A Trendelenburg gait is an abnormal walking gait resulting from a defective or weakened hip abductor.The gluteal musculature is the primary musculature that includes the gluteus medius and gluteus minimus muscles. Weakness in these muscles causes sagging/dropping of the pelvis on the opposite side while walking. There will be a noticeable side-to-side motion if the glutes are too weak to support the body’s weight when walking. It can look as though the individual is limping or missing a step. Individuals can minimize the effects with foot orthotics, core strengthening, chiropractic, and physical therapy.
Trendelenburg Gait Causes
This gait often results from straining the hip abductor muscles during physical activity. Exercises specifically for the glutes done improperly are a common cause. When improper exercise form is the cause, the abnormal gait usually goes away as muscle inflammation fades. The gait can also present after total hip replacement surgery, as the procedure requires incisions in the gluteus medius muscle. This can weaken the muscle causing an abnormal gait. Weakness in these muscles can also be caused by:
Nerve damage or dysfunction in the nerves that run through the gluteal minimus and medius muscles.
Osteoarthritis is a type of arthritis that occurs when joint cartilage starts to wear down.
Muscular dystrophy is a condition that causes the muscles and bones to become weak over time.
Poliomyelitisis a condition associated with polio that weakens the muscles.
Cleidocranial dysostosis is a condition present from birth that can cause your bones to develop improperly.
Symptoms
The walking gait is made up of two phases:
Swing – When one leg moves forward.
Stance – The other leg stays still and maintains balance.
The main symptom of Trendelenburg gait can be seen when one leg swings forward and the hip drops down and move outward. This is because the hip abductor of the other leg is too weak to support the weight. Individuals may lean back or to the side slightly when walking to maintain balance, or they may lift the foot higher off the ground with each step to avoid losing balance or tripping as the pelvis shifts unevenly.
Diagnosis
Abnormal hip movement during a swing of one or both legs can give a doctor enough evidence to diagnose a Trendelenburg gait. A doctor will observe the individual’s walk in front and behind to get a detailed view. A doctor will also use the Trendelenburg test to diagnose the condition. The doctor will instruct the individual to lift one leg for 30 seconds. If the individual cannot keep the hips parallel with the ground while lifting, it could indicate Trendelenburg gait. X-rays of the hip will be used to identify any causes of weakness in the gluteus minimus or medius.
Treatment Options
Treatment options will depend on the severity and cause of the gait.
Medication
If the gait is causing pain, over-the-counter nonsteroidal anti-inflammatory NSAIDs, like ibuprofen or acetaminophen, will help ease symptoms.
In severe cases, a doctor may prescribe cortisone injections to help reduce pain.
Foot Orthotics
A doctor could also recommend using a foot orthotic in one or both shoes to compensate the hip abductor muscle weakness.
Chiropractic, Physical Therapy, and Exercise
Chiropractic and physical therapy can help adjust, realign, and strengthen the muscles to regain control of the Trendelenburg gait. The chiropractor or physical therapist will move the legs in various directions to help the joints become more accustomed to moving in certain directions and increase muscle strength and resistance. Exercises that can strengthen the hip abductor muscles include:
Lie on the side and extend the leg straight out.
Lie on the floor and move one leg up, over the other, and back in the opposite direction.
Step sideways and onto an elevated surface, then back down again.
Talk with a doctor or chiropractor before beginning any new exercise routine so they can recommend specific exercises and educate on proper form.
Complications
If left untreated, moderate-to-severe cases of Trendelenburg gait can become debilitating, leading to severe complications. These include:
Pinched nerves.
Sciatica.
Pain, stiffness, or grinding in the hips.
Loss of range of motion in the hips and gait.
Losing the ability to walk, which could require the use of a walker or wheelchair.
Trendelenburg gait is treatable with special shoes, orthotics, and exercises designed to strengthen the hip abductor muscles. Chiropractic and physical therapy can help limit the condition’s impact on the body’s health, the ability to walk, and reduce the risk of complications.
Body Composition
Heart-Healthy Foods
Citrus
The bright and tangy fruits are packed with vitamins and unique plant compounds known as polyphenols that can help lower blood pressure naturally.
However, it’s important to note that grapefruit and grapefruit juice could interact with certain prescription medications.
Beans and Lentils
Foods high in magnesium, potassium, and fiber can help maintain healthy blood pressure.
