For individuals who want to eat healthier, can selection and moderation make mayonnaise a delicious and nutritious addition to a low-carbohydrate diet?
Mayonnaise Nutrition
Mayonnaise is used in various recipes, including sandwiches, tuna salad, deviled eggs, and tartar sauce. It is often considered unhealthy, as it is mostly fat and, as a result, calorie-dense. Calories and fat can quickly add up when not paying attention to portion sizes.
What Is It?
It is a blend of different ingredients.
It combines oil, egg yolk, an acidic liquid (lemon juice or vinegar), and mustard.
The ingredients become a thick, creamy, permanent emulsion when blended slowly.
The key is in the emulsion, combining two liquids that would otherwise not naturally come together, which turns the liquid oil into a solid.
The Science
Emulsification happens when an emulsifier – the egg yolk – binds the water-loving/hydrophilic and oil-loving/lipophilic components.
The emulsifier binds the lemon juice or vinegar with the oil and does not allow separation, producing a stable emulsion. (Viktoria Olsson et al., 2018)
In homemade mayonnaise, the emulsifiers are mainly the lecithin from the egg yolk and a similar ingredient in mustard.
Commercial mayonnaise brands often use other types of emulsifiers and stabilizers.
Health
It contains health-promoting properties, such as vitamin E, which improves heart health, and vitamin K, which is important for blood clotting. (USDA, FoodData Central, 2018)
It can also be made with healthy fats like omega-3 fatty acids, which maintain brain, heart, and skin health.
While reduced-fat mayonnaise has fewer calories and less fat than regular mayonnaise, the fat is often replaced with starches or sugar to improve texture and flavor.
For individuals watching carbohydrates or sugar in their diet, check the nutrition label and ingredients before deciding on the right mayonnaise.
Body In Balance: Chiropractic, Fitness, and Nutrition
References
Olsson, V., Håkansson, A., Purhagen, J., & Wendin, K. (2018). The Effect of Emulsion Intensity on Selected Sensory and Instrumental Texture Properties of Full-Fat Mayonnaise. Foods (Basel, Switzerland), 7(1), 9. doi.org/10.3390/foods7010009
Mozafari, H. R., Hosseini, E., Hojjatoleslamy, M., Mohebbi, G. H., & Jannati, N. (2017). Optimization low-fat and low cholesterol mayonnaise production by central composite design. Journal of food science and technology, 54(3), 591–600. doi.org/10.1007/s13197-016-2436-0
Zhu, J., Li, J., & Chen, J. (2012). Survival of Salmonella in home-style mayonnaise and acid solutions as affected by acidulant type and preservatives. Journal of food protection, 75(3), 465–471. doi.org/10.4315/0362-028X.JFP-11-373
Institute of Medicine (U.S.). Committee on Dietary Guidelines Implementation., Thomas, P. R., Henry J. Kaiser Family Foundation., & National Cancer Institute (U.S.). (1991). Improving America’s diet and health : from recommendations to action : a report of the Committee on Dietary Guidelines Implementation, Food and Nutrition Board, Institute of Medicine. National Academy Press. books.nap.edu/books/0309041392/html/index.html www.ncbi.nlm.nih.gov/books/NBK235261/
For individuals dealing with chronic fatigue syndrome, can incorporating acupuncture with other treatment protocols help regain functionality and improve quality of life?
Acupuncture For Chronic Fatigue Syndrome
Research is looking at how acupuncture can help manage symptoms of chronic fatigue. These studies focused on specific acupoints and techniques and how they affected certain symptoms or abnormalities linked to the condition. The researchers found that acupuncture may help manage and alleviate some symptoms (Qing Zhang et al., 2019). However, they were still unable to determine the mechanisms of how acupuncture exactly works.
