Are you suffering from pain during or after sitting?

Pain in the buttocks commonly emanates from the spine, but can also stem from the sacroiliac joints and ligaments, and the muscles and bursae –fluid –filled sacs-of the hip. Most pain in the tail bone area originates in the coccyx.

Causes For Buttock and Coccyx pain

Lumbar and lower thoracic sources such as facet joist, disks, nerves and even muscles can produce pain in this area. Injuries to the lower thoracic vertebrae such as compression fractures also create pain lower down the back. The sacroiliac joint and ligaments of the pelvis can cause pain more locally-deep into the buttock, sometimes to the side of the hip and groin, and occasionally down the leg. Buttock muscles may develop tension, trigger points and tears and can rub the bursae between layers, leading to bursitis-inflammation of the bursa-in the side of the hip. The gluteus medius muscle can tighten and cause hip and buttock pain. The tail bone or coccyx can be painful long after a fall or blow, while the hip joint and associated structures such as the labrum can cause buttock pain.

Symptoms

Lumbar spine nerve-root irritation can radiate to your buttock, and may cause piriformis syndrome. Sacroiliac pain can cause spontaneous, severe pain in inflammatory conditions. Mechanical pain from the joint and ligaments is common and may rise from a fall, or more progressively from ligament laxity during pregnancy or often childbirth. It causes aching pain with sharp stabs, locking sensations, and a sense of instability and may interfere with walking-see hypermobility. Muscle dysfunction may also arise due to overload from sport, or from asymmetrical back, hips, or legs causing a dull ache that worsen the exercise. If hip is the source, walking or running will cause aching, stiffness and pain at night. Bursitis in the hip causes pain from pressure-lying, walking and sitting; coccydynia is painful mainly when sitting.

RISKS AND COMPLICATIONS

The main risk here is incorrect diagnosis: treatments for inflammatory and mechanical condition are quite different. Cancer from the pelvic organs can spread to the bony structure, so ruling out more serious problems is vital.

Physical Therapy for Buttock and Coccyx pain

Once your doctor has referred you, your therapist will perform a thorough assessment. Depending n the assessment your therapist may:

• Perform manual therapy such as manipulation of the coccyx, massage, and stretching of the ligaments attached to the coccyx.

• Perform electrotherapy or acupuncture.

Your therapist may advise you to:

• Sit only for short periods of time and use a coccyx cushion to take the pressure off your tail bone. If you do not have a cushion, you can roll up a towel or fold a pillow.

• Apply ice packs for the first few days after the pain starts,

• Apply heat packs after the few days, several times a day.

• Take stool-softening medication and increase fiber and water intake in order to reduce the pressure on your coccyx during bowel movements

Once your pain has reduced, you may:

• Start a rehabilitation program.

You therapist may advice you to:

• Perform seated-to-seated chair squats, clams, McKenzie extensions; leg raises side-lying leg raises, one-leg circles, and supine and kneeling pelvic tilts.

You May:

• Start low-impact cardiovascular training on the cross-trainer or in the water in the form of aqua aerobics

• Perform deep breathing and relaxation exercises.

Once you are nearly pain-free you may:

• Increase the impact of cardiovascular training such as jogging or running on the treadmill, cycling and aerobics.

• Continue strengthening your hip with leg raises, side –lying leg raises and adductor lifts.by gradually adding weights to your legs, such as ankle weights.

• Continue stretching your back, hip flexors and extensors with knees-to-chest stretches, McKenzie extenshions, kneeling hip flexors and hamstring flexors.

• Resume sports, gradually increasing the load and duration

Some diseases involve the whole spine or develop suddenly in a specific area for example as a result of an osteoporotic compression fracture. Other conditions develop gradually and cause symptoms in several areas such as postural pain and muscle tension, scoliosis and hypermobility syndrome.

Causes

The causes of a problem that affects the whole spine depend on the specific condition. The spine is a single functioning unit with 25 mobile segments, controlled by muscles that can span nearly its whole length as a result a condition that starts at the bottom can spread upward involving new areas of the spine by a chain reaction. Furthermore, the joints of the spine are made of the same tissues as other joints in the body, so an inflammatory disease can involve several joints. In addition bones lose mineral content with age and progressively weaken as a result.

