), you might benefit from using a heel lift in your shoes to compensate for the difference.
I hope this is helpful for you.
Good luck!
Dr. Best
jim gibson
March 22, 2013The doctors have not yet determined what the cause of my leg pain is . I am going for an MRI on the 28 of march . I have had 2 separate accidents resulting in 7 damaged vertebrae 3 broken ribs and a fractured collar bone. Naturally I tend to think of these as the culprit of my Sciatica symptoms. Now however I will get my foot checked out as over the past year I have experienced a lot of pain that seems to come and go on my right foot
Thank You for the heads up in this area
Dr. George Best
March 22, 2013With the types of injuries you’ve had it would certainly not be unusual to also have one or more bulging discs that could produce sciatica. Foot and ankle dysfunction is quite common in auto accidents and is often overlooked in favor of the more obvious injuries, so it is definitely a good idea to get that checked out as well. Good luck!
Dr. Best
Naresh Kumar Bansal
May 20, 2013As per my latest MRI dated 14th May 2013, result is as “PIVD at L4-L5 with secondary moderate to severe canal stenosis. Pls. advise accordingly.
Dr. George Best
May 20, 2013I suggest you start with the basic self treatment methods found in the free ebook. If you do not already have it, you may download it at:
http://www.sciaticaselfcare.com/basic-sciatica-exercises/
With more severe cases like yours, it may take several weeks to get maximum improvement, but if you are not noticing significant reduction in symptoms within one to two weeks, it may be necessary to consider surgical treatment at some point. If that does become necessary, in most cases “minimally invasive” surgery is usually the best option. It is done through small incisions using a scope and it allows for trimming away the bulging disc and other tissue from around the nerves without cutting a lot of muscle or resulting in a lot of post-surgical scar tissue. Hopefully that will not be necessary, but it may be an option in your case.
Good luck!
Dr. Best
Jerome Rosen
June 9, 2013Thank you Dr. Best for your very informative videos.
I have had lower lumbar disk-related problems, primarily in L5-S1 area for many years. My biggest problem is sciatica (right side). It’s chronic and I believe it’s piriformis-related as opposed tp ‘true sciatica.’ (I learned the difference from you.) I never thought of a possible linkage between foot problems & sciatica until I watched “The Feet & Sciatica.”
I have a condition in my left foot diagnosed by a podiatrist as Morton’s Neuroma (between the 3rd & 4th inner spaces). It’s always painful when I walk. Is it possible that it could be a contributing factor re my sciatica? I am planning to have surgery to correct the neuroma.
Thank you.
P.S. I’m 75 years of age & otherwise in reasonably good health.
Dr. George Best
June 9, 2013Hello Jerome,
It’s quite possible that your gait has been altered somewhat in response to the pain from the neuroma and this may be contributing to your sciatica issues. After you have the neuroma removed and the foot is healed up, it might be a good idea to have a physical therapist, chiropractor, or orthopedist take a look at your gait to make sure you don’t need gait training to correct any abnormalities that may have developed. The disc issue you mentioned may also be a factor, even if there’s not major nerve compression because even mild irritation of the nerve can in turn cause excessive contraction of the piriformis. For this reason, I’d suggest trying the McKenzie method per the instructions to see if that helps your recovery, even though it seems like the piriformis is the major issue.
Good luck!
Dr. Best
Jerome Rosen
June 11, 2013Thanks again for the quick response Dr. Best. I just wish you had an office in Southern California…
Dr. George Best
June 11, 2013Glad to help. Take care, Jerry.
RAJAN
October 6, 2013Sir, My daughter of 12 years has “FLAT FOOT”, and is using arched foot wears . But since she is very small , she has not begun feeling any pain any where now. My question is ,
1. Can she be cured !?
2. Will there be a resultant mechanical imbalance in the upper links like knee, hip, etc !?
3. Your recommendations please sir !!!
RAJAN.
Dr. George Best
October 8, 2013Hello Rajan,
I can’t help but get the impression from the tone of your question that you may have been unduly frightened by a health care provider or orthotics salesperson regarding the effects of flat feet. While flat feet (also called fallen arches) will cause some added mechanical stress on the body, it’s not the type of problem that tends to be severely damaging or disabling by itself.
Although there are exercises that can help restore the arches, my advice is to simply stick with the arch supports. Wearing shoes most of the day diminishes neurological stimulation of the muscles in the feet that stabilize the arches. It is very difficult to overcome this with exercises, so although the arch supports don’t correct the problem, they do a very good job of compensating for the problem and minimizing the mechanical stress on the body that it causes.
One last suggestion is to try not to worry too much if and when your daughter resists wearing the arch supports. The shoes that the supports fit in are not always the most attractive and while your daughter at the age of 12 may not yet be too fashion-conscious, there’s a good chance that she will become fashion-conscious in the next few years. If this occurs, she may not want to use the arch supports. Fear not, because eventually she’ll probably realize at some point that she feels better when she wears them and will start wearing them again (but it may take some years). Like I said, the damage that flat feet can cause is usually not a big deal, so while it’s better to use the arch supports, it’s not too critical if she chooses not to.
Good luck!
Dr. Best
Philgood
October 15, 2013Dr. Best, the information on your site has been extremely helpful. You helped me discover that most likely i have true sciatica, and steered me away from trying methods that may exacerbat my condition. In the past few days of doing the McKenzie exercises I have gotten tremendous relief, However, sometimes upon standing up after resting, and taking a few cautious steps, the pain shoots right back down my leg. What can I do?
Dr. George Best
October 16, 2013If it’s only been a few days since you started the exercises, the first suggestion I have is to give it some more time. Depending on the severity of the underlying problems it can take several weeks to reach a point of maximum improvement. Since you’ve had a lot of improvement in just a few days, your recovery probably won’t take very long as compared to what some people go through. Just to give you an idea, a typical treatment program with a physical therapist for this type of condition is 6 to 8 weeks. The basic rule of thumb I have is if things have improved overall in any two week period as compared to the previous two weeks, you’re on the right track and the recommendation is to continue what you’re doing. It is not unusual to have some ups and downs from one day to the next, so you’re looking for a trend of improvement over a period of several days.
Sitting places the spine in slight flexion, which tends to cause the disc to bulge more into the space the nerve occupies. When you first stand up and the spine goes into slight extension, the combination of the increased bulging of the disc and the slight narrowing of the nerve canals that occurs with extension will temporarily increase the pressure on the nerve. Once you have been up and around for a little while, the disc bulge gradually decreases again and the space around the nerve opens up. It is somewhat different when you’ve been lying down, but the effect is similar. When lying down, the disc has less pressure on it than when weightbearing and will often take in fluid. The increased fluid volume will then cause increased bulging when you first sit or stand up, and it takes a few minutes of weightbearing for it to go back down again.
Anyway, from what you’ve said, it sounds like you just need a bit more time to recover, so for right now I don’t have any new recommendations besides to continue what you’ve been doing.
Dr. Best
Tim
December 9, 2013Great information regarding the correlation between the foot arch and sciatica. I’m 37 and have had foot pain for 20 years after aggressive exercise, and sciatica associated with an L5 S1 herniation for 10 years (microdiscectomy 2 years ago). I was told a few years ago that I had high arches which was the source of my discomfort at my toes. Could that also be associated with the disc herniation? Typically my sciatica and low back pain begin with right side hip pain. Thanks for the info!
Dr. George Best
December 10, 2013Hello Tim,
Lower back problems are more commonly associated with fallen arches than high arches, but I suppose it is possible that your arch issues might have participated in the development of the disc herniation.
Dr. Best
Rajesh Dontamala
January 3, 2014Dear Dr George,
First of all thank you very much for your videos and support for patients with sciatica and lower back issues.
I was met with a motor bike accident direct collision with a huge truck direct hit to my right patella and blown up my right knee cap and also femur shaft fracture in sep, 2006 for which my doctor implanted plate screws into my thigh bone and a couple of wires for patella. The fracture was well cured and all plate, screws and wires were removed from my leg two years of post opp. But i gradually started pain in my left side of lower back after surgery for which my doctor said that was because of strain. As i use to get that pain when i was in stress or strain, i took it easy and never look at it so serious. But as the pain never went off i visited my doctor for the same issue on 22/11/2013 for which he asked me to take a MRI scan. I was diagnosed with disc bulge with posterior tear at L5-s1 and also very slight sign of disc bulging at L1, L2, L3, L4.
I worked in a warehouse for couple of months while i was doing graduation where i had to lift weights contineously and had to bend but i left that job recently.
Could you please help me out with options to solve my problem or the steps and exercises to take for my issue.
I also want to know whether i have This discs problem because of my work or of my surgery to right knee and femur saft. I believe it is because of surgey as i use to not put more pressure on my right side of my body and shifted that pressure onto left side which caused me disc bulge on left side.
