For truckers, sitting is just part of the job description. Unfortunately, lower back pain, or sciatic pain (pain radiating from the lower back down the leg), is common for people who sit long time periods. A recent case study focused on a 55-year-old truck driver with lower back pain. The driver received treatment from a doctor who used lifestyle modifications instead of surgery.
Continue reading to learn how the doctor was able to heal the driver with stretching exercises instead of surgery and what steps can be taken to ease back pain without going under the knife.
Case Study
This driver had been suffering from pain in his lower back that shot down to his right knee and he did not regularly exercise. He only noticed the pain while he was driving. However, the pain gradually worsened, and he decided to go to the doctor.
The Daily Routine
The doctor asked for a description of the driver’s daily routine to evaluate his situation.
- He sat in a truck all day.
- He’d never had any unusual aches or pains in the past.
- He carried his wallet in his right back pocket regularly.
- He frequently ate processed foods while on the road.
The Tests/Assessments
- Visual assessment of musculoskeletal system. The doctor checked his alignment and did a gait analysis. He had a forward-tipped pelvis and his leg swung out a little as he walked. This is a common condition called lordosis.
- Standing flexion test. This test can be used to assess sacroiliac joint dysfunction and is when the patient stands erect, with feet at shoulder width apart. The doctor stands or squats behind the patient and places his thumbs directly under each posterior superior iliac spine (PSIS). The patient bends forward, starting with flexing the neck, then the upper thoracic spine to the lumbar spine, and as far as possible while keeping the knees extended. This test revealed that the driver had pain and dysfunction on his right side.
- Spinal Check. Misalignment might not be the problem, but it doesn’t hurt to fix it. His spine was out of alignment.
- Palpation of the gluteal muscles. This is when the doctor examines the patient to determine the muscle’s size, shape, firmness, or location. This was the source of the driver’s pain.
The Diagnosis
The piriformis muscle, a muscle in the gluteal region of the lower limb, was irritating the driver’s sciatic nerve. This is a fairly common condition called piriformis syndrome, and can be fixed without expensive surgery. Also, the high amounts of processed food and fast food consumed was promoting inflammation in his body.
The Treatment.
- First, the driver lay on his back. With his leg straight up, the doctor applied pressure until he reached the point of the stretch where the leg would go no further.
- Then the driver pushed his leg against the pressure from the doctor for three seconds, and then relaxed.
- They repeated this sequence three times.
- A contract-relax cycle uses the natural response of the muscle to increase the range of motion.
- Then the driver turned on his stomach and the doctor located the tender point on his piriformis again.
- Keeping a finger on the tender point, the doctor moved the driver’s leg until he reached the position that reduced the most pain, and held it there for 90 seconds.
- When the leg was brought back up to its original position, the doctor rechecked the tenderness. After this simple stretch, his pain was reduced by half!
The Prescription
- Take the wallet out of his back pocket. Sitting on a big wallet in your back pocket, especially if done for years, can irritate your piriformis and sciatic nerve.
- Stretching and mobility exercises. The driver was given exercises to do whenever he got a chance.
- While seated in the truck, cross one ankle over the opposite knee, then lean forward gently from the hips, keeping the spine straight. Switch legs and repeat.
- Do a ‘home massage’ by tucking a tennis ball under the small of the back. Then, roll around until finding the tender spot, and massage it by rolling over the ball.
- Take fish oil. Fish oil is a natural anti-inflammatory substance and would help counteract his inflammatory diet.
- Modified Diet. Eliminate the oils high in omega-6 as well as margarine, deep-fried foods and any foods that contain trans fat. Also, he should reduce the intake of foods high in saturated fat.
The driver came back a month later. He’d taken the plan to heart and felt much better. Now he only felt pain when driving for very long periods. Needless to say, he was pretty happy.
Take Home Points:
- If you have back pain, see a doctor! The solution may be as easy as taking your wallet out of your pocket and stretching. But it could also be a sign of something serious that needs medical attention.
- Tell your doctor your daily routine. Sciatica can have many causes. It is important to diagnose the root cause because some conditions are dangerous if left untreated. Common culprits for sciatica include sitting a lot, driving, pressure on the hip joint (including sleeping on a hard mattress), and long-distance running or cycling.
- Stick to your treatment plan. Rehab can be slow, but consistency pays off.