Symptom Relief
Various studies showed that acupuncture could improve physical and mental fatigue symptoms, including:
One case study showed improvements in groups of athletes who were put through a series of exhaustive physical exercises and short-term rest. One group of athletes was treated with acupuncture on selected acupoints while the others were given an extended rest. Analysis was applied to the metabolic profiles of urine samples collected from the athletes at three points: before the exercises, before and after the acupuncture treatment, or taking extended rest. The results indicated that the recoveries of disturbed metabolites in the athletes treated with acupuncture were significantly faster than in those who only took extended rest. (Haifeng Ma et al., 2015)
Researchers said studies involving acupuncture alone or in combination with other treatments appear to show that it is effective at lessening fatigue. (Yu-Yi Wang et al., 2014) However, further studies are needed to confirm the benefits. This is a significant change from a review that found limited evidence for the effectiveness of alternative treatments for relieving chronic fatigue symptoms. (Terje Alraek et al., 2011)
Another review of alternative therapies found acupuncture and certain meditation techniques showed the most promise for future investigation. (Nicole S. Porter et al., 2010)
Another study compared prednisone, a steroid, with an acupuncture technique called coiling dragon and an additional treatment called cupping. It suggested that acupuncture and cupping treatments surpassed the steroid regarding fatigue. (Wei Xu et al., 2012)
Another study found that needling with heat application or moxibustion produced better results than standard acupuncture regarding physical and mental fatigue scores. (Chen Lu, Xiu-Juan Yang, Jie Hu 2014)
From Consultation to Transformation: Assessing Patients In A Chiropractic Setting
References
Zhang, Q., Gong, J., Dong, H., Xu, S., Wang, W., & Huang, G. (2019). Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 37(4), 211–222. doi.org/10.1136/acupmed-2017-011582
Frisk, J., Källström, A. C., Wall, N., Fredrikson, M., & Hammar, M. (2012). Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 20(4), 715–724. doi.org/10.1007/s00520-011-1134-8
Mandıroğlu, S., & Ozdilekcan, C. (2017). Impact of Acupuncture on Chronic Insomnia: A Report of Two Cases with Polysomnographic Evaluation. Journal of acupuncture and meridian studies, 10(2), 135–138. doi.org/10.1016/j.jams.2016.09.018
Zhu, L., Ma, Y., Ye, S., & Shu, Z. (2018). Acupuncture for Diarrhoea-Predominant Irritable Bowel Syndrome: A Network Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2018, 2890465. doi.org/10.1155/2018/2890465
Ma, H., Liu, X., Wu, Y., & Zhang, N. (2015). The Intervention Effects of Acupuncture on Fatigue Induced by Exhaustive Physical Exercises: A Metabolomics Investigation. Evidence-based complementary and alternative medicine : eCAM, 2015, 508302. doi.org/10.1155/2015/508302
Wang, Y. Y., Li, X. X., Liu, J. P., Luo, H., Ma, L. X., & Alraek, T. (2014). Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complementary therapies in medicine, 22(4), 826–833. doi.org/10.1016/j.ctim.2014.06.004
Alraek, T., Lee, M. S., Choi, T. Y., Cao, H., & Liu, J. (2011). Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC complementary and alternative medicine, 11, 87. doi.org/10.1186/1472-6882-11-87
Porter, N. S., Jason, L. A., Boulton, A., Bothne, N., & Coleman, B. (2010). Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia. Journal of alternative and complementary medicine (New York, N.Y.), 16(3), 235–249. doi.org/10.1089/acm.2008.0376
Lu, C., Yang, X. J., & Hu, J. (2014). Zhen ci yan jiu = Acupuncture research, 39(4), 313–317.
Can physical therapy with instrument-assisted soft tissue mobilization or IASTM improve mobility, flexibility, and health for individuals with musculoskeletal injuries or illnesses?
Instrument Assisted Soft Tissue Mobilization
Instrument-assisted soft tissue mobilization or IASTM is also known as the Graston technique. It is a myofascial release and massage technique used in physical therapy where the therapist uses metal or plastic tools to improve soft tissue mobility in the body. The ergonomically shaped tool is gently or vigorously scraped and rubbed across the injured or painful area. The rubbing is used to locate and release tightness in the fascia/collagen covering the muscles and the tendons. This helps reduce pain and improve movement.