I am really sorry for such a long comment.
Your suggestion will be helpful to me and much appriciated.
Thank you.
Rajesh Dontamala
26 years male.
Dr. George Best
January 3, 2014Hello Rajesh,
There’s really no way to say for sure what caused the disc problems. They may have been initiated in the accident, they could have started as a result of the uneven stresses on the spine following the knee surgery, or they may have started developing long before you even had the accident. There’s simply no way to know.
With regards to treatment, my suggestion is to start with the methods in my free ebook, focusing particularly on the things for disc-related problems (although the treatments for the piriformis may provide some help as well). If you do not already have the ebook, your may download it from this link.
Good luck!
Dr. Best
Rajesh Dontamala
January 5, 2014Thank you doctor. I will follow the book. Rajesh
Ann
January 26, 2014Very well presented information.
Dr. George Best
January 26, 2014Thank you for your comment!
Dr. Best
Ani
February 1, 2014Hi Dr.,
I too had similar issues,but not sure what it is.From last few months i feel something weird in my foot(@sole),its like some nerve is pulled at bottom of my foot.Then sometimes i noticed a nerve comes on top of knee (feels as if something stuck thr).Last week while i again getting nerve on knee,i sat in squat postion suddenly and felt some nerve movement in my calf muscle,since then i am getting mobile like vibration feeling in my left calf,which moves sometimes to thigh.It is not painful,feel like something is being pulled.FYI– i sit in from of computer for long hrs,so thinking it might also be one of the causes.
I have gone through ur videos and started doing mkenzey excercise.Please throw some light on my situation and guide me.
Thank u for all ur videos !!
Dr. George Best
February 1, 2014From your description, I don’t think you have sciatica. My best guess without being able to examine you is that the primary issue is in the foot. Most likely you’re having some collapse of the arch and that’s causing plantar fasciitis (inflammation of the supporting tissue on the bottom of the foot) as well as causing some rotation of the knee and abnormal stress on the calf muscles. I’d suggest you try getting some arch supports as a starting point and if that doesn’t help, then I’d recommend seeing a sports chiropractor to have the joints in the feet and legs checked out as well to evaluate the spine just in case the problem is coming from there.
Good luck!
Dr. Best
Greg Poston
February 27, 2014How does this video apply for flat feet? My flat feet never have given me any problems. (And didn’t do me any good in avoiding the Army draft — they took me anyway!)
Dr. George Best
February 27, 2014Fallen arches and flat feet are basically the same thing. Even though your feet don’t bother you, the flat arches do place extra mechanical torsion and stress on the structures above as discussed in the video.
Dr. Best
Jim Houck
April 2, 2014What an amazing person and doctor to spread such wisdom and beneficial information to the world, FOR FREE. How seldom do we see this in American medicine? Nice work, doctor. I’m very impressed with your right-minded thinking and experience.
Dr. George Best
April 2, 2014Thank you very much, Jim!
Vanessa
November 5, 2014I had never had any back issues until I had my son 2 years ago. I have a horrible pain that runs from my lower back through my buttocks down my thigh & calf & into the arch of my foot. The dr. Told me it was my sciatica. He gave me a few exercises to do but due to my trashed knees I am unable to do them. I ice nightly I have been on anti inflammation meds & pain meds for months & I am always in pain. Please any ideas would be appreciated. Thank you. ..
Dr. George Best
November 5, 2014I’m guessing you found this page from a direct link and haven’t been through the rest of the site since you didn’t mention trying any of the methods here, so I recommend you start with my free ebook which can be downloaded from the link on the right side bar of this page: http://www.sciaticaselfcare.com/basic-sciatica-exercises/. The McKenzie method shouldn’t be too much of a problem with bad knees. The piriformis stretch might be, but you can modify it by reaching behind the knee and keeping it less-bent than is shown in the instructions (the main thing is bringing the thigh across toward the opposite shoulder, and this can be done without bending the knee a lot).
Dr. Best
Liz Galo
November 25, 2014I do wear over-the-counter orthotics, and only buy shoes with good arch supports. So, although I am 68, and have increased shoe size by 1/2 a size, I feel I have good arch support.
However, I have had one chiropractor and one DO tell me my right leg is longer that my left. The DO took careful measurements, and then gave me a 3mm gel insert for the heel of my right shoe. I have two more appointments with the DO, but is that a reasonable track to explore. (I have a herniated L5 disc on the right side, that sent electric pain to my toes the day it happened, and paralyzed the right toes. Now they are 50% better, but the leg is weak and the thigh and glutes are atrophied.) Liz
Dr. George Best
November 25, 2014Hello Liz,
Evening out the leg length may or may not help with your symptoms, but it is a simple fix if it is helpful and so I recommend you give it a try. Depending on the cause of the leg length difference (for example, a congenital difference in bone length versus a loss of joint space in the knee and/or hip joint due to degenerative changes), your body may be adapted to it, so the heel lift might even increase your symptoms temporarily.
With the improvement in your pain, it sounds like you are on the right track. The loss of strength can take some time to recover from – muscles take a lot longer to build up than they do to lose strength and mass after a neurological loss. All you can do is try to be patient and consistent with your rehabilitation.
Good luck!
Dr. Best
Andrew
January 3, 2015Dr Best,
I’ve been suffering with lower back pain for a number of years and have ruptured L4/L5 and L3/L4. The level of discomfort got significantly more uncomfortable following the birth of our first child 2.5 years ago, where I would flex my spine to put her to sleep in a travel cot, which was almost down at my feet!
I have tried several therapist and more laterly have been a bit more successful in managing the level of discomfort that I have been experiencing.
I was a very active sportsman and find my situation very frustrating. The therapist that I have recently been seeing has advised me that he thinks that I sit down too much as I have a desk job but I have recently ordered and sit stand desk that I hope will deliver some further results. I’m following a hip flexor stretching program and have included some of the stretches that you recommend, pulling the leg towards you and across.
Is there anything else that I can be doing? I’m determine to get get back to some level of regular exercise and manage my back so that I can lead a relatively normal life.
Dr. George Best
January 3, 2015Hello Andrew,
You didn’t mention doing any of the McKenzie exercises, so if you have not gone through the testing procedure and started using the position that best centralizes (or, if you only have low back pain and no sciatica, reduces) your symptoms, I recommend you do so. Frequent use of the McKenzie exercise (see my free ebook for the full instructions – if you don’t have it, you may download it from the link on the right sidebar of this page) at first can improve things faster than anything else when the symptoms are disc-related.
You described your discs as “ruptured” and that terminology gets used very loosely, even among doctors. In terms of treatment decisions, it’s very important to distinguish between ruptured and bulging/protruding. Bulging / protruding discs typically respond well to conservative (non-surgical) treatment methods such as exercises, but actual ruptures usually require surgery for good long-term resolution of symptoms. If the disc is actually ruptured, you’ll usually see the term “extruded” or “extrusion” or perhaps “sequestered” on the imaging report. If one or both of the discs are actually ruptured, my advice would be to consult with a surgeon who does some type of minimally invasive procedure. This is done through small incisions using a viewscope and the ruptured disc material is removed. In most cases this will bring about major symptom relief within a few days and most patients can resume normal activities within a week or so. You still have to be careful and continue taking preventive measures, but you’re likely to do far better than trying to manage an actual disc rupture with exercises.
If there is not an actual rupture of the discs, I’d also suggest consulting with an experienced chiropractor. Physical therapy does a great job with soft tissue and muscular conditions, but if there are joint dysfunction issues that have not been addressed, recovery will be limited and/or delayed. Physical therapists will often work on joint issues, but often in a much less direct way than is typical with chiropractors. I have seen many patients who have undergone several weeks to several months of physical therapy with slow progress improve dramatically with one or two chiropractic treatments. In my practice I incorporate deep tissue massage techniques along with joint manipulation and if you have not had any deep massage work in your therapy, I would highly recommend that as well. Stretching is important, but in many cases there are focal areas of muscle contraction that create a lot of pain and these “knots” usually do not fully resolve with stretching alone.
If you have further questions, let me know.
Good luck!
Dr. Best
John Kerwin
February 11, 2015Hi Dr Best I had really bad sciatica 10 years ago & was in bed for 3 months & a year before I was back to normal except for a stabbing pain in by big toe every now & again. Fortunately it only happened now & again when I was walking. Now it has returned with varied sensations from a dull ache to a burning pain which comes & goes with changing my body position usually but not always. Is there a particular exercise I should use or avoid, can you advise. I do the stretches most mornings as soon as I get up. I’m concerned that I may be about to get a repeat of severe sciatica which I want to avoid at all costs. At my age I think I’d prefer to die than go through all that again.
