Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

sciatica and pf

Posted by gilbert on 7/27/01 at 23:04 (054592)

I have suffered from pf for about a year and just recently was diagnosed with sciatica. My question is: How do I know if the sciatica is the cause of my foot problems and not some combination of sciatica and pf? I've tried all the treatments suggested on this board except ESWT or surgery. but still have pain.

Re: sciatica and pf

Julie on 7/28/01 at 02:49 (054609)

Gilbert, I am not a doctor, and I'm sure one of them will respond to your post. But to enable the doctors, or anyone else, to help you could you give us more information? How long have you had the pain that has recently been diagnosed as sciatica? Did it begin before the PF, or has it only recently begun? I ask because if it is of recent origin, it may have been the PF that caused the sciatica, rather than the other way around. Often, the changes we make in our way of walking when we have a painful foot, lead to problems above, in the knees, hips and lower back.

Sciatica is impingement of the sciatic nerve by a herniated disc, which can happen when the body weight is thrown forward leading to compression of the lower lumbar spine. Altered gait could lead to this. On the other hand, the nerve impingement, if it came first, could certainly have caused the PF.

A chicken-and-egg situation. The whole lower extremity and lower back need to be investigated. The trouble is, a podiatrist, unless you have a really good one, might not look any higher than the feet. (No disrespect to the foot doctors here, who all would, I know). Have you consulted a chiropractor? It might be an idea. Whether the sciatica is the cause of the PF or the other way around, the whole situation needs investigating as a whole.

There is an interesting chiropractic website, with articles about the relationship between the feet and the lower back

Re: sciatica and pf

Julie on 7/28/01 at 02:55 (054610)

Here is the link to the chiropractic website, in case you want to have a look:

http://www.chiroweb.com/archives/11/18/18.html

Re: Had Sciatica and Piri.Syndrome for 3 years

Carmen H on 7/28/01 at 15:24 (054654)

I have had the Sciatica for about 3 years and within the last 7 weeks gotten PF in my feet. I went to the doc Thurs. and he ordered x rays on my pelvis (as I have been told My pelvis is rotated or tilted) and that may be causing part of the problems in my hips, legs and feet. Julie gives me great advice on everything I ask her and if you are comfortable going to a Chiro. please make sure you tell him RIGHT away you have sciatica.....When I went in and told my chiro. the sympoms I was having he actually made things worse. I went to another chiro and he also tried th same treatments and it made it worse. Just be careful...I have been going to a chiro. since I was about 8 or 9 off and on and have very mixed feelings about their treatment sometimes. I have found that if they aren't sure what's wrong there is always 'something out of place' that will help no matter what.

Re: Chiropractic

Julie on 7/29/01 at 02:08 (054673)

You're right, Carmen: as in every profession, there are good guys and bad guys, and we have to be careful and exercise self-responsibility. But I think only an irresponsible practitioner would treat as randomly as you describe. I suggested chiropractic because I know it's more common in the States than osteopathy, which I have more experience of, as it's more common here in England. Osteopathic practitioners vary too, of course: I prefer those that do more soft tissue work and less manipulation. But osteopaths and chiropractors, whose training is in structure, are well placed to evaluate the spine and the effect it may be having on the legs and feet.

One of the articles I've read on the chiro site suggests that podiatrists and chiropractors really ought to work together in the interests of their patients, and that sounds a good idea to me. The author (a chiropractor) pointed out that his colleagues would get a very different and much fuller picture of what was going on with their patients' spines if they got them to take their shoes off.

Re: Chiropractic

Ed Davis, DPM on 7/29/01 at hrmin (054698)

Julie-
What was the site you are referring to?
A lot of podiatrists who are biomechanically oriented like working with chiropractors. Some podiatrists try hard not to be associated with chiropractors, feeling, mistakenly, that it will hurt their image with MD's..sort of a long story. Many chiropractors are what I call 'lone rangers.' The lone rangers may feel somewhat persecuted by other health professions and refuse to work with anyone. I share several patients in common with a lone ranger a few blocks from me. I have made numerous calls to him to discuss the cases but he refuses to return the calls. It is simply in the best interest of patients for various health specialties to be willing to coordinate their efforts.
Ed

Re: Chiropractic

Julie on 7/29/01 at 14:04 (054703)

Ed, the site is

http://www.chiroweb.com

That's an extraordinary situation you describe. I can understand how it arises, but it's sad. It seems pretty obvious that the lower back, legs and feet are related, and that it's in the interest of patients for the health professional who treat them to co-ordinate their efforts. It's good that you try - I hope you find a more co-operative lone ranger one of these days.

All the best

Julie

Re: Had Sciatica and Piri.Syndrome for 3 years

Dr. Zuckerman on 7/29/01 at 14:27 (054706)

I work with alot of Chiropractic Physicians and have been treated by many myself. When ever I feel that there is a lower back involvement especially SI involvment Chiropractic treatment is very benefical.

Re: Had Sciatica and Piri.Syndrome for 3 years

Carmen H on 7/29/01 at 18:00 (054718)

I will mention this to my foot doc and see if he can recommend anyone if he sees it fits into my treatment. Maybe with the 'right' help I will get relief in all areas! Hips, feet and Piriformus Muscle. I can always dream...

