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Sciatica caused by hip problems

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nickji

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Hi Everyone,

If anyone can advise me about the relationship of hip arthritis to Sciatica I'd be grateful.

I had no idea that sciatica could be caused by hip problems, but MrT mentioned in January that he had a hip replacement because of Sciatic Pain.

Before my THR I had sciatic pains in both calves when going uphill. I had assumed that the pain was caused by my herniated lumbar discs, and have worked a lot on improving my lower back. Now it seems my hips may well have been the cause, since my new hip has totally cured that side's sciatic calf pain, but I don't know of any exercises (other than standard ROM) for my non-operated hip (also mildly arthritic) that might help. Any info gratefully received.

Thanks.

Nick
 
Nick
I have one remaining slightly arthritic hiip as well as lumbar problems. My whole spine is a problem actually.
But the exercises my spine surgeon has prescribed are the core strengthening ones. I am sure if you google them you can see a lot. It is all about strengthening the rectus abdominus core to stabalize your back.
judy
 
Nick
I have one remaining slightly arthritic hiip as well as lumbar problems. My whole spine is a problem actually.
But the exercises my spine surgeon has prescribed are the core strengthening ones. I am sure if you google them you can see a lot. It is all about strengthening the rectus abdominus core to stabalize your back.
judy

Thanks Judy,

These I do, though I would add a word of caution as too much work on the rectus abs can put them in a hypertonic state, effetively shortening them, and adversely affect the lordosis of the lumbar spine. I personally prefer core strengthening exercises for the transverse abdominals, which are also great for the back.

But these don't address the hip directly, and I'm wondering what it is about having a THR that stopped the sciatic pain in its tracks - clearly the op. didn't affect the spine, at least not directly. The sciatic nerve runs behind the hip joint; could it be affected by an inflammatory response around the joint? I can't figure it out. At the moment it seems odd.

Did you have surgery on your spine?

Nick
 
Nick
I do not have to worry about too much strength in my core!!! Wish I did have that problem.

I had cervical spine fusion (3 levels) in july '07. This past January I had an 8 level thoracic spine fusion. That really just about killed me!!!
Now I am back to dealing with my lumbar stenosis/degeneration. I had epidural injections in my lumbar spine last week and they seem to have taken away some of the pain, but not enough. I have had those injections about 6 times.

My spine doc was all for my hip replacement hoping most of the pain was from the hip. But, no I still have lumbar pain.

I imagine the inflammation in the area could have effected your sciatic nerve and if the inflammation is gone now.........
judy
 
That's exactly it, Nick. It gets caught up in the inflammatory processes that are emanating from the hip joint. Had you ever had the opportunity to witness a posterior approach hip op, you would see just how close to the hip joint the sciatic nerve runs. But I found this image that shows it almost as well. You can also follow it down the leg to see how sciatica radiates right into the calf and even the foot.

[Bonesmart.org] Sciatica caused by hip problems
 
Well Judy, I'm slightly stunned at what you've been through. Thankyou for taking the time to offer help for my relatively very trivial problems.

With your experiences I'm sure you'll know more about the back than I do, but for what it's worth, I work in the Yoga and Ayurvedic traditions of body therapy, so if there's anything I can suggest . . .

I'll sign off the way I usually do, without in any way minimising the pain and difficulties you must have; but still -

Enjoy it all,

Best wishes,

Nick
 
Thankyou Jo,

That's very clear. The sciatica is the only symptom from my left hip, no need for a THR, so I guess I'd better start a good multi-disciplinary approach to reducing the inflammation (wish I wasn't so lazy!!). Glucosamine/ROM/hydrotherapy for starters. Hey ho.

Enjoy it all,

Nick
 
Nick
Your problems are not trivial by any means. I am always willing to learn anything and try any therapy.
I sure wish the back were as easy a fix as a hip!! I am going to look up the yoga therapy you mentioned. For now it is off to physical therapy.

Jo, what happend to the image. I am dealing with sciatiaca right now and do not have an understanding or image of where the nerve goes. So , just from what you said, that could very well explain my calf pain!! Also why the medrol does pak worked on it.
judy
 
Judy,,,,,rectus abdominus,,, is that for real??? :ope your bike ride was fun!!! :),,
 
It's the two muscles down the front of your body, Judles. What keeps your body erect, hence the name. In fact, in body builders (or other nice masculine hunks) it's often referred to as the six-pack!