Dr. George Best
February 12, 2015Hello John,
Without knowing more specifics about the underlying problem, about the only thing I can suggest is to follow the recommendations in my free ebook (if you don’t already have it, you may download it from: ). You didn’t say how old you were, but given what you did say, I’m guessing you’re probably somewhere past middle-aged. If that’s the case, new disc protrusions are relatively unusual, so the culprit is probably more of a degenerative or inflammatory issue, or it could be muscular (piriformis or gluteus minimus). It would still be a good idea to test the various positions for the McKenzie exercises (discussed in detail in the ebook), but if it’s a degenerative issue, you’ll probably do best with one of the flexion positions. If things don’t improve over the next few weeks, it would probably be a good idea to look into having an MRI or CT scan to evaluate things and give an indication of what your best treatment options are.
Good luck!
Dr. Best
Ravik
September 3, 2015Hello Dr.Best:
I had first symptoms of sciatica pain on the left side of my body back in 2009.I had consulted a doctor back then who had suggested some stretches which i have been doing almost regularly since then and that has helped me out a lot.However, he could not identify the exact cause of it.I have realized much later that i have almost flat feet and would like to know if that has been causing my sciatica pain.I do stretches and exercise 4-5 times a week (cardio & weights)now and play racquetball.
Should i use any arch support/special type of shoes on a regular basis,any specific exercises to help prevent injury in general,are deadlifts/T-bar risky for me ?
I need your valuable suggestions regarding these please.
Regards:
Ravik
Dr. George Best
September 3, 2015As discussed in the video, flat feet (unstable arches) can be a factor in sciatica because they cause compensations in the body that place added stress on the lumbar spine. General “off the shelf” arch supports are usually helpful to some degree and custom-made orthotics will maximize the arch position and minimize mechanical stress while providing what’s typically a more durable product than the generics. My personal preference for custom supports is the Footlevelers line of orthotics, most often dispensed by chiropractors.
With regards to exercises, deadlifts and T-bar exercises are risky for anyone and are particularly risky for anyone with a history of back problems or sciatica. If they are done with perfect form, they’re not so bad. But doing them perfectly every time, especially if you’re tired or distracted, is the tricky part, and even a minor break in proper form makes them very dangerous for the lumbar discs. The main thing to keep in mind with exercises is to avoid anything where you bend forward at the waist from a standing or sitting position unless the upper body is somehow supported.
Dr. Best
Paul S.
February 19, 2016Hi Dr. Best — I stumbled upon your website the other day and have spent a good couple hours going through your posts. I love the stuff you are saying! I have been dealing with mild low back pain, throbbing pinching in my glute, and then burning foot pain — for just over a year. I’m 46 and was an active triathlete, but I didn’t have the best nutrition, and I didn’t have a foundation of strength. On top of it, I sat at the computer all day and had no core strength. It’s no wonder I’m injured. I have had extensive imaging done, and doctors say my back looks good for my age. But then some chiropractors tell me that a minor bulge in the back could be a larger bulge when you are seated or standing. Have you seen cases like this where imaging looks good, yet weird sciatica and biomechanical issues exist? Thank you!
Dr. George Best
February 19, 2016Hi Paul,
Actually it’s very common for imaging to show little or nothing that is the definitive cause of a patient’s symptoms. With regards to disc protrusions specifically, as the chiropractors told you, how much protrusion is present when lying down is sometimes much different from what occurs in an upright position, so for patients whose symptoms mostly occur when upright, I try to get an upright MRI done if at all possible. The other common issue that creates a discrepancy between imaging findings and the patient’s symptoms is motion. To give you an analogy, if you look at a car while it’s parked, the wheel alignment may seem fine, but if you look at the same car while it’s moving, you may see the wheels wobbling all over the place, completely misaligned. The same thing occurs when looking at the spine. A static X-ray or MRI shows the spine in a single position, usually a relatively optimal position of standing or lying straight, so a lot can be missed regarding possible causes of symptoms. By the time someone reaches middle-age, there’s usually some degenerative change or clinically unimportant “abnormality” that doctors can point to and proclaim it to be the problem, but in my experience, diagnosing based solely or primarily on imaging findings is pretty unreliable except in cases of overt pathology with clear neurological and/or biomechanical compromise.
Dr. Best
Paul S.
February 20, 2016Thanks for your reply, Dr. Best. Your info gives me reassurance I’m on the right path to pursue this further. I’m impressed how well you respond to questions — I think it will be worth it for me to sign up for your membership. 🙂 Thank you.
Dr. George Best
February 20, 2016You’re welcome, Paul. Let me know if you have further questions.
Dr. Best
Sabir
March 8, 2016Hello doctor,
I suffer from a pains right down the left foot ankle.I went to see a doctor and he prescribed some pain relief medicines.the pain continues.after a second visit he asked if I have sciatica.I replied from time to time.my question is a pain down the ankle resulting from a torsion can be emanating from a back pain?thanks.
Dr. George Best
March 8, 2016It is possible that ankle pain might be radiating from the low back, but if you suffered a torsion injury to the ankle, I would say there’s probably a problem in the ankle itself. Actual sciatica does not usually skip the leg and go straight to the ankle. Individual nerve roots from the low back can cause radiating pain just to the ankle, but usually back pain will also be present in those cases. So again, I think the ankle itself is probably the problem. Many times with ankle torsion injuries, one or more joints can become jammed or misaligned, and most medical doctors are not particularly well-versed in assessing or treating such issues. My suggestion is to get checked by a sports chiropractor or osteopathic doctor who is experienced with extremity problems. As long as there’s no ligament or other significant soft tissue damage, it’s probably something that can be corrected relatively easily. Good luck!
Dr. Best
Sklee
May 2, 2016Can the sciatica nerves problem of the foot affect the sensation the soles of the fèetc?
Dr. George Best
May 2, 2016When sciatica extends to the foot, it can cause symptoms such as burining, tingling, electric shock sensations or numbness. But symptoms in one or both feet without symptoms higher up in the leg(s) is usually not from sciatic nerve irritation. If only the feet are involved, and especially if it’s both feet, it’s more likely to be some type of peripheral neuropathy (such as from diabetes) or possibly due to spinal stenosis impinging on the spinal cord and producing a condition called myelopathy.
Dr. Best
Brenda
June 17, 2016I have just the opposite issue…. I have been diagnosed with Plantar Fasciitis. I got custom orthotics for my shoes and my Sciatica has flared up.
How long before it quiets or will it?
Dr. George Best
June 18, 2016There are too many variables to be able to answer your question. If you only developed sciatica after you started using the orthotics, I would recommend discussing the issue with the doctor who provided the orthotics. It is possible that they are not fitted quite right for you and may be causing alterations in your gait that are causing irritation of a pre-existing disc condition and/or piriformis syndrome.
Dr. Best
Juan Herrera
June 18, 2016Hello Dr.,
A little off the subject but related to my foot. I noticed the the arch on my left foot had started to fall about 8 years ago. I first started noticing that my arch would cramp up out of nowhere which caused severe temporary pain. Now I have pain all the time.
Most recently, on the same foot I have notice that I lost noticeable strength in the last three toes. I am not able to push off, and the tips seem floppy. The pinky toe is the most noticeable because it flops over to the left as if the were double jointed. Have you ever encountered this in your practice, and is it related to my falling arch?
I did have a fractured 3rd L/H metarsal about 18 yrs ago and have been diagnosed for my lower back pain with mild anterior wedging of T12 and mild disc narrowing L4-L5 & L5-S1.
Any help is greatly appreciated as I have been to a pediotrist and he has recommended exercising my toes.
Thank you,
Juan
Dr. George Best
June 18, 2016My guess is that you’ve altered your gait over the years due to the pain and it has resulted in weakness of the toes. You may also have some joint dysfunction/misalignment in the foot that could be either a cause of the pain, or an effect of the aforementioned gait alteration. Assuming that there is not some sort of neurological loss producing the weakness, exercising the toes should help. I would suggest consulting with a sports chiropractor (one who is experienced with working with extraspinal joints – not all chiropractor are) to have the joint alignment and motion evaluated, as it is a potential issue and not something that most podiatrists are trained to evaluate.
Good luck!
Dr. Best
Kabeer
July 25, 2016Hey doctor
Am i have painful pain in my back,glute thight knee and foot mostly the pain is more painful in the lower back,glute and knee I can’t sit for more than 20mn without pain coming i like standing,walking rather than sitting it pain me most while sitting in the car mostly in my glute and very sensitive to hand touch in the thigh.Any help please
Dr. George Best
July 26, 2016First of all, please allow a little time to receive an answer to any questions you post. I answer all questions personally and it may take me a day or so to get to it. Repeatedly requesting a response only slows the process down.