Individuals often develop tissue tightness or restrictions in the muscles and fascia after an injury. These soft tissue restrictions can limit the range of motion – ROM and can trigger pain symptoms. (Kim J, Sung DJ, Lee J. 2017)
History
The Graston technique of instrument-assisted soft tissue mobilization was developed by an athlete who created their instruments to treat soft tissue injuries. The practice has grown with input from medical experts, trainers, researchers, and clinicians.
Physical therapists use different types of tools to perform IASTM.
These massage instruments comprise various types for specific massage and release.
The Graston company designs some of the tools.
Other companies have their version of metal or plastic scraping and rubbing tools.
The objective is to help release soft tissue and myofascial restrictions to improve body movement. (Kim J, Sung DJ, Lee J. 2017)
How It Works
The theory is that scraping the tissues causes microtrauma to the affected area, activating the body’s natural inflammatory response. (Kim J, Sung DJ, Lee J. 2017)
The body activates to reabsorb the tightened or scar tissue, causing the restriction.
The therapist can then stretch the adhesions to alleviate pain and improve mobility.
Treatment
Certain conditions respond well to instrument-assisted soft tissue mobilization, including (Kim J, Sung DJ, Lee J. 2017)
Limited mobility
Decreased muscle recruitment
Loss of range of motion – ROM
Pain with movement
Excessive scar tissue formation
Augmented soft tissue mobilization or ASTM techniques can treat certain injuries and medical conditions that include:
A review compared hands-on myofascial release to instrument myofascial release for chronic low back pain. (Williams M. 2017)
Little difference was found between the two techniques for pain relief.
Another review compared IASTM to other methods for treating pain and function loss. (Matthew Lambert et al., 2017)
The researchers concluded that IASTM could positively affect blood circulation and tissue flexibility and reduce pain.
Another study examined the use of IASTM, pseudo-fake ultrasound therapy, and spinal manipulation for patients with thoracic/upper back pain. (Amy L. Crothers et al., 2016)
All groups improved over time with no significant negative events.
The researchers concluded that instrument-assisted soft tissue mobilization is no more or less effective than spinal manipulation or pseudo-ultrasound therapy for thoracic back pain.
Every case is different, and musculoskeletal conditions respond differently to various treatments. For any questions or concerns, contact your primary healthcare provider to determine if IASTM is an appropriate treatment that can help.
From Injury To Recovery
References
Kamali, F., Panahi, F., Ebrahimi, S., & Abbasi, L. (2014). Comparison between massage and routine physical therapy in women with sub acute and chronic nonspecific low back pain. Journal of back and musculoskeletal rehabilitation, 27(4), 475–480. doi.org/10.3233/BMR-140468
Kim, J., Sung, D. J., & Lee, J. (2017). Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. Journal of exercise rehabilitation, 13(1), 12–22. doi.org/10.12965/jer.1732824.412
Chughtai, M., Newman, J. M., Sultan, A. A., Samuel, L. T., Rabin, J., Khlopas, A., Bhave, A., & Mont, M. A. (2019). Astym® therapy: a systematic review. Annals of translational medicine, 7(4), 70. doi.org/10.21037/atm.2018.11.49
Matthew Lambert, Rebecca Hitchcock, Kelly Lavallee, Eric Hayford, Russ Morazzini, Amber Wallace, Dakota Conroy & Josh Cleland (2017) The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review, Physical Therapy Reviews, 22:1-2, 76-85, DOI: 10.1080/10833196.2017.1304184
Crothers, A. L., French, S. D., Hebert, J. J., & Walker, B. F. (2016). Spinal manipulative therapy, Graston technique® and placebo for non-specific thoracic spine pain: a randomised controlled trial. Chiropractic & manual therapies, 24, 16. doi.org/10.1186/s12998-016-0096-9
For individuals dealing with ulcerative colitis, can acupuncture treatment benefit those with UC and other GI-related issues?
