The Feet and Sciatica

An often-overlooked factor in sciatica is the alignment and support of the feet. The feet are the foundation for the whole body’s structure when standing upright, and as with a house, a faulty foundation can adversely effect the entire structure.

The video below explains how something as simple as fallen arches in the feet can translate to serious problems in the knee, hip, and low back, and can lead to or exacerbate sciatica, and what can be done to correct such problems.

Click To Download Video

125 Comments

  • Suzi Hanney

    Reply Reply September 3, 2011

    Just posted a comment above= Have a swollen and puffy right pins and needly right foot and sciatic pain and lower back pain! help! x

    • Dr. George Best

      Reply Reply September 3, 2011

      Hi Suzi,

      I replied to your facebook comment, but I figured I’d reply here as well to make sure you receive it…

      I suggest you start with the basic sciatica exercises shown on the video at:
      http://www.sciaticaselfcare.com/sciaticaexercises/basic-sciatica-exercises/

      In many cases, the basic McKenzie exercise will start relieving symptoms right away, although it can take several sessions to make a difference. Also, applying cold packs to the lower back for about 15 minutes every few hours will reduce inflammation and should also help reduce symptoms.

  • Gelo

    Reply Reply September 6, 2011

    Hi Doc,
    I’m undergoing therapy, they put hot compress during the start of the session and then some devices after which they explain applies heat that deeply penetrates. After which, they put me on the traction. I’m not so sure if it helps, because i dont realy feel that it makes my condition better. I can hardly sit for a minute because of the pain. Thanks

    • Dr. George Best

      Reply Reply September 7, 2011

      Hello,

      There are differences of opinion on this, but when someone is in severe pain, that’s a sign of inflammation. In my opinion, you should NEVER apply heat or heating modalities like ultrasound (which is probably the deep heat therapy you described). Heat will temporarily sedate irritated nerves while it is being applied, but it will increase inflammation and overall make symptoms worse and often delay recovery. My suggestion is to ask them if you can forgo the heat and just do the traction and maybe electrical stimulation and either get them to use cold packs instead or start using cold packs on your own (about 15 minutes at a time up to every 2 hours – use a t-shirt or other thin cloth to separate the cold pack from the skin.

      Besides getting off of heat and onto ice, I suggest you start with the basic McKenzie exercise (register with your email on my homepage to get access to the video and free ebook which demonstrate what to do).

      Good luck!

      Dr. Best

  • Tyler Pearson

    Reply Reply September 29, 2011

    Dr. Best,

    THANK YOU!!!!! sincerely from my heart! After watching this video I had a moment of clarity and realized that my sciatica is being caused by my flat feet!! I went and got a pair of custom orthotic inserts for my shoes to help give me that extra arch support, and tada!!! MY SCIATIC DISAPPEARED LITERALLY OVERNIGHT!!!!! The quality of my life is back to normal again and I truly have you to thank for it.

    • Dr. George Best

      Reply Reply September 30, 2011

      You’re welcome!

  • Doug Bone

    Reply Reply October 5, 2011

    An unrelated question – I’ve been diagnosed with a benign tumour in my colon, which is to be removed next week.
    Is there any remote possibility that this will also ‘FIX’ my sciatica?

    Thanks for very informative videos!

    • Dr. George Best

      Reply Reply October 5, 2011

      Hi Doug,

      I responded via email, but for the benefit of others who might have an interest, the answer is that it is unlikely, but possible. Small to moderate-sized tumors outside the spine itself usually don’t cause significant nerve compression, but they can sometimes trigger muscle reactions that in turn might cause sciatic nerve irritation and/or muscle referral symptoms that mimic sciatica.

      Good luck with the surgery!

      Dr. Best

  • Robert T. Anselmi

    Reply Reply October 6, 2011

    I am not aware that I may have fallen arches, or that it is the reason for my sciatica. But there is a former Denver Bronco football player that advertises for a company that makes foot support inserts. Do you think going to them, and checking out their recommendation for foot support may be advisable?