This is where beans and legumes come in, as they are high in fiber, potassium, and magnesium.
Individuals that swapped beans and lentils noticed a lower blood pressure, whether or not they had been diagnosed with hypertension.
Pumpkin Seeds
These seeds are packed with potassium, magnesium, and arginine.
Arginine is an amino acid used to make nitric oxide, which helps the blood vessels relax and dilate, allowing lower blood pressure.
A study found that postmenopausal women who took 3 grams of pumpkin seed oil daily for six weeks saw a significant decrease in their systolic blood pressure.
Garlic
Garlic contains nitric oxide, which has been shown to relax blood vessels.
Kyolic garlic, in particular, has been shown to help with arterial stiffness and can improve cholesterol levels.
References
Feyh, Andrew et al. “Role of Dietary Components in Modulating Hypertension.” Journal of Clinical & experimental cardiology vol. 7,4 (2016): 433. doi:10.4172/2155-9880.1000433
Gandbhir, Viraj N., et al. “Trendelenburg Gait.” StatPearls, StatPearls Publishing, 19 August 2021.
Giangarra CE, et al. (2018). Clinical orthopedic rehabilitation: A team approach.sciencedirect.com/science/book/9780323393706
Gilliss AC, et al. (2010). Use of osteopathic manipulative treatment to manage compensated Trendelenburg gait caused by sacroiliac somatic dysfunction.
jaoa.org/article.aspx?articleid=2093879
Maricelli JW, et al. (2016). Trendelenburg-like gait, instability and altered step patterns in a mouse model for limb-girdle muscular dystrophy 2i. DOI:
10.1371/journal.pone.0161984
Mayo Clinic Staff. (2017). Osteoarthritis.mayoclinic.org/diseases-conditions/osteoarthritis/home/ovc-20198248
Michalopolous N, et al. (2016). A personalized monitoring and recommendation framework for kinetic dysfunctions: The Trendelenburg gait. DOI: 10.1145/3003733.3003786
Chiropractic medicine is used as a standard musculoskeletal injury/strain treatment and for rehabilitation. Chiropractic helps with:
Different types of back pain
Headaches
Neck pain
Shoulder pain
Arm pain
Hand pain
Leg pain
Foot pain
Spine and nervous system health are essential for a properly functioning body and overall health. There are significant benefits of chiropractic care that can improve an individual’s overall quality of life and health. Chiropractic treatment can help:
Relieve Stress
Stress is natural in life, and it’s too much or poor management techniques that can cause pain and or injury. Chiropractic can improve how the body responds to stress. The nervous system is responsible for adapting the body to its environment, especially a stressful environment. Around 90% of the central nervous system travels down and through the spinal column. Spinal vertebral subluxations/misalignments can interfere with proper nerve flow disrupting body functions. Vertebral subluxation decreases the body’s ability to adapt to the environment. When this happens, stress can have a high adverse impact on the body’s health. An aligned spine along with an optimally operating nervous system helps the body to manage stress easier.
Improve Posture
Posture shifts affect spinal alignment and nerve function. The most common is Forward Head Posture/FHP. This is where the head shifts forward and down on the shoulders. This affects the natural curve in the neck, causing tension to form in the spinal cord. Improper ergonomics and overuse of electronic devices play a role in FHP. Chiropractic treatment helps and restores proper spinal alignment, significantly improving the body’s posture.
Elevate Mental Mood
Individuals in pain are often in a bad, sad, low mood reflecting their pain level. Balancing the body’s nervous system restores the balance of chemical flow in the body. Conditions like depression and ADHD have shown improvement with regular chiropractic care.
Strengthen Immune System Function
Spinal misalignment adversely affects the nervous system. The nervous system sends all the necessary information to different areas of the body. If the spine has been compromised, specific sites will not receive the vital signals required to function at full potential. This can affect any or all the systems in the body, especially the immune system. Chiropractic improves nerve flow to the organs of the immune system.
Enhance Thorough Sleep
Lack of sleep leads to all kinds of health issues. Lack of proper sleep can be from a nervous system that does not shut down, add pain, stress, and nightly symptoms do not allow the body to rest. Optimal spinal alignment relaxes the nervous system decreasing pain. Sleep improves over time, with individuals reporting reduced pain and an increase in health and wellness.