Acupuncture For Ulcerative Colitis
Acupuncture has been used to treat symptoms related to pain and inflammation. Studies suggest it may help reduce inflammation and symptoms like diarrhea and abdominal pain, which could benefit individuals with inflammatory bowel disease. Individuals with ulcerative colitis, an inflammatory bowel disease/IBD affecting the large intestine, may find acupuncture beneficial in managing symptoms, including pain and gastrointestinal symptoms. (Crohn’s and Colitis Foundation, 2019)
The pathways connecting the acupoints generate energy, which contributes to overall health.
A disruption to the energy flow can cause injury, illness, or disease.
When acupuncture needles are inserted, energy flow and health are improved.
Benefits
Acupuncture can be used for the relief of various conditions. Studies have shown that acupuncture can reduce inflammation and disease activity in individuals with an IBD, like UC and Crohn’s disease. It can help with: (Gengqing Song et al., 2019)
Pain symptoms
Gut microbiome imbalances
Gut motor dysfunction
Intestinal barrier function
Anxiety
Depression
Studies suggest the use of acupuncture with heat, known as moxibustion, can improve several GI symptoms including (Crohn’s and Colitis Foundation, 2019)
Studies found the use of acupuncture along with moxibustion reduced inflammation in individuals with Crohn’s disease and ulcerative colitis. (Crohn’s and Colitis Foundation, 2019)
Stress and Mood
Chronic conditions like ulcerative colitis can cause feelings of depression and/or anxiety. Acupuncture may be used to address symptoms related to stress and mood and can benefit emotional health issues that include: (Johns Hopkins Medicine. 2024)
Insomnia
Anxiety
Nervousness
Depression
Neurosis – mental health condition characterized by chronic distress and anxiety.
Side Effects
Acupuncture is considered a safe practice. The most common side effects are: (GI Society. 2024)
Needle shock is rare but more common in individuals:
Who are regularly nervous.
Who are nervous around needles.
Who are new to acupuncture.
Who have a history of fainting.
Who are extremely fatigued.
Who have low blood sugar.
For some, GI symptoms may worsen before they improve. It is recommended to try at least five sessions as this is part of the healing process. (Cleveland Clinic. 2023) However, individuals should contact their doctor if symptoms become severe or last more than two days. (GI Society. 2024) Individuals considering acupuncture to help manage symptoms of ulcerative colitis should speak with their healthcare provider to help determine the appropriate treatment and where to start.
Wilkinson J, Faleiro R. (2007). Acupuncture in pain management. Continuing Education in Anaesthesia, Critical Care and Pain. 7(4), 135-138. doi.org/10.1093/bjaceaccp/mkm021
“Can understanding moderate exercise and how to measure the amount of exercise help expedite individuals’ health goals and well-being?”
Moderate Exercise
Various physical activity guidelines recommend regular, moderate exercise for achieving and maintaining health and wellness. Getting the minimum, moderate weekly physical activity can help prevent disease, increase mental well-being, support weight loss and maintenance, and improve quality of life.
Moderate-intensity cardiovascular exercise includes – brisk walking, yard work, mopping, vacuuming, and playing various sports that require consistent movement.
When engaged in moderate exercise, individuals should breathe harder but still be able to carry a conversation. (American Heart Association, 2024)
The talk test is a way to monitor whether the exercise is at moderate intensity.
A heart rate chart or calculator can determine an individual’s maximum heart rate.
To measure heart rate mid-exercise, individuals can take their pulse or use a heart rate monitor, app, fitness tracker, or smartwatch to ensure they stay at a moderate intensity.
MET
M.E.T. stands for Metabolic Equivalent for Task and refers to the amount of oxygen the body uses during physical activity.
Assigning METs to an activity allows individuals to compare the amount of exertion an activity takes.
This works for individuals with different weights.
During moderate physical activity, breathing and heart rate increase, and the body burns around 3.5 to 7 calories a minute.