    Thaks

    • Dr. George Best

      Reply Reply October 7, 2011

      Hello Robert,

      Custom shoe inserts that provide good arch support and shock absorption are usually a good investment with or without sciatica. They may or may not alleviate your sciatica specifically, but most people find that they make their feet more comfortable and usually reduce low back pain. Custom shoe inserts typically cost a few hundred dollars depending on the brand and features. If that’s comfortably within your budget, I encourage you to give them a try. If you’re hesitant to spend that much money, I suggest trying generic arch supports (available at most drug stores and some sports equipment stores) first, and see how it goes. If the generics help some, you’ll probably get even better results with the custom inserts, so that can help you determine whether or not they are a good investment for you.

      Good luck!

      Dr. Best

  • Marge

    Reply Reply November 8, 2011

    Dr; I had X-rays and was told that I have arthritis in both hips and my back. The left hip is the worst and I got exercises off the internet and was doing very well with them until sciatica hit me on the opposite leg. I know it comes from my lower back. I am afraid to do any exercises for fear that I might do more harm than good. Both my legs cramp up on me if I sit for long and it is really difficult to walk. It feels as though I need to stretch out both legs but not sure that it would be a good idea. I have been to a chiropractor and he helped me somewhat but I don’t think I will go back. I have had this sciatica for a week now. What do you think about exercises??

    • Dr. George Best

      Reply Reply November 8, 2011

      There are many different exercises, and it’s important to find exercises that are appropriate for your specific problems. Arthritis varies considerably in its presentation and severity, so with the general information you’ve provided it is difficult to give you definite recommendations. Most people will benefit from at least some kind of exercise, it just depends on the specific location and severity of your arthritis as well as any other underlying causes there may be for your symptoms.

      With regards to sciatica and stretching the legs, you need to be careful with how you do the stretches. Most cases of sciatica are due at least in part to bulging discs in the low back. Bending forward at the waist when in the seated or standing position can place pressure on bulging discs and cause increased bulging and/or inflame the discs, thereby causing increased pressure on the spinal nerves that produce sciatica. Straight leg stretching of the hamstrings will also create tension on the sciatic nerve, so I don’t recommend doing hamstring stretches while there are significant sciatica symptoms present.

      If you have further questions, feel free to email me at info@sciaticaselfcare.com

      Dr. Best

  • Manuel Spiteri

    Reply Reply November 24, 2011

    I am a long distance runner and have been suffering sciatica for a long time.To day an x ray showed that the cartilage between the vertebra in the lower back has totally worn off.Doctor referred me to physiotherapy and after 6 months,if still in pain an MRI test and operation has to be done.I was advised to stop RUNNING which I did not agree at all,[I am passionate for running].ANY ADVISE PLEASE.

    • Dr. George Best

      Reply Reply November 25, 2011

      From what you’ve described, you have severe disc degeneration in the lumbar spine. Unfortunately, running places pretty significant compressive force on the lumbar discs, and with the degeneration you have, it is going to tend to keep things pretty inflamed in that area and will make it very difficult to recover. It is quite possible that you can get some relief with exercises, physical therapy, and possibly treatments like spinal decompression, but continued running is likely to continue to cause problems for you. Even with a successful surgery, there is a strong likelihood that distance running would cause symptoms to return within a few years.

      You could probably continue to run with the pain for some time, but the problem is that eventually the nerve compression will likely become more severe and start to interfere with muscle function. Diminished nerve function in the lower lumbar spine could lead to weakness in the lower leg and produce foot drop or weakness in toe-off, either of which would dramatically reduce your ability to run – or walk – normally.

      I wish I could tell you what you want to hear, but I have to agree with your doctor that it would be best for you to stop running. That being said, there are other activities you can do without putting nearly as much stress on the lumbar discs and you might want to consider switching to something different. I know some runners scoff at it, but power walking is a good type of endurance exercise that is usually well-tolerated by people with low back problems. I know a few people who switched to power walking from running and they’ve all commented on how much more difficult power walking is than running. Activities like swimming and cycling (I recommend a recumbent bike for long distance cyling) are also good conditioning exercises that are much easier on the low back than running.

      Good luck!

