STOP Chasing Centralization of Sciatic Leg Pain!

Описание: Centralization of sciatica (sciatic nerve pain) is a sign that your pain is coming from a disc in your lower back. It's also a sign that shows your pain is changeable using movement... which gives you a better chance of healing naturally. However, this concept of centralization is often taken too far- whereby people with back, butt, and leg pain are left chasing the centralization phenomenon. Which involves countless McKenzie Press-ups (extensions, cobras, backbends) with the intent of taking the pain out of the leg and towards the spine. Now, oftentimes the pain gets worse as it moves up the leg. And instead of stopping the press-ups, people are told that this is a good sign and to continue with treatment with the chief aim being full centralization of symptoms. So, should you trade worsening of pain for centralization of pain?

In my experience, centralization is NOT more important than symptom reduction in general. After all, what are you striving for- centralization or pain relief?

Research suggests that both centralization AND peripheralization are both "good" responses to movement, as the simple discovery that pain is changeable (regardless of location) points to a better outcome than symptoms that do not respond to movement. Not to mention, repeated movements in the backwards direction (the most common exercise to achieve centralization) closes down on the spaces where the nerves travel and loads the facet joints.

The result of chasing centralization with a 'more is better' approach often results in other issues, like sensitization of the facet joints or worsening of nerve function or can even delay disc healing.

Regardless of if symptoms centralize or not- the goal is to find movements that reduce symptoms overall. By taking this approach- one has permission to move in ways that feel safe vs. moving only in ways that centralize pain and avoiding motions that peripheralize pain.

#drcharliejohnsonpt #sciatica #centralization #pressups #herniateddisc
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