Anyway, from the description of your symptoms, my best guess is that you probably have a disc protrusion in your low back. I suggest you start with the methods in my free ebook. If you have not already downloaded it, you may do so from this page:
http://www.sciaticaselfcare.com/basic-sciatica-exercises/
If you do not get significant improvement with the methods in the ebook within 1 to 2 weeks, I would strongly recommend being evaluated by a doctor, and probably have an MRI to evaluate the situation and determine the best course of action.
Good luck!
Dr. Best
Michael O
August 14, 2016Great video. I think my latest, bad and persistent, relapse into sciatica was caused in part by wearing sandals without arch supports. I had usually been using Finn Comfort insoles in everything – shoes, rubber boots, slippers for about 10 years. Having been pain free for about two years (I think thanks to daily Yoga and time on the inversion table) I got overconfident. Built a deck that involved lifting 16 foot lumber and swiveling it to get it sawed and in place. And wore regular sandals. I’m currently two days into the exercise and icing recommended in your e-book. Thanks.
Dr. George Best
August 15, 2016You’re welcome. The lifting, bending, and twisting involved in building the deck probably contributed to the flare-up as well, but the better the arches are supported, the less problems you are likely to have.
Dr. Best
Bethany M
September 30, 2016Hi,
Had an L4/5 s1 building disc from 16 years ago. Siatica used to come and go, recently acted up again. Started PT about 8 weeks ago, doing Macenzie method and other strenthgnen exercises. Had a recent MRI , showed some mild edema and some progression of building disc same area. Other nothing too significant. Was getting better in PT but know developed sharp nerve pain on bottom of foot. Pain when walking and also when having a bowel movement. Also, when I press on my buttocks I get the pain on the bottom of the foot. Could this be piriformis muscle , my PT says he thinks mostly muscular . Confused because was getting better? Help please!!
Dr. George Best
September 30, 2016The problem could be the piriformis and/or gluteus minimus muscle, but there could be direct nerve involvement up around the bulging disc as well. In either case, a number of things can cause flare ups in symptoms, ranging from stress, to increased amounts of sitting, to even dietary factors (sometimes foods can trigger inflammatory reactions in certain people and it can be difficult to determine what it is that’s causing the reaction). If you had initial improvement with your PT, chances are they will improve again. A lot of times it’s a matter of overcoming the “bad” activities that aggravate the back like prolonged sitting with more frequent use of the McKenzie and other exercises that have been helpful.
Good luck!
Dr. Best
Aleshanee
October 1, 2016I’ve had sciatic flares for over 3 decades now. Usually, my first response is my inversion table and lower back stretches and the flare usually lasts 3-4 day. Currently, I’m having an extreme flare that has lasted 6 weeks! I have been bedridden for 4 of those weeks because the pain is unbearable. I’ve been to the emergency room twice, screaming for relief. The medical community has let me down. I haven’t been able to get appointments for neurologists, orthopedists or even pain management until many weeks from now. I’m undergoing acupuncture, which helps relieve the pain some, but my gait is really messed up. I’m shuffling like an elderly person. This ordeal has left me psychologically scarred with depression and hopelessness. My chiropractor isn’t even helping, and I’m at a loss as to what is going on and what else I can do. Walking, sitting or standing is impossible for any length of time, like more than 30 seconds. I’m at my wit’s end.
Dr. George Best
October 1, 2016You didn’t mention what, if any recent diagnostic imaging has been done or what the results were, so I’m going to assume that you have not had a recent MRI. If that’s the case, I’d say that would be the first step to get an updated evaluation of the potential underlying cause(s) to give an idea of what your treatment options are. In most cases, a chiropractor can order an MRI and you can have it done and get the results within a few days. Depending on the results of the MRI, you may be able to get an expedited appointment with a specialist if needed. So, my recommendation is to see if your chiropractor can/will order an MRI for you ASAP. In the meantime, you can try the methods in my free ebook and hopefully that will help to some degree. If you don’t already have the ebook, you may download it from this page: .
Once you have the MRI results, if you have further questions, feel free to contact me.
Good luck!
Dr. Best
Aleshanee
October 1, 2016Sorry, yes during one of the emergency visits, they did an MRI. They spotted the pinch in the L5-S1. They told me to visit my family doctor, who tried to do a muscular injection that didn’t work. He has referred me to specialists, who have a long waiting lists so I’m confined to lying flat with pillows supporting my lower legs. He prescribed Gabapentin, which doesn’t do much in pain relief. I have tried to do some floor stretches and every time I do the nerve pain increases. My mind is crazy from the constant agony and the frustration of getting no help. I have to resort to crawling to get to the bathroom.
Dr. George Best
October 2, 2016Depending on the specifics and severity of the MRI findings and where you live (the following strategy usually doesn’t work in Canada, UK, or other countries with a National Health System), your family doctor might be able to get you in to a specialist sooner. In my experience with cases that needed faster intervention, when I called the doctor I was referring to personally (or at least spoke directly to his/her office manager) and explained the situation, I’ve usually been able to secure a much faster appointment for my patients who were in dire need – in some cases, same day appointments with doctors with a 3 month or longer waiting list (and as a chiropractor, I don’t exactly have such high status in the medical community that they’d be bending over backwards just to make me happy). That would be something to inquire with your doctor about.
In the meantime, my original suggestion to try the methods in my free ebook stands. Just be sure to carefully review and follow all of the instructions for the McKenzie method, especially regarding testing for the ONE position that best centralizes the symptoms (explained in the directions). In addition to using cold packs as directed in the ebook, I also recommend you either try over the counter anti-inflammatories (such as ibuprofen or naproxen), or talk to your doctor about possibly getting a prescription for some type of anti-inflammatory. In many cases, inflammatory swelling is a significant contributor to nerve compression symptoms and anti-inflammatory medication often works much better than pain medication in such cases.
Good luck!
Dr. Best
Edmund
October 20, 2016Dr. Best, this is exactly the problem I have! Do you have any recommendations for treatment or even a referral for someone who can treat this in NYC? Thanks!
Dr. George Best
October 20, 2016Hello Edmund,
The most practical approach is usually to get fitted for orthotics. I have had good results over the years with Footlevelers and they are a popular brand among chiropractors. While I don’t have a specific provider to recommend in your area, I suggest you contact Footlevelers (http://www.footlevelers.com) for a list of local doctors.
Good luck,
Dr. Best
Cory
November 11, 2016Dr. Best,
2 years ago I developed sciatica down my right leg that resulted in pain in my foot along the S-1 nerve from heel to toe(s). I ended up having a microdiskectomy L-5/S-1 because of nerve root impingement which did not help and just recently had my L-5/S-1 vertebrae fused. The sciatic pain down my leg has subsided but I still have pain in my foot that increases the longer I stand and walk around. I have noticed that the muscle tissue from the front right side of my foot to my heel is plagued with small knots, I believe now that they are the left over damage from 2 years of my S-1 nerve being impinged upon due to a herniated disk.
My question is: how do treat what seems to be muscle tissue that has been knotted up and scarred from 2 years of nerve root impingement?
I have found some relief with (self)dry needling and massaging the area but I would like your take on it. The more I stand up and walk around the more inflamed each of these little knots becomes and the pain is unbearable.
Dr. George Best
November 11, 2016Hello Cory,
I suggest you see a chiropractor who works with foot issues (not all do). In addition to the soft tissue knots, you may have some areas of joint misalignment or dysfunction that is contributing to your symptoms. If so, then getting the joints corrected will make it a lot easier to get the soft tissue problems to settle down. It might also be worthwhile to have some professional massage therapy on your foot to help get you past the worst of the restrictions and make it easier to manage it on your own.
Good luck!
Dr. Best
Chris Gigliotti
November 17, 2016Doctor,
I am a bit confused with what I saw on the You Tube Video and so I am submitting a Comment for your response.
I have fallen arches and did get some arch supports (not professionally sized by a Doctor) that I have been wearing in my shoes for a few years now.
My confusion is that the heels of my shoes are wearing out on the Outside Edge of each shoe. (Not the inside edge of each shoe as the You Tube Video describes.)
Question: Could my Arch Supports possibly be TOO HIGH OF AN ARCH and causing my walking gait to be causing the above phenomenon??
(My knees do not hurt but I do have lower back issues and wonder if there is something I should consider doing to help my lower back situation somewhat.)
Your response would be greatly appreciated.
Sincerely,
Chris Gigliotti
Dr. George Best
November 17, 2016Hello Chris,
I’m not sure which video you’re referring to, but the most common situation is for the heels of shoes to wear faster on the outside edge. A small amount of wear on the outside edge is not really a concern, but if it’s significant on relatively new shoes, it may be a sign of foot pronation, which is commonly associated with inadequate arch stability/support. So, in answer to your question, it is unlikely that you have too much arch support. Even with good arch support, people who tend to pronate will still usually have some increased wear on the outer edge of the heels of shoes, and that wear tends to accelerate as time goes on (the tilting of the shoe leads to more stress on the outer heel). Because of this, it is important to monitor one’s shoes and replace or re-sole them before significant wear occurs and it produces undue mechanical stress on the body.