      Dr. Best

  • Xavier Goh

    Reply Reply December 3, 2011

    Hi Doc,

    I am 23, I have been suffering aching pain at the butt area whenever I am sitting down. Its been for a year, I tried your stretching exercises on your informative website, after a week, the aching pain start to shift upwards, towards the lower back. Is this a good sign? Also does chiropractic treatment serves any effective or essential results?

    Thanks.

    • Dr. George Best

      Reply Reply December 3, 2011

      Hello Xavier,

      Yes, the shift of the pain towards the low back is a good sign. This is what is referred to as “centralization” in the McKenzie method and is an indicator that nerve irritation is decreasing. In some cases, as symptoms centralize, they may feel more intense, but as long as they are moving closer to the spine, it is a positive sign. In most cases, over a period of a few days to a few weeks, the symptoms will continue to shift closer to the spine, and then will go away altogether.

      Chiropractic treatment can be helpful in speeding up recovery in many cases, but there is also a chance that forceful manipulation may temporarily increase symptoms. There is a wide variety of chiropractic treatment methods and of course the skill and experience of individual chiropractors varies as well. I suggest trying to find a chiropractor who uses more than one style of manipulation as this alows for customizing the treatment to your condition and level of comfort. If you can get a referral to a chiropractor from someone who has had a good experience, that is always the best way to go about finding a good one. Failing that, I suggest looking for one on Google or another search engine who has at least a few good reviews on their business listing (search using a term like chiropractor with your town name to get the business listings). You can also look in the yellow pages for one with just a regular listing – avoid ones with large display ads because the more advertising they are doing, usually the fewer referrals they get.

      Good luck!

      Dr. Best

  • Sally Wing

    Reply Reply December 12, 2011

    Dear Dr Best, I have benefitted from Chiro care MANY times over the past 30+ years; I truly believe in its therapeutic value. I have extremely high arches, wear supports and get regular exercise. The pain in my feet is reletively recent campared to a lifetime of low-back issues. X-ray showed no problem structurally (bones, position) but the pain I experience in my heels and rolling off the balls of my feet has me “grounded” (middle toes). I miss my aerobic dance and fitness walking but the pain is not worth it. Could this be sciatica? Is there something specific to address the foot pain? It does not travel up my leg; it’s isolated in my feet.

    • Dr. George Best

      Reply Reply December 13, 2011

      Hello Sally,

      Since the pain is isolated in the feet, it’s probably not sciatica. My guess is that there’s probably some jamming in one or more of the joints of the feet and ankles and possibly some plantar fasciitis (inflammation of the connective tissue that runs the length of the foot). My suggestion is to see a chiropractor who evaluates and adjusts the feet and ankles (not all do). Depending on how old your arch supports are, it may also be time to get re-casted or re-scanned for new ones.

      Good luck!

      Dr. Best

  • jack albee

    Reply Reply December 28, 2011

    ahh. relief! Decided to wear my tennis shoes exclusively when I went to Austin for T’giving. By the time I got to our airport, they had to wheel me to the gate; at Austin coming and going I was also wheeled. Went to two doctors there and an acupuncturist; returned home and went to two more doctors, physical therapist, another acupuncturist, pharmacy, and chiropractor, each time going to their respective offices, bent from the waist to reduce the pain and they all said the big S. They gave me pain killers, narcotics, muscle relaxers, steroids, poked holes in me, pushed my body around, gave me stretches and still the pain went on ; even your stretches kept me in pain—but no one asked me to take off my shoes so that they could look inside! After the above video, this morning at 3am, I awoke and looked into the tennis shoe and found no arch supports! Have worn shoes with such all day today and….. ahhh, relief!

    • Dr. George Best

      Reply Reply December 28, 2011

      Hello Jack,

      I’m glad you figured out the problem. It’s amazing how much of a difference some arch support can make!

      Dr. Best

  • Owen

    Reply Reply December 31, 2011

    Hi Doc,

    I suffer from Sciatica and have now started on the exercises as suggested by you. It has brought me relief. I do have a problem with my feet as well and I’m now wondering if that has something to do with Sciataca. Thanks heaps for the help.

    • Dr. George Best

      Reply Reply December 31, 2011

      You’re welcome. Good luck for further recovery and have a great New Year!