Symptoms

Symptoms of postural disorders or advanced scoliosis that affects the whole spine will vary from pain and aching due to sustained contraction of muscles, fascia and ligaments being stretched or strained. In inflammatory disorders aching is symmetrical or strained. In inflammatory disorders aching is symmetrical and is usually worse in the morning or after a period of inactivity. In osteoporosis there are no symptoms apart from a gradual change in posture until a trivial fall or knock causes a vertebra to collapse producing intense pain. Hypermobile joints will seem to keep “catching” and clicking and will feel unstable.

Risks and Complications

The risks are related to the condition that is causing your symptoms. Some spinal pains are part of a chronic pain condition called fibromyalgia which involves other regions of the body. A diagnosis of fibromyalgia will prevent you from receiving unnecessary and excessive localized treatment. Some metabolic conditions such as vitamin D deficiency may cause widespread aching and this requires careful medical screening.

Physical Therapy for Whole Spine Conditions

Once your doctor has referred you your therapist will perform a thorough assessment. Depending on the findings of the assessment your therapist may:

• Perform soft-issues massage, passive mobilizations and postural taping.
• Teach you about posture and ergonomics.
• Begin functional retraining.

You may begin:

• Mobilizing exercises such as Mckenzie extensions, seated and lying trunk rotations.
• Strengthening exercises such as four-point supine knee lifts, kneeling supermans and calms.
• Stretching exercises such as knees-to-chest stretches, side glides, levator scapulae stretches, seated back extensions, seated waist extensions and seated twist extensions.

If you have a lot more mobility and less pain and have modified your daily activities to prevent postural strain, your therapist may advice you to:

• Move from moderate core-strengthening exercises to high-level exercises such as curl-ups, Swiss ball twists, side crunches, prone arm and leg lifts planks from knees, single leg bridges and side planks.
• Begin functional training such as squats, stationary lunges, forward lunges, reverse lunges with knee lifts and walking lunges.
• Begin sensorimotor training such as single-led stands.
• Begin cardiovascular training by using a cross-trainer or running on the treadmill or outdoors.

If you now have no pain and a full range of movement in your back, your therapist may advice you to:

• Begin more intense strengthening exercises such as prone breast stroke, Swiss ball side crunches, Swiss ball side crunches with twists and Swiss ball back stretches.
• Begin swimming, tai chi or pilates.

At the clinic, we see more clients with herniated disks than with any other back pain symptom.

Herniated Disk:  A herniated disk occurs when all or part of a spinal disk is forced through a damaged part of the disk. This places strain on nearby nerves. Disk herniations occur mostly in middle-aged and older men, particularly those concerned in tiring physical activity.

Many of them bring X-rays that show that the disk – a rough pad of tissue that acts as a cushion between vertebrae- has been squeezed by the bones until it comes into contact with the nerve. The disk is either bulging like a balloon that is being squeezed, or it actually ruptures with its softer inner core material oozing out like a jelly doughnut leaking its filling. All these are the symptoms of herniated disk.

Exercises

There are five exercises that are mitigating musculoskeletal pain in the low back.

•        Sitting Knee Pillow Squeezes

Description

 ¨     Sit right on the edge of a bench with your feet flat on the floor, hip width apart, toes pointing straight ahead.

¨     Position a pillow between your knees

¨     Rotate your hips ahead to place a curve in your low back and hold this pose     throughout the exercise.

¨     Squeeze and free the pillow with your knees

¨     Repeat as directed and do the squeezes slowly and evenly on both sides.

Purpose: This exercise strengthens the hip’s abductor/adductors to help pull the back of flexion.

•        Static Back Knee Pillow Squeezes

Description

¨     Lie down on your back with your legs up over a block

¨     Position a pillow between your knees

¨     Set your arms out to the sides at 45 degrees from your body with palms up

¨     Loosen up your upper back

¨     Using your inner thigh squeeze the pillow and release evenly.

¨     Feet remain parallel to one another.