Body Composition
Gluten Effects
Gluten causes digestive issues/problems for individuals that have celiac disease or autoimmune thyroid disease. Individuals with these conditions that eat gluten foods can present with uncomfortable and painful effects. Symptoms can vary and have different classifications.
Classical Celiac Disease – CD
Classical celiac disease presents with symptoms that include:
Diarrhea
Discolored stools
Constipation
Abdominal bloating
Pain
Weight loss
However, these symptoms are more common in children with CD than adults. In adults, symptoms are more similar to those in non-classical celiac disease.
Non-Classical Celiac Disease
Non-classical celiac disease symptoms may not present with severe digestive symptoms as in classical CD but suffer from other symptoms. These include:
Silent CD is less visible. There might not be any symptoms, but damage to the intestines is still occurring.
References
Khodakarami, Nima. “Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation.” Healthcare (Basel, Switzerland) vol. 8,1 44. 24 Feb. 2020, doi:10.3390/healthcare8010044
Rubinstein, Sidney M et al. “Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomized controlled trials.” BMJ (Clinical research ed.) vol. 364 l689. 13 Mar. 2019, doi:10.1136/bmj.l689
Urits, Ivan et al. “A Comprehensive Review of Alternative Therapies for the Management of Chronic Pain Patients: Acupuncture, Tai Chi, Osteopathic Manipulative Medicine, and Chiropractic Care.” Advances in therapy vol. 38,1 (2021): 76-89. doi:10.1007/s12325-020-01554-0
Chiropractic medicine specializes in the musculoskeletal system. It treats the whole body because if one area of the body is inflamed, swollen, out of place, or damaged, it affects other areas. Chiropractic’s goals are to bring the body back into balance and get it functioning at an optimal level. Achieving overall health and wellness requires an individual’s body to be at its appropriate weight.
Obesity and Pain
Chronic pain and obesity are linked, according to various studies. Individuals dealing with chronic pain are more likely to become obese, and those who are obese have an increased risk of developing a chronic pain condition. Research studies also show that individuals that lose weight have a reduction to complete alleviation of pain.
The Pain Gain Cycle
The goal is to break the cycle. When an individual is dealing with pain symptoms, eating foods high in sugars and starches can be comforting. However, unhealthy food is fueling the pain and causing inflammation. Back pain commonly occurs in individuals that are obese. Chiropractic helps kickstart the weight loss process by relieving pain naturally and safely.
Spinal Alignment and Weight Loss
Spinal alignments go beyond relieving pain to help with weight loss. Adjustments improve the body’s ability to burn fat and maintain overall health. A spine that is out of alignment can affect the nerve pathways of the central nervous system and the communication signals affecting nearly every aspect of the body. Problems with the central nervous system can affect how the whole body burns fat and the metabolic system.
Hormone Regulation
Spinal misalignments can affect the body’s hormone regulation. These hormones include those for breaking down foods during digestion. Affected hormones can contribute to weight gain and prevent weight loss. Chiropractic corrects the nerve’s pathways, allowing for proper hormone regulation, which can help with weight loss.
Pain Relief and Exercise
Exercise is pivotal to losing weight, building muscle, and maintaining health. The problem for overweight individuals is that they are in too much pain to exercise. With back pain, just walking a quarter of a mile can become excruciating, and this is where chiropractic care for pain relief comes in. When managing pain through chiropractic, individuals can exercise regularly.
Nutrition and Lifestyle
The whole body is a unit where everything affects something else. Chiropractors are becoming or teaming up with certified nutritionists and health coaches. Part of a treatment plan includes nutritional recommendations personalized to individual needs and weight loss goals. They also recommend:
Specific exercises
Lifestyle adjustments
Third-party support
Whole Body Composition
Weight Loss and Cheat Meals/Days
A cheat day or meal every once in a while will not undo weeks and months of regular workouts and eating healthy. Cheat days can help individuals stay motivated for the long term. But this does not mean getting carried away and going on a bender or making cheat days a routine. The goal is to develop healthy eating habits that become the norm while decreasing the craving for junk food. Changing body composition and losing weight is a long-term journey, but done correctly and with support turns into a healthy body.