      Dr. Best

  • jack albee

    Reply Reply January 1, 2012

    per my comment last week. Perhaps it wasn’t the insole that helped. I was a lot better the first day but then it slowly went down hill. Last night I was really hurting again. Did the McKensie and others, used a heating pad, still hurt. This morning I did the massage and the acupressure. Don’t know which one did it for me, but I guess I will on with both of them because something helped.

    You haven’t mentioned heat pads, dry & moist, or cold packs. What are you thoughts on those?

    jack.

    • Dr. George Best

      Reply Reply January 2, 2012

      Hello Jack,

      In most cases, sciatica is caused by a combination of nerve compression and irritation directly by various structures such as bulging discs, and indirectly from inflammatory swelling.

      It sounds like you may be having fluctuations in the amount of inflammatory swelling present, and that’s resulting in changes in your symptoms. Inflammation varies in response to a number of factors, including diet, activity, emotional stress, barometric pressure changes, and the use of anti-inflammatory measures such as cold packs, acupressure, and medication.

      I discuss the use of cold and hot packs in detail in my ebook, but the basic idea is when there is sharp or intense pain, use cold and when things are just stiff and achy, use heat. Heat may feel better while it is on than cold, but heat increases inflammation so it tends to prolong recovery from pain related to inflammation in most cases.

      If you have further questions, let me know.

      Good luck!

      Dr. Best

  • laskesha

    Reply Reply January 14, 2012

    Have ms and having unbareable pain in lower back and hip and leg and feet goes nomb cant tell if its ms or compression on my sciatic nerve cant bend and cant sit long nor stand long is it anyone else experiancing the same symptoms .

    • Dr. George Best

      Reply Reply January 14, 2012

      Hello Laskesha,

      Your symptoms could be related to MS, but they could also be due to sciatic nerve irritation. I suggest you give the sciatica self-treatment methods a try, and see if they help. I suggest you start with the basics in the video and ebook that are found at: http://www.sciaticaselfcare.com/basic-sciatica-exercises/ . If those methods do not help, then I recommend you consult with your doctor about possible treatments.

      Good luck!

      Dr. Best

  • Mike

    Reply Reply January 25, 2012

    I was watching the foot support and I was born with flat feet. No wonder why I have Sciatica.
    I have been doing the excersies and they are beginning to work.

    • Dr. George Best

      Reply Reply January 25, 2012

      Hello Mike,

      Having flat feet doesn’t always result in sciatica, but is certainly can be a contributing factor. I’m glad to hear that the exercises are already bringing about some improvement. Good luck for continued improvement!

      Dr. Best

  • Orabi

    Reply Reply May 10, 2012

    How do I know that I have a fallen arch, my foot looks flat and fat

    • Dr. George Best

      Reply Reply May 11, 2012

      One simple test is to rub water or lotion on the bottom of your feet and then stand on some paper. The outline of the foot mark on the paper should curve inward where the arch is. If the outline is more like a straight line or outward curved line running from the big toe to the heel, you’ve probably got fallen arches.

      Dr. Best

  • Rama

    Reply Reply June 14, 2012

    i am getting lots of pain in my leg area starting from calf muscles to ankle and can’t put whole wt on the left foot.

    Would u suggest something for me Dr Best’

    I am 55 yr old and having 80 kg body wt.

    With thanks and regards. I sweat a lot due to leg pain.

    Rama

    • Dr. George Best

      Reply Reply June 15, 2012

      Hello Rama,

      If the symptoms are only from the calf down, the problem may or may not be sciatica. If you have not already, I suggest you try the treatments in my ebook available at: http://www.sciaticaselfcare.com/basic-sciatica-exercises/. If you don’t get any relief, I’d recommend you see a doctor to get checked out to determine what is causing your symptoms.

      Good luck!