¨     Relax your stomach and do not contract your stomach muscles while squeezing

Purpose: This exercise stabilizes the pelvis bilaterally. It allies the adductor adductors with the force of gravity and disengages the lower extremities.

•        Modified Floor Block

Description

¨     Lie on your stomach with your forehead on the floor.

¨     Your feet should be pigeon-toed and the buttocks relaxed.

¨     Rest your elbows on blocks so that the arms and hands are in the “Don’t shoot, sheriff- I give up” position.

¨     Make sure your shoulders are level from right to left. Breathe deeply, and relax the upper body.

¨     Do not press your arms into the blocks; let the chest and stomach fall into the floor, and that will cause the hips to tilt forward.

¨     Hold the position for six minutes.

Purpose:  This exercise loosen the shoulders.

•        Static Extension

Description

 ¨     Start down on the floor on your hands and knees with your main joints aligned (i.e. shoulders should lie straight above elbows and wrists, hips directly above knees)

•   Hands should be placed shoulder width apart, palms flat with fingers pointed straight ahead.

•   Arms must remain straight, elbows locked

¨     Walk your hands about six inches forward and then move your upper body forward so that your shoulders are again above your hands but now your hips are forward of your knees about six inches

¨     Loosen up your low back allowing it to arch with the movement coming from the slope of your pelvis

¨     Collapse your shoulder blades together and fall your head down

•   Your shoulders should be directly above your hands

•   If your low back begins to hurt, back your hips up toward your knees; this will make the exercise a bit easier

¨     Do as directed.

Purpose: Generally, extreme flexion causes a herniated disk, and this E-cise promotes, as name implies, extension, relieving the pressure on the disk. This exercise allows the back to sway and restore the missing lumbar arch.

•      Air Bench

Description

¨     Stand with your back to the wall.

¨     Push your hips and minute of your back into the wall.

¨     Position your feet forward and at the same time sliding down into a sitting position.

¨     Stop when you reach a ninety-degree angle.

¨     Knees should be placed over the ankles.

¨     Push the low back and mid back beside the wall to feel the quadriceps working along the top of the thigh.

¨     Hold for one or two minutes.

Purpose:  This exercise re-links the ankles, knees and hips.

•        Supine Groin Stretch

 Description

 ¨     Lie down on your back in the supine groin position with one leg straight out on the floor and the other leg on a block with the knee bent at 90 degrees

¨     Relax your upper body with your arms placed 45 degrees with body with your palms facing upwards.

¨     Flatten your leg and tighten your thigh.

¨     Notice which part of your body feel contraction or tightening of the muscle.

¨     Loosen up the thigh tightening for five minutes and recheck ones more at next five minute point. The contraction should be at the upper part of  the leg this time and with each successive test

¨     Relax then repeat on other leg

Purpose: This exercise promotes an elongation of hip and groin muscles. The result of this action will generate a chain result of muscular response in the upper body

If the pain continues undiminished, do only Supine Groin Stretch and Air Bench; the lingering pain is telling us that we first remove the extra rotation from the hips. After about a week, try including the first five items, adding one or two at a time every couple of days. Back pain is a symptom of conditions that have been developing from years. It will take more than a few minutes to get results and some of the exercises, since they work on different muscles and functions, may take longer than others.

Acute neck and nerve root pain describes several conditions that effect the cervical spine region and can also cause head pain. In the long term, it is rarely as disabling as low-back pain, but the severity of acute nerve-root pain can be just as bad as sciatica.

CAUSES

The pain can be caused by sprain of the facet joints and ligaments and disk herniation. Muscular Pain is more of a chronic condition but can flare up. Your neck is also vulnerable to external indirect trauma as in whiplash syndrome. When acute neck pain arises spontaneously in young adults or youngsters it is called acute torticollis. Disk prolapsed with nerve-root compression is the cause of the most severe pain.

SYMPTOMS

You may feel sharp pain, centrally or to one side of the neck with intense dull aching that can spread further into the shoulder blade area and halfway down the thoracic spine. You may have the stiffness being trapped by muscle spasm movements such as bending forward, backward, sideways or rotating. You may also find it hard to sit in a car or at computer for long periods. The Pain is often troublesome at night and lying down may make it worse. If a nerve is compressed or irritated, a sharp pain will radiate down your arm as far as your hand, accomplished by sensory disturbance such as pins and needles or numbness. If your motor nerve fibers have been damaged, you may develop weakness in your upper arm and forearm.