The actual number burned depends on your weight and fitness level.
The body uses 1 MET for basic functions like breathing.
Grades of activity:
1 MET – Body at rest
2 METs – Light activity
3-6 METs – Moderate activity
7 or more METs – Vigorous activity
Perceived Exertion Scale
Individuals can also check their activity level using the Borg Rating of Perceived Exertion scale/RPE. (Centers for Disease Control and Prevention, 2022) Using this scale involves monitoring how an individual feels about how hard their body is working during physical activity. The scale starts at 6 and ends at 20. A perceived exertion between 11 and 14 is considered moderate physical activity.
6 – No exertion – sitting still or sleeping
7-8 – Extremely light exertion
9-10 – Very light exertion
11-12 – Light exertion
13-14 – Somewhat hard exertion
15-16 – Heavy exertion
17-18 – Very heavy exertion
20 – Maximum exertion
Examples
Many activities are counted as moderate-intensity exercise. Choose some appealing and learn to add them to a weekly routine.
Ballroom dancing
Line dancing
Gardening
House chores that get the heart pumping.
Softball
Baseball
Volleyball
Doubles tennis
Brisk walking
Light jogging
Walking or jogging on a treadmill
Using an elliptical trainer
Bicycling under 10 miles an hour on ground level
Leisurely swim
Water aerobics
Mobility Challenges
Individuals with mobility issues can achieve moderate intensity using a manual wheelchair or a handcycle and swimming or water aerobics.
Individuals who can use their legs but can’t tolerate walking or jogging can try bicycling or swimming.
Getting More Exercise
There are different ways to incorporate and increase moderate physical activities. These include:
10-minute Activity Bursts
Walk briskly for at least 10 minutes at a time.
Walk at an easy pace for a couple of minutes.
Pick up the pace for 10 minutes.
Try to walk during work breaks or lunch and/or before or after work.
Walking Workouts
Individuals can walk indoors, outdoors, or on a treadmill.
Proper posture and walking techniques make it easier to achieve a brisk pace.
Once comfortable walking briskly for 10 minutes, begin to extend walking time.
Try different walking workouts that offer fast walks, jogging intervals, and/or adding hills or treadmill inclines.
New Activities
Individuals are recommended to experiment with various exercises to find what works for them.
Consider roller skating, blading, or skateboarding to increase heart rate.
Moderate physical activity will get and keep the body in shape. Individuals should not become distressed if they can only do a little at first. Allow time to build endurance and gradually make time each day for enjoyable physical activities.
For individuals experiencing eye problems, can acupuncture treatment help and benefit overall eye health?
Acupuncture For Eye Health
Acupuncture is an alternative medical practice that involves inserting thin needles at specific points on the body. The objective is to restore balance and health by restoring and balancing energy circulation through pathways throughout the body. These pathways, known as meridians, are separate from nerve and blood pathways.
Studies have shown that the insertion of needles manipulates accumulations of certain neurotransmitters by nearby nerves and may be what causes beneficial health effects. (Heming Zhu 2014)
Scientists are not sure exactly how acupuncture works, but it has been shown to provide pain relief and alleviation of cancer treatment nausea. (Weidong Lu, David S. Rosenthal 2013)
Studies have shown that acupuncture can help treat eye conditions like dry eye syndrome. (Tae-Hun Kim et al., 2012)
Eye Problems
For some individuals, a body imbalance can be caused by eye problems or disease. With acupuncture, imbalance-causing symptoms are addressed. Acupuncture promotes the circulation of energy and blood around the eyes.
Acupuncture has been used as an alternative treatment for chronic dry eye syndrome. (Tae-Hun Kim et al., 2012)
Studies have shown acupuncture helps reduce the eye surface’s temperature to reduce the evaporation of tears.
The procedure is also sometimes used to treat glaucoma.
Glaucoma is an optic nerve disease usually caused by above-normal eye pressure levels.