      Dr. Best

  • Tricia

    Reply Reply June 19, 2012

    Hi
    All of the info I have read is very informative, but not sure if I have sciatica, I have discomfort in my right hip when turning in bed but not walking, when standing still i get pins and needles in the outside of my lower right leg radiating around the ankle and into my toes, this pain builds the longer I stand. This all started after a bout of lower back pain but might not be related,can you help with any advise. x

    • Dr. George Best

      Reply Reply June 20, 2012

      Hi Tricia,

      What you described could be true sciatic nerve irritation, but the description is more consistent with muscle trigger point referral symptoms. The most likely suspect is the piriformis, but the gluteus minimus muscle might also be contributing. Since the symptoms started after having low back pain, my guess is that the sacroiliac joint is probably involved. My suggestion is to start with the piriformis stretch shown on the video at: http://www.sciaticaselfcare.com/basic-sciatica-exercises/. If it seems to help, try doing it frequently throughout the day for a few days (it’s a good idea to stretch both sides). If you can’t get lasting improvement, you may need some work on the sacroiliac joint to get things resolved. There is a technique in my members area for this (the pelvic repositioning technique), but you might need to see a chiropractor or osteopath for manipulation treatment.

      Good luck!

      Dr. Best

  • Gail Ramirez

    Reply Reply September 27, 2012

    Hello Dr. Best,

    I need either an article or research written by you that explains the fallen arches theory leading to knee problems and Sciatica. Your Video, “The Feet and Sciatica” perfectly explains my medical conditions of Fallen Arches, degenerative knees, Scoliosis, and Sciatica. I’m presenting a medical case to the Veterans Administration for these conditions they failed to diagnose during my service years. Can you email a written version of the video, “The Feet and Sciatica?” Thanks.

    • Dr. George Best

      Reply Reply September 27, 2012

      Hello Gail,

      I’ll reply via email.

  • annamarie

    Reply Reply November 26, 2012

    I broke the bones in the arch of my right foot some 35 yrs ago and have now realized the plethora of imbalances between the left and right sides of my body it has caused. Pelvic rotation, short leg syndrome, sciatic pain.. and that is just the lower half. The upper half tilts to the right as well and the muscles do not know how to properly function. I am 54 yrs old and extremely fit having rode race horses for 25 years. I now own a gymnastic club so I am still active,but much more aware of my body. I never realized how imbalanced I was until I started jumping on the trampline. A sharp pain would radiate under my glutes and down my leg..since my job as a coach is too work on postural alignment with my students I figured I better start working on myself. Unfortunaley, I am finding it hard to spot the students on my right side ( I just don’t feel safe (for the kids sake) ) so I am always using my left side to do all the strength work. Would inserts ( I can’t afford to go to an orthopedic, so I use the generic ones help to raise my lower right hip, or do I have to consciously hike it up to stay level and balance. I do the exercises and don’t mind the pain but so much of the day I can’t remember to stay centered. At night I do alot of visualizing when I am laying down in bed..which makes me feel good but I don’t know if it really matters because when gravity takes over, I stand the same. bend over the same, reach for something the same way I’ve been doing for last 30 years..I would love to change the way I do everything.. Should I become right-handed to get my right side involved and give my left side a break..poor thing..the muscles are so tight and contracted.. Lots of questions I know but..you’re the expert.. Sometimes I feel like I should double up the inserts in my right foot to level out the hip but my foot won’t fit in the shoe..lol..thanks for thinking about it for me… anna

    • Dr. George Best

      Reply Reply November 26, 2012

      Hello,

      First, it is important to understand that there are two main types of short leg syndrome. A structural short leg is one in which one or more of the bones in the legs vary in length from left to right. The other type, which is far more common with significant leg length differences is a functional leg length inequality in which the difference comes from unleveling of the pelvis due to any of a number of biomechanical issues (fallen arches, knee issues, hip issues, sacroiliac issues, and cervical spine issues, just to name the most common areas of involvement). While using a lift to compensate for an actual bone length difference is usually helpful, compensating for a functional short leg with a lift will often make things even worse. Since I don’t know what the cause of your leg length inequality is, my recommendation is to have a doctor, chiropractor, or physical therapist evaluate you to determine what the source of the leg length difference is so it can be properly addressed. Most chiropractors I know will work with you to make your care affordable, so my suggestion is to talk to some and try to find someone who you can work with

      With regards to trying to switch to being right-handed, that’s no easy task, and if you have mechanical issues on the right side, that mightonly serve to move the problems not really fix them. So, before you go to the effort, I’d definitely get things checked out first and find out what the recommended course of action is.