Dr. Best
Sabrina
January 11, 2017These are all my symptoms!!!! I am a bartender, on my feet all day! Can you sugges some in soles for my shoes???
Dr. George Best
January 11, 2017The best would be a custom-fitted orthotic such as Footlevelers available through many chiropractors or orthotics from a podiatrist (the semi-flexible type with some built-in shock-absorption are preferable to the rigid type in my opinion). Custom orthotics are usually in the $300-$500 range (it pays to shop around because there can be a big price difference for the exact same orthotic from one clinic to another), but they will work better and far outlast any generic insole I know of. That said, if you need something more budget-friendly at least in the short-term, almost any of the off the shelf insoles with arch support will probably help. Dr. Scholl’s Custom Fit system was very popular as a way of getting semi-custom orthotics initially, but I’ve seen some complaints recently about their durability (specifically the Custom Fit line, not Dr. Scholl’s in general). At the price (about $50 a pair), I think you’re better off going with a higher grade of custom orthotics and just use an off the shelf insole in the meantime if you need to save up for the custom ones.
Good luck!
Dr. Best
Sabrina
January 14, 2017Thank you so much Dr best. Is this burning in my feet something I have to live with for the rest of my life or is there something I can do to heal the nerves in my feet….the pain wakes me up out of my sleep. I take gabapentin and also a cream with gapatetin in it…I’m just completely miserable. Im 45 with a wonderful grandson, and I don’t want to suffer from this forever.can you provide me with something I can do? Thanks Dr Best!
Dr. George Best
January 14, 2017Hello Sabrina,
You haven’t said what your diagnosis is, or if you’ve even really been diagnosed. All too often doctors will just write a prescription based on symptoms without really making an effort to determine what the problem actually is. With what information you have provided, I don’t think what you have is sciatica, but more likely either plantar fasciitis or some type of peripheral neuropathy in your feet. If there is confirmed peripheral neuropathy (documented by some sort of neurological testing), I would recommend being checked for diabetes as well as Vitamin B12 and Folic acid deficiency. Many cases of peripheral neuropathy are “idiopathic”, meaning that no cause can be determined. In those cases, drugs like gabapentin are the common medical treatment, but I’d suggest looking into acupuncture or possibly magnetic insoles as a means of decreasing the symptoms. If the problem is plantat fasciitis, the symptoms will typically be worst after a prolonged time off your feet and will gradually decrease once you are up and moving around. Plantar fasciitis typically responds well to the use of orthotics, as well as massage and chiropractic manipulation of the feet and ankles.
The prognosis for recovery really depends on what the problem is. Most likely your symptoms can at least be greatly improved if the problem can be identified and properly addressed.
Dr. Best
David Daddona
January 14, 2017I had formed inserts made in August 2016..Was supposed to go back to Doc after a few weeks if adjustments were needed. Due to other family issues, never made a return appt.Inserts were a Godsend for about 2 months, but I started having issues with my left foot.This past week, I started having issues with a heavy leg at times and tingling in the back of leg, with knee pain..Went to family Physician, and he diagnosed Sciatica.I know I need to call my foot Doctor, but til I get appointment, are there exercises I could do? Should I stop wearing my inserts til appointment? Something elseto use til then? Thanks!
Dr. George Best
January 14, 2017Hello David,
If the inserts were working well for 2 months, it’s unlikely that they’d suddenly become a problem. I don’t think there’s a reason to stop wearing them unless your symptoms seem to improve when you’re not wearing them. With just the innformation you’ve provided and without being able to examine you, I’d say that your symptoms are most likely coming from the lower spine and/or pelvis area. My suggestion is to try the self-treatment methods in my free ebook to start. You may download it from the link on the right sidebar here.
Good luck!
Dr.Best
Selby Myers
January 23, 2017Doctor,
I am very impressed to find a doctor who understand the interconnection of the foot and sciatic pain. I was about an hour in composing the development of my Odyssey from foot pain through hospital treatment, inpatient therapy, outpatient therapy, two neuro surgeons, disc stabilization, an epidural shot, referral to a physiatrist, another steroid shot into my hip, opioid medicine, and most lately an MRI of my pelvic region.
My e-mail draft somehow disappeared, much before I could conclude it. I even forgot to mention early visits to my chiropractor and two massage therapists. Long story short, I received only very short help from each massage. The drug–Nucynta–is the first opioid I can tolerate but it is outrageously expensive!
My Richie brace isn’t effective because it is constructed with Velcro straps, the least effective method for fastening a brace I have seen. So I have newly recurring left foot pain. I may still have surgery.
I am a complicated patient. I have type two diabetes, hypothyroidism,slight kidney impairment, enlarged prostate, knee replacements,and hypertension–all conditions addressed successfully. Until last year, I attended aquatic exercise class three times each week, walk my dog, work a small vegetable garden, and am reasonably active.
With my genetic history, I should live another two decades. But I have trouble with hip pain and impaired mobility. Hopefully my physiatrist will solve my hip pain. What do you advise about my left foot and ankle?
Dr. George Best
January 25, 2017Hello Selby,
You didn’t say what the issue is with your foot and ankle other than pain, if you’ve even been given a diagnosis. Given the other health conditions you mentioned, the foot and ankle issues may be a primary problem – in other words, an issue directly in the structures of the foot and ankle. The symptoms may also be secondary to sciatic nerve issues and/or your diabetes. So, I can’t provide any suggestions without knowing more specifically about the foot and ankle.
Dr. Best
Jyoti
June 5, 2017Hi! My name is Jyoti. I suffered a lot of pain in my hamstring and buttocks a couple of months ago, the doctor advised to get a MRI. The report revealed that I have a mild disc bulge at L5-S1 junction. I have been doing back exercises as advised by the doctor religiously but the pain doesn’t seem to go away. It has reduced significantly a couple of time but then increased again. I do not have any pain in my back. I also don’t have any pain while sitting. It only comes while standing or walking. Please help.
Dr. George Best
June 5, 2017Mild disc bulges often produce no symptoms at all and my thought is that the disc bulge may not be the source of your symptoms at all. The fact that you only have the pain while standing or walking actually sounds more like a sacroiliac problem to me. My suggestion is to consult with a chiropractor to get the joints checked out. Chances are it is something that can be corrected relatively easily.
Good luck!
Dr. Best
Jyoti
June 6, 2017Thank you so much Doctor. So far I am being treated for the disc bulge only. I have had sciatica for over 2 months now. Can sacroiliac also cause sciatica like pain?
Dr. George Best
June 6, 2017Yes, misalignment or dysfunction in the sacroiliac joint often causes reaction in the piriformis and gluteus minimus muscles, both of which can produce symptoms similar to sciatica.
Dr. Best
Laura
June 29, 2017Hi Dr. …I had a ligament injury in the knee that I now know developed from collapsing arch (the arch itself is higher than on healthy foot, but dr says I have collapsed arch from looking at forefoot etc). I developed nerve pain in foot and up leg to knee. Was walking on crutches because of knee problem, but compounded everything by developing a disc issue from crutches and wear and tear. MRI showed a protrusion and l4/5. My knee was healing so I ditched crutches, but still suffered sciatica pain. PT gave me McKenzie exercises which got rid of that pain in leg. My problem is my arch differences in my two feet and pronating was giving me tendinitis in anterior t and posterior t tendons of the one foot. So I was fitted with custom Eva orthotics with arch support. For years I had been wearing softer off the shelf (air plus) 3/4 length with a bit of arch support. The change from the softer to harder insole with is putting pressure on sole and giving me nerve pain under my foot radiating up to knee and am feeling some muscle weakness in leg again so it’s a vicious cycle with sciatica coming back or just plantar f being irritated? Should I ditch insoles? My sciatica or collapsing arch led to inability to stand on toes so I can’t afford to have more muscle weakness. But the tendinitis is horrible in posterior and anterior tibial tendons without arch support. Ultra sound showed minor inflammation in these tendons, but thickness and pain makes walking difficult. Thanks for any advice.
Laura
June 29, 2017Let me add..worked in daycare on my feet all day, lifting children etc, so it seems as if the bulging disc may have triggered the knee and foot issues. But I distinctly remember feeling something in my back give while using crutches for knee problem..so it’s a case of chicken or the egg for the origins of my three issues:). My main concern is my foot right now..I used to walk miles every day and since all of this happened in March, I can only manage 500 meters at a time because of tendon pain.