RISKS AND COMPLICATIONS

The risk of serious consequences of acute neck pain is extremely small. Usually the pain eases over a few weeks without specific treatment. The main risk lies in too much rest, the fear of triggering pain through everyday movements, and the idea that more pain means further harm, because these can lead to loss of confidence and mobility. If you have developed pain after direct trauma, such as a blow to the back of neck, then you should obtain immediate medical advice.

 Cervical Nerve Root Neck Pain Treatment by Physiotherapy

Once your doctor has referred you, your therapist will perform a thorough assessment. Depending on findings of the assessment, your therapist may:

•  Perform soft-issue mobilization, gentle spinal joint mobilizing and manual traction of the involved segment.
• Teach you how to perform active joint-mobilization in a supine position.

Your therapist may advise you to:

•  Avoid activities such as blending, lifting, carrying, straining, and prolonged sitting.
• Use laxatives to avoid straining during bowel movements.
•  Practice breathing from your diaphragm to ease the pressure on your cervical spine.

If you have arm or hand pain or other neurological symptoms, you may be suffering from cervical radiculopathy. You will be advised to rest your neck to relieve compression of the spine.

After a few days or weeks, depending on your symptoms, your therapist may:

•  Suggest further passive and active mobilizations to increase the range of movement in your neck.
•  Advise you to perform self-positional tractions between treatments.

After your symptoms have subsided, you may be ready for more vigorous stretching exercises in weight-bearing positions. Your therapist may advise you to perform shoulder rotations, neck rotations, passive and active neck retractions, seated shoulder squeezes. As your pain diminishes you may introduce flexion and extension exercises such as towel neck flexions and towel neck extensions without causing pain.

Do you need a Doctor’s Care?

Knee pain includes any kind of ache or discomfort relating the knee. Knee pain is a general trouble that we are all familiar with and mostly we either ignore it or simply don’t exercise. The knee joint consists of three bones: the femur, tibia, and patella that are fully designed to provide smooth, stable motion. These bones are enclosed in the joint capsule lined with synovium, which produces a thick fluid called synovial fluid which is essential to lubricate, guard and nourish your joints.

Knee Pain Causes and Symptoms

Knee pain usually results from excess exercise, poor structure during physical movement, not warming up or cooling down, insufficient stretching. Very common causes of knee pain are Overweight and Fatigue. The other causes can be Medical Band Syndrome, Osgood, IIiotibial Band Syndrome, Bone Chips, Tendonitis and Partially Dislocated Knee Cap. Knee pain symptoms include bruising, deformity of the joint, instability of the joint, swelling, redness and warmth of the skin.

Activities avoided:

Although you will be able to carry on most activities but you should avoid some activities like Twisting, Kneeling, Jogging, Repetitive bending, leg extension, Aerobics, , Swimming using the frog or whip kick

How to get relief:

¨     Strengthen your Butt               

From a research we came to know that knee damage including ACL tears happen mostly when large hip muscles became imbalance.

Hip extensions are helpful exercises to strengthen the glutes.

¨     Stretch muscles that support Knees

Sitting long hours in office or home makes butt muscles weak and imbalanced, so to avoid it we should stretch out these support muscles .

 ¨     Tone your core muscles

Abdominal fault can cause your pelvis to incline frontward. Strengthening your core will keep your back in neutral backbone position and especially your knees.

¨     Maintain a healthy weight

 Overweight is the main problem to develop knee osteoarthritis. Just 10% decrement in weight can result in 28% increase in knee function.

The vital thing you want to do when you’ve got a bad knee is to try to pay a visit to physiotherapist. Physical therapy is indeed an effective treatment method. People of all ages can take the advantage of physical therapy. Effective physical therapy treatment can address a number of conditions and help in promoting overall health and well-being. Physical therapy stretching and strengthening exercises greatly help in improving the function of your muscles and maintaining or improving the range of motion