References
DeMaria, Anthony, et al. “A weight loss program in a chiropractic practice: a retrospective analysis.” Complementary therapies in clinical practice vol. 20,2 (2014): 125-9. doi:10.1016/j.ctcp.2013.11.007
James M Whedon, DC, MS, Andrew W J Toler, MS, Louis A Kazal, MD, Serena Bezdjian, Ph.D., Justin M Goehl, DC, MS, Jay Greenstein, DC, Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain, Pain Medicine, Volume 21, Issue 12, December 2020, Pages 3567–3573, https://doi.org/10.1093/pm/pnaa014
Okifuji, Akiko, and Bradford D Hare. “The association between chronic pain and obesity.” Journal of pain research vol. 8 399-408. 14 Jul. 2015, doi:10.2147/JPR.S55598
Scoliosis causes the spinal curvature to go sideways and can cause various symptoms. One of the most common symptoms is scoliosis hip pain. This happens because the spine’s curvature can pull the hips out of alignment, causing one side to be raised higher than the other. A result of this is one hip begins to take on more weight. This overloads the hip causing strain, soreness, aches, and pain, especially after standing or walking.
Scoliosis Hip Pain
Idiopathic scoliosis typically occurs in children, but often there are no pain symptoms. This type of scoliosis can go on unnoticed and undiagnosed for years even until adulthood. When the spine stops growing, even a small scoliosis curve can cause hip pain. The hip pain varies but generally presents with:
Sharp pain.
Throbbing pain.
Pain that increases with activity like walking, running, standing for a long time.
Stiffness with combined pain after sitting or lying down for a long time.
The type of scoliosis – degenerative or idiopathic.
Bodyweight. Individuals that are obese are more likely to have severe hip pain because of the added weight.
Activity level. Physical activity can cause the pain to worsen.
Lifestyle.
It varies from person to person.
The Higher Hip
When scoliosis has progressed enough, the curvature and uneven hips are pretty apparent. However, only around 10% of scoliosis cases get this far. If the curvature is minimal, which is usually the case, trying to determine which hip is higher usually requires medical assistance.
The hip that presents with pain is generally the one taking on more weight.
This causes the muscles to fatigue faster and places added stress on that hip joint.
A way to tell which hip is higher stand on bare feet in front of a mirror holding a piece of yarn, or string with both hands.
Place the heel of each hand on the corresponding hip bone.
The string will be tilted if the hips are uneven or will be straight if they are not.
Adult Scoliosis
Hip pain caused by scoliosis is most common in adults. However, it is not the only cause of hip pain. Unless diagnosed with scoliosis as a child, individuals may be suffering from de novo scoliosis or degenerative scoliosis.
De Novo/Degenerative Scoliosis
As the body ages, the spinal discs between the vertebrae begin to wear down. The worn-down discs can cause the spine to develop a sideways curve, that can pull the hips out of alignment. Studies are showing that this type of scoliosis is widespread. Loss of bone density can be a contributor to scoliosis in older adults. Bone density loss from menopause means women are more susceptible than men. Past the age of 70, both men and women lose on average, the same amount of bone density. There are effective integrative, natural treatment therapies that incorporate:
Exercises
Nutrition
Posture correction
Chiropractic
Physical therapy
Scoliosis Hip Exercises
For uneven hips, there are exercises to help relieve pain and strengthen weak muscles.
Hip Stretch
Lie on the back with both legs straight out.
Lift the right leg
Using the hands pull the knee toward you, keeping the foot pointed up.
Pull the knee to your chest as far as you can without causing discomfort or pain.
With the right hand, reach toward the left foot, touching if possible.
Return to the original position.
With the left hand, reach toward the right foot.
Repeat 6 to 8 times.
Chiropractic
If misaligned and uneven hips are causing pain, chiropractic care for scoliosis is recommended. Spine and hip realignments help relieve pain, stretch the muscles, and corrects posture. One study showed that multi-approach chiropractic for adult scoliosis was found to be beneficial even two years after treatment was finished. Injury Medical Chiropractic and Functional Medicine Clinic can help with recommending nutrition and lifestyle tips. Instead of just treating symptoms, our team helps manage the cause.
Body Composition
Body Analysis for Disease Prevention
Early identification of disease is imperative for developing the proper treatment plan. Testing can help improve long-term health outcomes. Testing is made easy with the data being easily implemented into patient management software. A comprehensive printout is ready for engaging and educating patients in understanding health risk management and reduction. In 60 seconds, an InBody Test will generate easy-to-understand, accurate, and objective measurements to evaluate potential disease risk. Medical providers can use the InBody to:
Monitor muscle, and visceral fat to provide an accurate measure of health risk.