Dr. George Best
June 30, 2017Hello Laura,
I suggest getting a second opinion on your foot issues. It definitely sounds like the orthotics you currently have are not right for you. Some people can’t tolerate the relatively rigid orthotics at all, and sometimes it’s a matter of them not having been properly fitted by the prescribing doctor, but whatever the reason, it sounds like the ones you have are not appropriate for you. If possible, I suggest seeing a sports chiropractor, as an assessment of the alignment and function of the joints in the foot and ankle, as well as the stability of the arch would probably be helpful. Most sports chiropractors also provide custom-fitted orthotics, and usually use a semi-flexible type that provides support as well as shock-absorption, which I think you’ll find are much more comfortable than the EVA type. If that’s not available to you, you may ery well be better off going back to the off the shelf inserts you were using before, perhaps going to one with a bit higher arch support if available.
Good luck,
Dr. Best
Janice
October 8, 2017Ball and heels of my foot cannot touch the griound, it’s a continuance of a sciatica episode that just started 2 wks ago
Dr. George Best
October 8, 2017In that situation, the foot is probably not really the cause of the problem, it’s just that the nerve is so irritated that any tension placed on it increases the symptoms, and that’s mos often associated with a disc protrusion. I suggest focusing on addressing the nerve irritation with cold packs and the McKenzie Method per the directions in my free ebook. If you have not already downloaded the ebook, you may do so from the link on the top right of this page: . If things are not improving much within a couple of weeks, I’d recommend seeing a doctor and probably getting an MRI or CT scan to evaluate the situation and help determine what your best treatment options are.
Good luck!
Dr. Best
Philip Baker
November 2, 2017Hi DR Best…
Is is possible to have Siatica in just the feet with no leg pain? I have burning in the soles of my feet for many months now.Have stenosis on the facet joint L4/L5 with a large synovial cyst also present sitting on the nerve root
Dr. George Best
November 2, 2017Hi Philip,
Burning in just the feet (not the legs) is probably not sciatica, but is more likely to be due to either some type of peripheral neuropathy or possibly myelopathy associated with the stenosis in the lower spine. Peripheral neuropathy is commonly associated with diabetes, which is why your doctors checked for that, but it can also be associated with nutritional deficiencies (most commonly of Vitamin B-12 and/or folic acid, or it may occur due to unknown causes, in which case it’s called “idiopathic neuropathy”. Idiopathic neuropathy is most common in older individuals and some theories suggest that it’s due to age-related degeneration of small blood vessels supplying the nerve in the feet and lower legs.
If you have not been checked for B12 and folic acid deficiency, I would recommend that, because usually correcting the deficiency will gradually correct the neuropathy. By the way, with B12 deficiency, you may need to use injectable or sublingual supplementation as opposed to oral supplements because B12 requires the presence of “intrinsic factor” in the stomach to be absorbed, and some individuals lose the ability to produce adequate intrinsic factor for various reasons, so they need a form of B12 that directly enters the bloodstream.
With idiopathic neuropathy, there’s not a specific treatment because there’s not a known specific cause. Some people find that supplementing with alpha-lipoic acid (a strong anti-oxidant) helps, some not. Other treatments that may or may not help are magnetic insoles, acupuncture, and various pain medications.
Myelopathy is a degeneration of the neurological tissues of the spinal cord that is most commonly associated with some type of mechanical compression, such as stenosis from bone spurs, synovial cysts, and disc protrusions. Typically the stenosis has to be pretty severe to cause myelopathy and it doesn’t sound like that’s the case with you, so I don’t think it’s likely, just a possibility to consider. Myelopathy is treated by means of reducing compression of the cord by various means depending on the case. More severe cases typically require surgery. One thing to keep in mind is that the myelopathy doesn’t have to be in the lower spine to cause symptoms in the legs and feet (doctors tend to forget this). The cord compression can anywhere up the spine, and even cervical spine (in the neck) myelopathy can cause leg symptoms. Again, I don’t think myelopathy is the issue, but if other more likely issues like peripheral neuropathy are ruled out, it should be considered.
I hope this is helpful for you.
Good luck!
Dr. Best
Philip Baker
November 2, 2017Also, the the “burning” is in both feet….
Philip Baker
November 2, 2017no diabetes or rheumatoid problems show up in my bloods
Michael Onstad
November 7, 2017This is a clear discussion but it seems to neglect the forefoot as contributor to the situation and as an access point for corrective action. When the calcaneus is pronated and the medial arch falls the forefoot is found to be adducted and supinated. This may actually be a contributing factor since many people try to compensate for lateral instability by widening their stance and “toeing-out” their feet. This shifts the line of compression medially in relation to the arch and internally rotates the knee in relation to the foot to facilitate forward motion. The result is as you have so well described. Adducting the forefoot while maintaining ground reaction contact at the metatarsal arch will, in a structurally sound foot, raise the arch without as much pressure on the plantar surface of the medial arch and bring the line of compression into a better relation with the line of progression of the foot. Work on lateral stabilization of the hips and proper foot alignment during walking may reduce valgum pressure on the knee and reduce dependance on orthotic intervention.
Dr. George Best
November 8, 2017I agree with your persepctive and when practical, well-motivated patients are no-doubt better served by going through the corrective treatment you propose than relying on orthotics. In my experience, although less than ideal, orthotics are a reasonably good solution for many people who lack the resources to undergo the type of treatment you are suggesting and/or lack the motivation to do the work to maintain the correction once released from active treatment. It all comes down to what the patient’s goals and preferences are, and what’s available to them. Many of the inquiries I receive are from people in places where access to the type of professional treatment you are recommending is non-existent or very limited, but things like generic shoe inserts can often be obtained. When treatment resources are plentiful, and it just comes down to preferences, some patients hate having to wear orthotic-compatible shoes and would much prefer to take the corrective approach (and continue their exercise program on a maintenance basis). Others would much rather stick something in their shoes and not have to devote any more time and effort to it than that. In my opinion, the best treatment is what works best for a given individual, not necessarily what is considered to be the best clinically.
Denise
January 4, 2018Dr.Best,
I am 61 years old and have been getting vibrations in my left leg and foot for almost two months now. About two weeks after it started I also was getting a very rapid heartbeat for about two days. Went to the doctor and he did blood work (glucose, HBA1C, Creatinine (eGFR), sodium, potassium, ALT, TSH, T3, T4), checked my dilantin and phenobarb levels (epilepsy for about 30 years) and I also had a chest xray and electrocardiogram done. Nothing was found but he told me to take an iron supplement and to ask the pharmacist how much, but she wanted to know what my iron level was first. When I went back to the doctor regarding the iron level he told me I did not have anemia but thought that taking iron would be a cheap way to fix the problem with the vibrations in my leg, but he then checked my ferritin level which I was told was normal (48) and not to take iron. He also ordered a 24 hour urine test at the same time, which I have not yet done. I was also taking nizatidine for acid reflux which I stopped after a second incident with rapid heartbeat about a month after the first one and since then it has not happened again, but the vibrations continue. My doctor didn’t feel that there was a connection between the rapid heartbeat and the vibrations, that I was just nervous, nor did he feel that either had anything do with my scoliosis.
I learned that I had moderate scoliosis T5-9 convex to right and early DDD after having an xray because of pain in my back in February 2012. I also have had swelling in my left knee at times and the top of my left foot seems to swell and aches after I’m walking on it a lot and it does curve inwards when I am walking. I also continue to have pain in the centre of my back, usually when walking and mostly on the left side and asked my doctor for another xray in June 2017 to see if the scoliosis was getting worse, but was told it was probably muscular and I should go for massage therapy. I find a heating pad helps so I did not bother.
I’ve been told by a massage therapist that the vibrations could be anxiety or my kidneys, my hairdresser said he gets this sort of thing all the time and goes to a physiotherapist and others have told me that I should go to a chiropractor, seek a second opinion or find another doctor. I’m feeling rather unsure and confused about what direction to take and would really appreciate any input you could offer. Thanks.
Denise
Dr. George Best
January 4, 2018Hello Denise,
Before anything else, I’d like to clarify what you mean by vibrations. Is this just a sensation you have, or does your leg and foot actually move? Also, is the vibration constant, or does it change with time of day, position, etc.?
Dr. Best
Denise
January 5, 2018Dr.Best,
It is similar to what Ani Feb. 1/2014 described(since then I am getting a mobile like vibration feeling in my left calf, which moves sometimes to the thigh. It is not painful).
My foot and leg do not actually move. I don’t feel it when I am moving around but sometimes when I stand in one place and usually always when I sit down and more recently when I lay down at night and it is fairly constant. It also moves around and sometimes I feel it in my foot or further up in different parts of my leg. Sometimes it also feels like it is in the groin area or higher up, which made me wonder if it had anything to do with the sciatic nerve or scoliosis. I though maybe something was pressing on a nerve and have read this can also happen with scoliosis.