[Bonesmart.org] Sciatica caused by hip problems

 
Hi Jo,

I'm wondering about the sciatic pain in my calf. As you say, it's probably caused by the inflammation around my hip, but since the pain manifests itself below the knee (i.e. jumping a couple of feet down the nerve - there's no pain in the posterior thigh) I am thinking there may be some kind of trigger in the lower leg, presumably muscular.

Could the nerve be irritated along its entire length at just below the level to cause pain, and then local conditions push it over the edge in one place? I don't know much about the causes of referred pain, but if you do have any thoughts. . .

It would be useful to know since I'd then know which area to focus on for therapy.

Thanks,

Enjoy it all,

Nick
 
Once again I am amazed at what I have learned on this forum! I have had sciatica problems for 20 years. The only treatment that helped was regular chiropractic adjustments. I was concerned that it would flair up during my healing phase because I wouldn't be able to get them, and thought it a small miracle that it didn't act up... Now to think I may be rid of it for good is almost too good to be true!
 
Thanks for the wonderful explanaton,Jo! ,Now a 6 pack,,,,,I can understand & appreciate!!! :) "
 
I never did get on the real bike today. Tomorrow as hubby is home and I can show him the problem I have as he has disconnected the garage door opener. I will not try to open it manually, it is too hard and there is not handle.
judy
 
Hi Jo,

I'm wondering about the sciatic pain in my calf. As you say, it's probably caused by the inflammation around my hip, but since the pain manifests itself below the knee (i.e. jumping a couple of feet down the nerve - there's no pain in the posterior thigh) I am thinking there may be some kind of trigger in the lower leg, presumably muscular.

Could the nerve be irritated along its entire length at just below the level to cause pain, and then local conditions push it over the edge in one place? I don't know much about the causes of referred pain, but if you do have any thoughts. . .

It would be useful to know since I'd then know which area to focus on for therapy.

Thanks,

Enjoy it all,

Nick

Well just imagine a load of electric wires coming from the circuit box and then supplying different sockets here and there around the house. The nervous system works in a similar manner. The sciatic nerve as it emerges from the spine, is comprised of a whole lot of small nerves that supply different parts of the leg. These small nerves or nerve roots, come together about 2-4" above the hip joint to form the large nerve we call the sciatic. And as the nerve progresses down the leg, different 'cables' of it split off to go to their target places. Look at the image again and you can see what I mean. The nerve just gets smaller and smaller (and has different names) the further down it goes. But the portion that supplies your calf will be a seperate and distinct part of the main nerve all the way back to the spinal cord.

Out of interest, a similarly complex nerve structure is to be found in the armpit (axilla) where it is called the brachial plexus. Though appearing in the axilla as a single large nerve, it is actually a bundle of many nerves each one supplying a different area, structure or function.
 
Thanks Jo,

I follow your point about the nerves being 'bundled', but I'm still slightly confused.

If the gastroc. is innervated from L5/S1 for example, then I can see that a herniation there would only cause pain in the calf, and not in the thigh, and that's been the basis for my personal therapy.

But if the sciatic pain is being caused by inflammation in the hip joint area, (and the relief in my right calf after RTHR implies that it is) then would that not irritate all the nerves in the bundle, and cause pain all the way down the leg? And if that is the case, could a second factor be involved so as to cause pain only in the calf?

Re-reading this I think I may have answered my own quesion!! The first 'factor' can be nerve root compression which on its own is not sufficient to cause pain in the calf, then the second (aggravating) factor of hip joint inflammation kicks in and leads to pain. Take away the hip inflammation and the nerve root compression is insufficient on its own to cause symptoms ?????

I'm thinking 'multi-factor causation of referred pain'. Never heard of it, but I've never heard of most things. What do you think?

Hope you're getting nice weather for the Easter weekend - blue skies and sunshine here in Switzerland :-)

Thanks,

Nick
 
That would be exactly it, Nick. It's along the lines of "everything is connected to everything else", meaning that one issue alone would not be enough to cause the symptoms in your calf but another issue on top of it would.

Looks quite nice here - sunny and bright but the way people are wrapped up, probably chilly. I shall be going out for a walk shortly but right now and watching a fascinating programme on Nat Geographic about archeological digs giving direct evidence for the validation of biblical texts.
 
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