Monitor muscle distribution to determine specific health risks related to diseases.
Identify fluid imbalances associated with certain diseases.
Track changes for effective long-term risk identification and reduction.
When back pain presents for a prolonged period, the back muscles reduce in mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.
Back muscles development
With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body’s ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:
Back muscles and core muscles increase in function and performance.
Muscles are strengthened.
Lean muscle mass increases.
The range of motion of the spine increases.
Body fat decreases.
Guidelines while using weights
When weight training, it is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:
Severe pain.
Back pain that originates from:
Previous spinal surgery
Tumor
Nerve root compression
Neurological symptoms
Sciatica
Spinal fracture/s
Spinal infection/s
Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.
Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
Trained physical/occupational therapists and sports chiropractors can educate an individual on:
Correct techniques
Frequency
Type of training that will help an individual’s condition.
Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.
Smaller weights build strength progressively
Effective ways to strengthen the spine.
Begin with small/light weights and exercise slowly.
Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
It is recommended to start with:
Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
Simple stretches
Exercise machines can be recommended instead of free weights.
Exercise machines can provide safe, effective, and progressive resistance to the exercises.
The machines can help reduce/prevent injury compared to free weights.
The machines can maintain proper support on the back and spine.
It is recommended to combine regular walking activity with a weight training program.
Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
This promotes healing and reduces stiffness.
Training program and benefits
Gaining the most benefits from strength training, tips to keep in mind:
Warm up for a few minutes using heat therapy and simple stretches.
Try for 2 or 3 times a week for 30 minutes.
Focus on building strength in the core muscles – back, abdominals, obliques, buttocks, and pelvic leg muscles.
There is no need to join a gym or buy expensive equipment.
Work out at home with small hand weights, resistance bands, and body weight.
The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
If back pain presents with a sustained increase, take time off or modify the strength training exercises.
Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.
Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.
Body Composition
Carbohydrates and Muscle Growth
Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.
Carbs prevent muscle weakness.
Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.
Carbs help muscles recover after exercise.
Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.
References
Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.
Lee JS, Kang SJ. Strength exercise and walking effects on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325
Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.
Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050
Losing weight can be one of the hardest things to do. It is also one of the best things anyone can do to get rid of back pain and optimize overall health. Achieving and maintaining a healthy weight impacts the whole body, especially the spine. It is prevalent for individuals who are overweight to experience back pain. This comes from the added weight that the feet, legs, pelvis, and spine have to support. For many, once the weight comes off, the back pain reduces significantly and/or disappears completely. For those embarking on a weight loss journey, our:
Chiropractic team
Physical therapists
Health coach
Nutritionist
Can provide resources to plan, encourage, and assist in reaching health goals.
Overweight, Obesity and Back Pain
Spine pain is one of the top reasons individuals see a doctor. The need to lose weight is based on body mass index/BMI. BMI can be an indicator that an individual’s weight might not be in a healthy range. BMI ranges:
Normal weight – Body Mass Index of less than 25
Overweight – Body Mass Index of 25 to 30
Obese – Body Mass Index of 31 to 35
Extremelyobese – Body Mass Index of 36 or higher
If unsure about how to get an accurate BMI measurement, talk to our team about InBody Testing.
Added Weight Places Pressure On the Spine
Added bodyweight places added strain on the low back. Studies have linked obesity with degenerative disc problems. Combined with the physical impact the added weight has on the spine and overall health, it can also affect spine surgery outcomes. Studies have shown that some overweight/obese individuals have an increased risk for surgery-related complications like:
Infection
Issues recovering from anesthesia
Overall recovery struggles
The good news is that individuals do not have to lose a significant amount of weight to see and feel the benefits. Losing 15% of excess weight will improve chronic back pain.
Exercise
Successful weight loss is the ability to maintain the loss. It needs to be something that can be committed to and brought into an individual’s lifestyle. Trying to go hard with an extreme diet or intense exercise program is not recommended. This is like not having any long-distance running knowledge along with training but entering a 12345K race. An individual will collapse after a few blocks. And sustained weight loss is just that, a long-distance journey that requires:
Getting educated about what is going on with the body
Understanding how foods affect/impact the body
Understanding the body’s unique needs to lose weight
Developing a personal health goal plan
Following through
Lifestyle factors contribute to healthy body weight. Being able to embed healthy habits into one’s life is the objective. Although it can sound easy to do, it can be a challenging process. With professional help, individuals can:
Maintain a nutritious and balanced diet
Have an active lifestyle
Maintain healthy sleep habits
Keep stress under control
Discussing a weight loss plan is very important. A professional health coach, nutritionist, and chiropractor will develop the right program that considers an individual’s specific health status.