Re: Had Sciatica and Piri.Syndrome for 3 years

Dr. Zuckerman on 7/30/01 at 09:24 (054787)

In Europe one of the treatments for chronic piriformus pain is ESWT. So keeps this in mind. I have a doctor who treats all of my lower back, hip, knee complaints in my practice. So go the chiropractic route and if no relief I will talk to you about ESWT for piriformus pain

Re: sciatica and pf

Julie on 7/28/01 at 02:49 (054609)

Gilbert, I am not a doctor, and I'm sure one of them will respond to your post. But to enable the doctors, or anyone else, to help you could you give us more information? How long have you had the pain that has recently been diagnosed as sciatica? Did it begin before the PF, or has it only recently begun? I ask because if it is of recent origin, it may have been the PF that caused the sciatica, rather than the other way around. Often, the changes we make in our way of walking when we have a painful foot, lead to problems above, in the knees, hips and lower back.

Sciatica is impingement of the sciatic nerve by a herniated disc, which can happen when the body weight is thrown forward leading to compression of the lower lumbar spine. Altered gait could lead to this. On the other hand, the nerve impingement, if it came first, could certainly have caused the PF.

A chicken-and-egg situation. The whole lower extremity and lower back need to be investigated. The trouble is, a podiatrist, unless you have a really good one, might not look any higher than the feet. (No disrespect to the foot doctors here, who all would, I know). Have you consulted a chiropractor? It might be an idea. Whether the sciatica is the cause of the PF or the other way around, the whole situation needs investigating as a whole.

There is an interesting chiropractic website, with articles about the relationship between the feet and the lower back

Re: sciatica and pf

Julie on 7/28/01 at 02:55 (054610)

Here is the link to the chiropractic website, in case you want to have a look:

http://www.chiroweb.com/archives/11/18/18.html

Re: Had Sciatica and Piri.Syndrome for 3 years

Carmen H on 7/28/01 at 15:24 (054654)

I have had the Sciatica for about 3 years and within the last 7 weeks gotten PF in my feet. I went to the doc Thurs. and he ordered x rays on my pelvis (as I have been told My pelvis is rotated or tilted) and that may be causing part of the problems in my hips, legs and feet. Julie gives me great advice on everything I ask her and if you are comfortable going to a Chiro. please make sure you tell him RIGHT away you have sciatica.....When I went in and told my chiro. the sympoms I was having he actually made things worse. I went to another chiro and he also tried th same treatments and it made it worse. Just be careful...I have been going to a chiro. since I was about 8 or 9 off and on and have very mixed feelings about their treatment sometimes. I have found that if they aren't sure what's wrong there is always 'something out of place' that will help no matter what.

Re: Chiropractic

Julie on 7/29/01 at 02:08 (054673)

You're right, Carmen: as in every profession, there are good guys and bad guys, and we have to be careful and exercise self-responsibility. But I think only an irresponsible practitioner would treat as randomly as you describe. I suggested chiropractic because I know it's more common in the States than osteopathy, which I have more experience of, as it's more common here in England. Osteopathic practitioners vary too, of course: I prefer those that do more soft tissue work and less manipulation. But osteopaths and chiropractors, whose training is in structure, are well placed to evaluate the spine and the effect it may be having on the legs and feet.

One of the articles I've read on the chiro site suggests that podiatrists and chiropractors really ought to work together in the interests of their patients, and that sounds a good idea to me. The author (a chiropractor) pointed out that his colleagues would get a very different and much fuller picture of what was going on with their patients' spines if they got them to take their shoes off.

Re: Chiropractic

Ed Davis, DPM on 7/29/01 at hrmin (054698)

Julie-
What was the site you are referring to?
A lot of podiatrists who are biomechanically oriented like working with chiropractors. Some podiatrists try hard not to be associated with chiropractors, feeling, mistakenly, that it will hurt their image with MD's..sort of a long story. Many chiropractors are what I call 'lone rangers.' The lone rangers may feel somewhat persecuted by other health professions and refuse to work with anyone. I share several patients in common with a lone ranger a few blocks from me. I have made numerous calls to him to discuss the cases but he refuses to return the calls. It is simply in the best interest of patients for various health specialties to be willing to coordinate their efforts.
Ed

Re: Chiropractic

Julie on 7/29/01 at 14:04 (054703)

Ed, the site is

http://www.chiroweb.com

That's an extraordinary situation you describe. I can understand how it arises, but it's sad. It seems pretty obvious that the lower back, legs and feet are related, and that it's in the interest of patients for the health professional who treat them to co-ordinate their efforts. It's good that you try - I hope you find a more co-operative lone ranger one of these days.

All the best

Julie

Re: Had Sciatica and Piri.Syndrome for 3 years

Dr. Zuckerman on 7/29/01 at 14:27 (054706)

I work with alot of Chiropractic Physicians and have been treated by many myself. When ever I feel that there is a lower back involvement especially SI involvment Chiropractic treatment is very benefical.

Re: Had Sciatica and Piri.Syndrome for 3 years

Carmen H on 7/29/01 at 18:00 (054718)

I will mention this to my foot doc and see if he can recommend anyone if he sees it fits into my treatment. Maybe with the 'right' help I will get relief in all areas! Hips, feet and Piriformus Muscle. I can always dream...

Re: Had Sciatica and Piri.Syndrome for 3 years

Dr. Zuckerman on 7/30/01 at 09:24 (054787)

In Europe one of the treatments for chronic piriformus pain is ESWT. So keeps this in mind. I have a doctor who treats all of my lower back, hip, knee complaints in my practice. So go the chiropractic route and if no relief I will talk to you about ESWT for piriformus pain