When it first began I was in a sitting position on the couch and it felt like the floor was shaking. At the time I thought maybe had it had something to do with shoes I wore a day or two earlier that I hadn’t worn in a while and are a wide width causing my left foot to curve inward and it would go away on its own. I hope this helps clarify things. Thanks.
Denise
Dr. George Best
January 5, 2018Hello Denise,
Since it’s strictly a sensation, my best guess is that it’s a symptom of some type of early-stage peripheral neuropathy. Since you have some back pain and scoliosis as well, it may be due to degenerative stenosis (narrowing of one or more nerve canals by bone overgrowth, disc protrusion, ligament thickening and other degenerative changes) in the lower spine. Depending on the factors involved, this might or might not show up on a regular X-ray. An MRI or CT scan would be more helpful in diagnosing this possibility.
Another common possibility is vitamin B12 deficiency. From what you listed in the lab work that was done, this was not checked, but it’s possible it was done and it just wasn’t mentioned. As we age. we tend to produce less of something called intrinsic factor, which is necessary for the proper absorption of vitamin B12 into the bloodstream. Some people have more of a decline than others, and without adequate intrinsic factor, you can have a B12 deficiency even if you are taking in a lot of B12 orally. I would recommend having your B12 level checked if it has not been done and if it is low, you may need to have periodic B12 injections or use a sublingual supplement (a liquid that you hold under your tongue to be absorbed directly by the tissues in the mouth rather than going through the digestive tract). Usually B12 deficiency would effect both legs, but since it hasn’t been terribly long since you started with the symptoms and there may be some predisposition of the left side to be susceptible due to the scoliosis and/or stenosis, it’s still pretty high on the list of suspects.
There are other more exotic possible causes for your symptoms, but spinal stenosis and B12 deficiency are by far the most common likely suspects and most likely one or both is at least partially involved in your case.
As you’ve said others have suggested, I think it might be worth considering finding a new doctor. I may be judging him unfairly without knowing all the facts, but it seems he’s not really doing a thorough job for you.
If you have questions, let me know.
Good luck!
Dr. Best
Denise
January 6, 2018Dr. Best,
I don’t know if it’s hereditary but my mother had pernicious anemia in her later years and had to take B12 injections. I believe she was older than I am when she began taking them but I’m not positive. I had asked my doctor in the past about checking my B12 level but he said he had in an indirect way and everything I listed is what was checked this time. I am not currently taking a B12 or any vitamin supplements.
If it turns out to be B12 will these sensations stop with injections? They can be very bothersome at times, especially at night affecting my sleep. Other than finding a new doctor would going to a chiropractor or physical therapist help if it is any of the other things you mentioned? Should I still follow through with the 24 hour urine test with this doctor or just go elsewhere. I’m not sure why he ordered it especially when I only went in to find my iron level since he suggested taking it. Thanks.
Denise
Dr. George Best
January 6, 2018Hi Denise,
The indirect way of checking for B12 deficiency is through the CBC (complete blood count), which usually shows changes in the size of the red blood cells and other structural changes in the blood cells (which is what pernicious anemia is). The important word there is “usually”, as there are documented cases of B12 deficiency causing neurological symptoms without causing alterations in the blood cells.
Since it’s still relatively early on, chances are very good that if your symptoms are due to B12 deficiency they will go away when the deficiency is corrected.
Chiropractic and/or physical therapy would probably be very helpful if the problem is related to spinal issues.
Regarding the 24 hour urine test, the usual purpose is to check kidney function. While there could be a kidney problem of some kind, I would have expected something to show up on the other lab work that was done. Frankly, it kind of seems to me like he may have ordered it as a means to make you feel like he was taking your complaints seriously and was doing something. I’d suggest just starting with a new doctor. The fact that he didn’t bother to directly check your B12 level despite your family history and your neurological symptoms is yet another red flag that he’s not doing a good job for you. Perhaps you have a friend who can give you a recommendation. If not, I suggest searching on Google and review sites to find one who gets consistently positive reviews (don’t be put off by one or two bad reviews, look at what the majority are saying).
Good luck!
Dr. Best
Denise
January 9, 2018Dr. Best,
If the CBC is the indirect way of checking B12 deficiency, what is the direct way of checking? Does the test have any special name? Thanks.
Denise
Dr. George Best
January 9, 2018The technical name is vitamin B12 serum assay, but most people just call it a vitamin B12 test.
Dr. Best
Fitsum
March 7, 2018Hello Dr. Best,
I was recently told by a doctor that my right leg is shorter than my left, and the doc put me on a 3mm heel lift. I felt so much better the first two days of wearing the heel lift, but the old symptoms came back after the third day, It’s been 12 days not and I have pain everywhere. Is this a common correctional stage (to experience lower back and sciatica pain)? Should I experience pain if the diagnosis was right and I put the heel lift as directed?
I look forward to hearing from you. Thank you so much!
Fitsum
Dr. George Best
March 7, 2018Since I don’t know your doctor or the reasons why he or she prescribed the heel lift, I’m going to start with the possibility that you have a functional short leg (the legs are uneven due to pelvic tilting from postural distortions or abnormal muscule contraction) versus a structural short leg (an actual bone length difference in the legs). When you have a functional difference, a heel lift will often make things better temporarily since it takes some demands off of the body’s compensation mechanisms that are producing the leg length difference. The problem is, the heel lift also reinforces the postural distortion/abnormal muscle contraction pattern and symptoms usually return relatively quickly and often get worse and/or the postural distortion is made worse. Heel lifts should never be used in cases of functional leg length differences in my opinion. Another possibility is that you do have a structural difference, but you adapted to it over the years. It’s not unusual for there to be reactions to heel lifts in such cases, and they can last a long time, especially the older someone is and the longer the body’s adaptations have been in place. I personally don’t usually recommend heel lifts in adults (kids in their rapid growth years are another story) unless they are having significant symptoms that appear due to compensation for the leg difference and/or the leg difference is fairly large (quite a bit more than 3 mm) and/or developed later in life (due to leg fracture, severe degeneration in the hip or knee, etc.). There are cases where they are very helpful, but I try to avoid using them for the very reason that, in my experience, they tend to cause negative reactions like what you’ve experienced.
Dr. Best
Onyi
March 20, 2018Hello Dr.
I am 18 weeks pregnant and have been experiencing a sharp shooting pain in my left foot (underneath the arch to be precise) . It started off happening only once a day and only when I’ve walked for about 20 minutes. Over the last 3 days it has escalated and happens frequently; when I sit or stand. The only time I’m free from it is when I lay on a bed.
I am in constant fear of when the next episode is and not sure what to do. I have bought orthotic insoles for my shoes but it does not allevate the pain. My Drs here say I have to manage it as its because of sofeting of ligaments or the baby pinching on a nerve
Please do you have any suggestions that can help me.
Kind regards
Dr. George Best
March 23, 2018Hello Onyi,
It sounds like you may have a misalignment of one or more bones in your foot. This can happen from just stepping down wrong and you may not even notice when it occurs. As time goe on though, inflammation can set in and it becomes quite painful to walk on. The changes in your ligaments may be somewhat involved, but it happens pretty commonly in people who aren’t pregant too. While orthotics sometimes help, it may require joint manipulation by a chiropractor or physical therapist to get the joint back into alignment. Not all chiropractors / therapists are trained on assessing and manipulating joints in the feet, so definitely ask about that particular service before scheduling an appointment. In the meantime, you might get lucky and be able to massage the joint back into place yourself by rolling your foot on something firm and round such as a tennis ball, piece of pipe, etc.. Applying cold packs (about 10 minutes at a time up to every two hours) may at least reduce the pain by bringing down the inflammation.
Good luck!
Dr. Best
Aaron
March 29, 2018Hello Doc,
I actually stumbled upon this site while browsing through 1000s and 1000s of pages searching for a fix to my pain. I was been ‘diagnosed’ with Sciatica as my MRI showed a disc herniation though I’ve never had this specific nerve pain until 2017 christmas when I tried pulling up myself from the sea into a boat. Thats when I first felt this nerve pain. Since then it disappeared and re-appeared a couple of times and this time it came back with vengeance. My lower back is pain free, the only painful areas are my glutes, calves, ankle and slight numbness in my big toe. I actually haven’t slept for more than an hour or two for the past one week. I’m flat footed. I’m not sure whether the diagnosis pointing the issue towards my L5/S1 is correct as I firmly believe its a trauma that caused this pain(as I’ve never ever experienced it before).
I’m seeing a Chiro and have scheduled for a deep tissue sports massage – as I’ve been told by my chiro that my tight muscles could be the reason behind. He said it might not even be sciatica and possibly peripheral neuropathy.
I’m super confused, super painful and clueless. Could you see something odd here? Any advice would be of great help to me. Thanks.