Another study showed successful reduced allergic and inflammatory eye disease symptoms. (Justine R. Smith et al., 2004)
Eye Acupoints
The following acupoints are for eye health.
Jingming
Jingming – UB-1 is located in the inner corner of the eye.
This point is thought to increase energy and blood and to help with problems such as blurry vision, cataracts, glaucoma, night blindness, and conjunctivitis. (Tilo Blechschmidt et al., 2017)
Zanzhu
The Zanzhu point – UB-2 is in the crease at the inner end of the eyebrow.
This acupoint is used when individuals complain of headaches, blurred vision, pain, tearing, redness, twitching, and glaucoma. (Gerhard Litscher 2012)
Yuyao
Yuyao is in the middle of the eyebrow, above the pupil.
This point is used for treating eye strain, eyelid twitching, ptosis, or when the upper eyelid droops over, cloudiness of the cornea, redness, and swelling. (Xiao-yan Tao et al., 2008)
Sizhukong
The Sizhukog – SJ 23 area is in the hollow area outside the eyebrow.
It is thought to be a point where acupuncture can help with eye and facial pain, including headaches, redness, pain, blurred vision, toothache, and facial paralysis. (Hongjie Ma et al., 2018)
Tongzilia
The Tongzilia – GB 1 is located on the outside corner of the eye.
The point helps brighten the eyes.
Acupuncture also helps treat headaches, redness, eye pain, light sensitivity, dry eyes, cataracts, and conjunctivitis. (GladGirl 2013)
Early studies with acupuncture have shown promise for improving eye health. Individuals considering acupuncture are recommended to consult their primary healthcare provider to see if it can be an option for those who have not found a resolution by traditional means.
Neck Injuries
References
Zhu H. (2014). Acupoints Initiate the Healing Process. Medical acupuncture, 26(5), 264–270. doi.org/10.1089/acu.2014.1057
Lu, W., & Rosenthal, D. S. (2013). Acupuncture for cancer pain and related symptoms. Current pain and headache reports, 17(3), 321. doi.org/10.1007/s11916-013-0321-3
Kim, T. H., Kang, J. W., Kim, K. H., Kang, K. W., Shin, M. S., Jung, S. Y., Kim, A. R., Jung, H. J., Choi, J. B., Hong, K. E., Lee, S. D., & Choi, S. M. (2012). Acupuncture for the treatment of dry eye: a multicenter randomised controlled trial with active comparison intervention (artificial teardrops). PloS one, 7(5), e36638. doi.org/10.1371/journal.pone.0036638
Law, S. K., & Li, T. (2013). Acupuncture for glaucoma. The Cochrane database of systematic reviews, 5(5), CD006030. doi.org/10.1002/14651858.CD006030.pub3
Smith, J. R., Spurrier, N. J., Martin, J. T., & Rosenbaum, J. T. (2004). Prevalent use of complementary and alternative medicine by patients with inflammatory eye disease. Ocular immunology and inflammation, 12(3), 203–214. doi.org/10.1080/092739490500200
Blechschmidt, T., Krumsiek, M., & Todorova, M. G. (2017). The Effect of Acupuncture on Visual Function in Patients with Congenital and Acquired Nystagmus. Medicines (Basel, Switzerland), 4(2), 33. doi.org/10.3390/medicines4020033
Litscher G. (2012). Integrative laser medicine and high-tech acupuncture at the medical university of graz, austria, europe. Evidence-based complementary and alternative medicine : eCAM, 2012, 103109. doi.org/10.1155/2012/103109
Tao, X. Y., Sun, C. X., Yang, J. L., Mao, M., Liao, C. C., Meng, J. G., Fan, W. B., Zhang, Y. F., Ren, X. R., & Yu, H. F. (2008). Zhongguo zhen jiu = Chinese acupuncture & moxibustion, 28(3), 191–193.
Can physical therapy treatment protocols aimed at improving range of motion and flexibility around the hip and relieving inflammation around the sciatic nerve help individuals experiencing deep buttock pain or piriformis syndrome?