Overall Health
Achieving a healthy weight will reduce to relieve back pain completely and significantly improve quality of life. Weight management is challenging, but once the benefits are seen and felt, it becomes second nature.
Body Composition
Healthy Kidneys
The kidneys pump more than 400 gallons of recycled blood through the body every day. These organs work nonstop to filter blood and remove waste. If the kidneys become impaired, the body can become overloaded with waste. Unhealthy lifestyle choices can harm/damage the kidneys. Kidney disease progresses slowly over the years. Individuals can lose 90 percent of kidney function before symptoms become serious. Chronic kidney disease is not reversible. However, with lifestyle adjustments, an individual can lower their risk of developing kidney-related diseases.
Proper Hydration
Drink plenty of water to clear sodium, urea, and toxins from the body and prevents kidney stones. Try to drink eight 8-ounce glasses of water each day. Every individual’s body water levels are different. A body composition test can determine what is normal for the individual.
Maintain healthy diet
Poor diet contributes to visceral fat gain. This has been linked to chronic kidney disease. Reduce visceral fat by eating a healthy diet of vegetables, fruit, and lean protein. Cut down on salty, processed foods. Body composition testing can help form an individualized diet plan to reduce visceral fat.
Supplements, antibiotics, and OTC medications
Overuse of common over-the-counter medications and supplements can cause kidney damage and disease. Consult with a doctor before taking medications and supplements if there is kidney function impairment.
Maintain fitness and physical activity
Cardio and strength training exercises are recommended. High blood sugar levels stress the kidneys. Building adequate muscle mass will help control blood sugar. A body composition test can make sure there are adequate amounts of muscle mass.
References
Liuke M, Solovieva S, Lamminen A, Luoma K, et al. Disc degeneration of the lumbar spine in relation to overweight. Int J Obes (Lond). 2005;29(8):903-908.
Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of Obesity Among Adults and Youth: the United States, 2011–2014. Centers for Disease Control and Prevention: National Center for Health Statistics.https://www.cdc.gov/nchs/products/databriefs/db219.htm. Page last updated: October 28, 2015. Accessed July 10, 2017
Samartzis D, Karppinen J, Chan D, Luk KD, et al. The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population-based study. Arthritis & Rheumatology. 2012;64(5):1488-1496.
The sciatic nerve is the largest in the body and is created by five nerve roots that come together and exit the lower spine. It goes through the buttocks on either side and down the thighs all the way to the heels and soles of the feet. The sciatic nerve connects the spinal cord to the muscles of the thigh, leg, and foot. Any type of pain and/or neurological symptom/s that comes from the sciatic nerve is known as sciatica. The symptoms can be felt along the nerve’s path. This could be the:
When the nerve is compressed, neurological symptoms can accompany the pain. These include:
Thigh muscle weakness
If the thigh muscles are affected, weakness can be felt when bending or flexing the knee.
Leg and foot muscle weakness
Weakness can be felt while attempting to bend the knee or pointing the foot/toes upward/downward. This can lead to foot drop, which makes lifting the front part of the foot when walking difficult. Difficulty can also present when getting up from a sitting position or walking on the tiptoes.
Numbness
Loss of sensation can happen when the nerve impulses/transmissions cannot pass all the way through. Common areas affected by numbness are the:
Side of the calf
Side of the heel
Bottom of the foot
Top of the foot
Paresthesia
This is an abnormal sensation felt on the skin. It is brought on by improper nerve transmission. This sensation can include:
Tingling
Tightness
Pins-and-needles
Crawling feeling along the back of the thigh and/or leg
The Sciatic Nerve Gets Affected
The sciatic nerve can become:
Irritated
Compressed
Inflamed
This lumbar/low back radiculopathy means that the pain originates in and around the lumbar and/or sacral/sacrum nerve roots.
Compression
Physical forces could affect the nerve following common conditions:
Disc Herniation
A disc in the lower back can bulge or herniate. This causes irritation that can lead to compression of a nerve root.