Dr. George Best
March 29, 2018Hello Aaron,
Given the history of how the pain started and where your symptoms are, an L5/S1 disc herniation is a likely cause. In many cases, lower lumbar disc herniations cause leg symptoms without any low back pain and trauma sustained trying to climb into a boat could cause a disc herniation or at least cause a previously asymptomatic disc herniation to become symptomatic.
Your chiropractor has had the opportunity to examine you in-person and has more information to go on, but from what you’ve said, I don’t think peripheral neuropathy (at least non-disc-related neuropathy) is likely. Peripheral neuropathy can be caused by several underlying conditions, including disc herniations, diabetes, and vascular diseases and when it’s not disc-related, it tends to effect both legs pretty symmetrically, and it’s usually a gradual onset, not something that comes on quickly. Referral symptoms from muscles in the buttock area are a potential cause, and these issues typically are associated with some sort of joint dysfunction in the hip, sacroiliac, and/or lumbar spinal joints, or potentially from a disc herniation causing nerve irritation that causes abnormal muscle contraction. If it is primarily a joint and muscle issue, the chiropractic and massage treatment should make a significant difference pretty quickly. Those treatments are often helpful for disc herniations as well, because improving skeletal alignment and reducing muscle tension in the area reduces the mechanical stresses on the discs. Disc cases tend to take longer to resolve than simple joint and muscle dysfunction though.
My best guess based on the information you’ve given is that the problem is at least partially disc-related. With that in mind, I would suggest you try the self-treatment methods in my free ebook. In many cases, using the intensive treatment protocol suggested for the McKenzie method and applying cold packs will bring about significant improvement within a few days to a week all by themselves. Just be sure to read all the instructions carefully, as I’ve found that people sometimes are anxious to get started and they skip over things that make a big difference in terms of results.
If you have not already downloaded the ebook, you may do so from the link on the right side near the top of this page.
If you have further questions, let me know.
Good luck!
Dr. Best
Aaron
March 30, 2018Thanks for the immediate reply Dr.Best, I could not even get an appointment to my GP this fast. This is truly remarkable and I owe you a lot.
Just one more question on top of your beautiful explanation – After my injury, I made a stellar recovery and I was more than 85% pain-free with all the stretches and workouts. Two weeks back somewhere something went wrong overnight(most possibly due to my sleeping posture) and I woke up with a very bad lower back spasm and the nerve pain. The spasm went through but the nerve pain is still killing me. Is it this simple for the sciatica pain to re-appear after getting subsided?
I’ve already downloaded the ebook, will be religiously following it from now on. Thanks a ton, again.
Dr. George Best
March 30, 2018Hi Aaron,
That’s common with disc herniations. The symptoms from a disc herniation are due to a combination of direct nerve pressure by the protruding disc and additional pressure from inflammatory swelling. As the swelling pressure goes down, the nerve symptoms will typically reduce and may disappear entirely, despite the fact that the disc may still be putting some pressure on the nerve. Many things can trigger an inflammatory response and/or cause the disc to bulge more. When something does, the symptoms may return. While the methods in my ebook will typically reduce the amount of disc protrusion to various degrees, the disc doesn’t go back to completely normal. In fact, discs really don’t return to completely normal regardless of the treatment, so it’s best to think of this as something to manage with some basic preventive measures rather than something that will be 100% “cured” even if you have no symptoms. Even surgery doesn’t restore the disc to normal and while it may be necessary for lasting symptom relief in a small percentage of cases, surgery often leads to further problems in the same or other discs later on due to changes in the mechanical function in the area of the surgery. So, the best case scenario is to take good care of your back so you can avoid most future problems.
Dr. Best
Yasmin
March 31, 2018Very informative video sir…
Thank you.
Can you please suggest, what kind of footwear do I buy,,,is any particular brand recommended.
I’m from India.
Dr. George Best
March 31, 2018Hello Yasmin,
Footwear is a very individual thing, so I don’t have any specific recommendations. All I can suggest is to look for shoes that have good arch support that feel good on your feet. In some cases it may be easier to get separate arch supports that can be placed in different shoes (if possible, it’s usually best to remove the insoles that came with the shoes first before putting the arch supports in). These range from inexpensive over the counter supports (that may be available in pharmacies or other businesses that sell medical supplies) to custom-fitted orthotics that are made by podiatrists, chiropractors, and other health care professionals.
Dr. Best
Ricardo
May 10, 2019I would like to join a previous person’s comment above who stated that after getting their custom insert their sciatica flared up. I am 28yo, healthy and overall fit weight and body-wise. I have had about 3 different times in my life when my lower back pain has been horrible. This latest episode was because I bought some shoe inserts at Walmart that had the ‘arch support’. I wore them and irritated my sciatica nerve worse than I had ever had. For 2 months I couldn’t walk correctly and I lost my ability to stand on tiptoes on my right leg which was the leg that was affected, down from my spine. Finally after a couple of months the pain was almost all gone and I was back to walking normal and even being able to stand on my tip toes again. Tried wearing the shoe inserts again today and after 3 hours I could feel all the symptoms coming back. Took the inserts off and it’s slowly getting better today after going for a walk. I CAN ATTEST THAT THE SHOE INSERTS WITH THE ARCH SUPPORT WERE CAUSING INJURY TO MY SCIATICA NERVE AND PERPETRATING MY DISABILITY.
Dr. George Best
May 10, 2019While shoe inserts / arch supports help or are at least neutral in their effects on sciatica in the vast majority of cases, every person is different and, as with any treatment intervention, inserts can make things worse for certain individuals. To minimize the potential for problems, I suggest getting custom-made inserts rather than buying something “off-the-shelf” (although the “off-the-shelf” ones work just fine for many people). By custom-made, I’m referring to inserts made from scans or casts of the individual’s feet, not just something that is size and shoe/activity appropriate. In addition, it’s very important to remove any existing inserts that came with the shoes before placing any therapeutic inserts, as they need to fit flat in the shoe (which they may not if you place them on top of an existing insert). Finally, while I can understand your negative feelings regarding inserts, they actually are helpful for many people, particularly when they are custom-made specifically for the individual.
Jenny Fox
June 19, 2019Hi Dr Best
The onset of my sciatica was during my second pregnancy; this was 30 years ago and it’s been over the last 15 years that it’s more frequent. I also have had Plantar in my right foot, but that’s ok at the moment, the sciatica is also on my right leg. I wear my shoes out on the outer edge so would that misalignment of my gait cause my problems? I do a lot of dog walking and Nordic walking, so very active, if I walk 6 to 8 miles then it gets worse, also I lie on my sofa with my legs up and leaning on the right, this will also cause discomfort and I have to stretch out my piriformus in order to get relief. Just wondering if I would benefit from using arch supports? I recently came back from a cruise where I attended a foot seminar after getting a print of my foot by walking over an ink pad, it showed dark patches on the outer edge of both feet, however they are not flat.
Dr. George Best
June 19, 2019It sounds like you probably have some mechanical issue that is causing the piriformis and possibly other muscles to react. It could be your feet, but it could also be any (or more than one) of the joints from the foot to the lower back. I suggest you get checked by a chiropractor who is experienced with evaluating extremities (many only deal with the spine) to see if there’s something that can be done to provide lasting relief.
Good luck!
Dr. Best
Sherry
July 13, 2019Hello
I was suffering from Morton’s neuroma and in the 5 months in the run up to surgery I was walking poorly and had a strained hamstring and calf as a result in my left leg. Two weeks after surgery during which I rested I ended up with severe pain in my leg at night. Physio did not resolve it and it soon turned to sciatic pain in buttocks, all the way down my leg and foot. Nights are extreme. . It’s now 10 weeks since surgery, 7 weeks of sciatic pain. There is real pain in my ham string and side of legs esp at night. Sitting is difficult for more than a few minutes at a time. MRI scan says no disc issue although I do have some wear and tear in L4/5. I don’t have any back pain and can bend, walk up stairs fine. Coming down stairs is v painful. I am trying cold packs now on legs and back. And doing mckenzie exercises. I don’t know what the source of problem is. I suspect it’s a hamstring issue which is causing sciatic pain.
Help!
Dr. George Best
July 13, 2019It sounds like it’s probably mostly a muscle reaction issue. In addition to the hamstrings and calf which may have been strained, there may be referred symptoms from the piriformis and/or gluteus minimus as well. Often such muscle reactions are associated with dysfunction in the sacroiliac and/or hip joint and problems in those joints would not be surprising with the months of altered gait associated with the neuroma. Stretching and massage of the piriformis and gluteus minimus (the basic piriformis stretch shown in my free ebook and the “figure 4” stretch – Google “supine figure 4 stretch” for directions) may be helpful, but you may need to have the joints corrected to get lasting improvement. I suggest seeing a chiropractor, preferably one who also offers massage therapy or works closely with a massage therapist. If you have further questions, let me know.
Good luck!
Dr. Best
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