Deep Buttock Pain
Piriformis syndrome, a.k .a. deep buttock pain, is described as sciatic nerve irritation from the piriformis muscle.
The piriformis is a small muscle behind the hip joint in the buttocks.
It is about one centimeter in diameter and functions in the hip joint’s external rotation or turning outward.
The piriformis muscle and tendon are close to the sciatic nerve, which supplies the lower extremities with motor and sensory functions.
Depending on an individual’s anatomic variation of the muscle and tendon:
The two cross over, under, or through each other behind the hip joint in the deep buttock.
This relationship is thought to irritate the nerve, leading to sciatica symptoms.
Piriformis Syndrome
When diagnosed with piriformis syndrome, it is thought that the muscle and tendon bind to and/or spasm around the nerve, causing irritation and pain symptoms.
The theory supported is that when the piriformis muscle and its tendon tighten, the sciatic nerve becomes compressed or pinched. This decreases blood circulation and irritates the nerve from the pressure. (Shane P. Cass 2015)
Tenderness with pressure on the piriformis muscle.
Discomfort in the back of the thigh.
Deep buttock pain behind the hip.
Electric sensations, shocks, and pains travel down the back of the lower extremity.
Numbness in the lower extremity.
Some individuals develop symptoms abruptly, while others go through a gradual increase.
Diagnosis
Doctors will order X-rays, MRIs, and nerve conduction studies, which is normal.
Because piriformis syndrome can be challenging to diagnose, some individuals with minor hip pain may receive a piriformis syndrome diagnosis even if they don’t have the condition. (Shane P. Cass 2015)
It is sometimes referred to as deep buttock pain. Other causes of this type of pain include back and spinal problems like:
Herniated discs
Spinal stenosis
Radiculopathy – sciatica
Hip bursitis
A piriformis syndrome diagnosis is usually given when these other causes are eliminated.
When the diagnosis is uncertain, an injection is administered in the area of the piriformis muscle. (Danilo Jankovic et al., 2013)
Different medications can be used, but the injection itself is used to help determine the specific location of the discomfort.
When an injection is given into the piriformis muscle or tendon, it is often administered by ultrasound guidance to ensure the needle delivers the medication to the correct location. (Elizabeth A. Bardowski, J. W. Thomas Byrd 2019)
Avoiding activities that cause symptoms for at least a few weeks.
Physical Therapy
Emphasize stretching and strengthening the hip rotator muscles.
Non-Surgical Decompression
Gently pulls the spine to release any compression, allowing optimal rehydration and circulation and taking the pressure off the sciatic nerve.
Therapeutic Massage Techniques
To relax and release muscle tension and increase circulation.
Acupuncture
To help relax the piriformis muscle, sciatic nerve, and surrounding area.
Relieve pain.
Chiropractic Adjustments
Realignment rebalances the spine and musculoskeletal system to alleviate pain.
Anti-Inflammatory Medication
To decrease inflammation around the tendon.
Cortisone Injections
Injections are used to decrease inflammation and swelling.
Botulinum Toxin Injection
Injections of botulinum toxin paralyze the muscle to relieve pain.
Surgery
Surgery can be performed in rare cases to loosen the piriformis tendon, known as a piriformis release. (Shane P. Cass 2015)
Surgery is a last resort when conservative treatments have been tried for at least 6 months with little to no relief.
Recovery can take several months.
Sciatica Causes and Treatment
References
Cass S. P. (2015). Piriformis syndrome: a cause of nondiscogenic sciatica. Current sports medicine reports, 14(1), 41–44. doi.org/10.1249/JSR.0000000000000110
Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 60(10), 1003–1012. doi.org/10.1007/s12630-013-0009-5
Bardowski, E. A., & Byrd, J. W. T. (2019). Piriformis Injection: An Ultrasound-Guided Technique. Arthroscopy techniques, 8(12), e1457–e1461. doi.org/10.1016/j.eats.2019.07.033
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