Stenosis
Stenosis means the opening where the sciatic nerve exit into the buttocks begins to get narrow in size. This creates a clog with the other nerve roots that compresses or irritates the sciatic nerve. Degenerative changes in the spine like the thickening of the facet joint capsules and/or ligaments can also compress the sciatic nerve.
Instability
Instability of a vertebral segment happens when one vertebra slips over the one below it, known as spondylolisthesis. There are also vertebral defects like spondylolysis which is a complete dislocation of one or more vertebrae. This can directly compress the sciatic nerve roots.
Inflammatory Response
The body’s own chemicals can irritate the nerve causing inflammation. These chemical irritants include:
Hyaluronic acid
Fibronectin protein fragments leak out of degenerated or herniated discs onto and around the sciatic nerve roots.
There are times when degenerated discs can cause nerve tissues to grow into a disc. The tissue penetrates the outer and inner layers of the disc, causing inflammation and pain.
Some studies have shown how an immune system response can contribute to sciatic pain when there is exposure to the disc material from herniated disc/s.
Glycosphingolipids which are fats, and neurofilaments which are protein polymers. They are secreted by the immune system and have been found to have high levels in individuals with sciatica. It is believed they are released in reaction to the nerve roots and exposed disc material. This can lead to inflammation of the sciatic nerve.
Body Composition
The physical characteristics of an individual can also affect the sciatic nerve. Research has shown an increased risk of sciatica in:
Overweight individuals
Obese individuals
Older individuals
Tall individuals
Work Injuries
Individuals with certain jobs can have an increased risk of developing sciatica. Examples include:
Semi-Truck operators
Machine operators
Construction workers
Hairstylists
Office workers
Athletes that lift weights
This comes from:
Sitting for long amounts of time
Poor posture
Constant bending forward or sideways
Regularly lifting the arms above shoulder level
All are risk factors.
Vitamin B12 deficiency
Adequate levels of vitamin B12 are important for nerve health. Vitamin B12 supports the myelin sheath that covers and protects the nerves. It is important in nerve function and in transmitting impulses. Sciatica can present from vitamin B12 deficiency. However, this is more common in individuals 60+.
Body Analysis
Alleviating Nerve Pain Through Clinical Nutrition
Clinical nutrition is a powerful tool to help alleviate sciatica. Many individuals can relieve their pain through diet adjustments. Here are a few diet tips to alleviate sciatic nerve pain through clinical nutrition:
Sometimes, sciatica can be triggered by constipation from an unhealthy diet
Oily fish like salmon and halibut are rich in omega 3 fatty acids
Fresh pineapples and berries are anti-inflammatories that support healing and boost the immune system
2-3 cups of green tea
Add turmeric, ginger, and garlic to meals
B-Vitamins are important to take in when going through sciatica and are found in green peas, spinach, navy beans, nuts, bananas
Foods that are rich in A-Vitamins like dairy products, dark leafy vegetables, orange-colored fruits, eggs, and oily fish
Foods rich in C-Vitamins, like citrus and tomatoes
K-Vitamins like broccoli and spinach
Drink plenty of water, between 6 to 8 glasses a day
Foods to Avoid
Nutritionists recommend cutting out meat products except for oily fish for the first two weeks.
Foods that contain sunflower oil, corn oil, sesame oil, margarine, and partially hydrogenated oil.
Stressor foods like caffeine, processed food, soda, refined sugars, and chocolate.
Alcohol
References
Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/.
Heuch I, Heuch I, Hagen K, Zwart JA. Association between body height and chronic low back pain: a follow-up in the Nord-Trøndelag Health Study [published correction appears in BMJ Open. 2015;5(10):e006983]. BMJ Open. 2015;5(6):e006983. Published 2015 Jun 15. doi:10.1136/bmjopen-2014-006983.
Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. nt. J. Pharm. Bio. Arch. 2011, 2.
Quero L, Klawitter M, Schmaus A, et al. Hyaluronic acid fragments enhance the inflammatory and catabolic response in human intervertebral disc cells through modulation of toll-like receptor 2 signaling pathways. Arthritis Res Ther. 2013;15(4): R94. Published 2013 Aug 22. doi:10.1186/ar4274.
Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E. Obesity as a Risk Factor for Sciatica: A Meta-Analysis. American Journal of Epidemiology. 2014;179(8):929-937. doi:10.1093/aje/kwu007.
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