      If you have further questions, let me know.

      Good luck!

      Dr. Best

  • Rajkumar

    Reply Reply November 26, 2012

    Hi Dr. Best,

    I had accident 2 years ago, i have taken treatment from different hospital in India but no relief in back pain. In MRI it show the second disc from the bottom bend toward right. I got your reference for the same.

    I can not sit or walk for long time. Dr. i want to know is it possible of treatment without surgery.

    prince.2007g@gmail.com

    Thanks and Regards.

    Raj

    • Dr. George Best

      Reply Reply November 26, 2012

      Hello Raj,

      Depending on the severity of the disc problem, it usually can be treated without surgery. Most disc bulges/herniations/protrusions can be treated with the methods in my ebook. If you don’t already have it, it can be downloaded from the right sidebar of this page:

      http://www.sciaticaselfcare.com/basic-sciatica-exercises/

      Severe disc protrusions and disc extrusions (discs that are actually ruptured) do often require surgery, but even in these cases, the self-treatment methods are sometimes effective, so they are worth a try.

      Good luck!

      Dr. Best

  • Ron

    Reply Reply December 19, 2012

    Thank you for giving me clear answers about what sciatica pain is. I have a L4L5 disc extrusion and L5S1 protrusion that has caused me much pain for about 2-3 months. You have given me more hope that I can get myself back to being somewhat healthy. I feel like I didn’t receive enough imformation from my Doctors about what I could do other than have a shot, take some pills, and let me adjust you to fix your spine. I feel like just a number when I go to see a Doctor. It is not a conforting feeling.

    Thanks again!

    • Dr. George Best

      Reply Reply December 19, 2012

      Hello Ron,

      With a little luck, you can manage your condition effectively with self-treatment and perhaps medication during flare ups.

      The problem with disc extrusions is that they are pretty unstable and unpredictable. Unlike a protrusion (a bulge), an extrusion (also called a rupture) means that the outer wall of the disc has been breached by the inner gel of the disc (although radiologically-speaking, the difference between a protrusion and extruson is a matter of size, so what the radiologist called an extrusion may not be a full rupture). This is a much more difficult situation to treat conservatively than a protrusion. My recommendation is to work with the methods here on the site and with your health care professionals to try to get the best results possible. If you are not much better within another 3 to 4 weeks, then I’d say your best bet is probably going to be a minimally invasive surgery. This is done through a scope using small incisions and they trim away the extruded and protruding disc material to open up space around the nerves. While it certainly would be preferable to avoid surgery altogether, most people do quite well with minimally invasive procedures. The recovery is pretty fast – most people can return to most normal activities within a week or so, and there are much fewer issues with post-surgical scar tissue development. It is very important to take good care of your back following such a surgery, but really that’s no different than for any other person with a history of back problems.

      If you have questions, let me know.

      Good luck!

      Dr. Best

  • Gregor

    Reply Reply February 14, 2013

    Dear dr. Best

    First I would like to thank you for all the information and treatment directions about the sciatica that everybody who has the interest can get here. It`s very empowering and guides people to stop leaning so much on the doctors and physicians as most elected “contributors” in the process of treatment. Of course valid information, diagnose and good medical approaches are crucial and comes from specialists, but the most important factor of healing derives (and people should know that) from the patient who is the one who can really help him/her-self. That`s where the responsibility lies to get better as well. And that is the true beauty of your work and your website.

    I found some interesting information; exercises and self-diagnosis tests that help me understand better my problem. But I still have a few questions that I would be very happy if you would answer. So let me tell you a bit more what the issue here is. I am 40 years old and I come from Slovenia. I am experiencing some of the problems you`re describing in your videos. It all began 4 months after a car accident that I had (December 2011). I didn`t need any emergency or medical help and a few days after the crash I didn’t feel much pain except some gentle feelings of tension in my back (between shoulder blades) and my neck. Later when I went to the examination the x-ray scans of my entire spine showed that my spine was not injured and my physician diagnosed me a whiplash injury (distorsio columnae vertebralis cervicalis). So the treatment was that my physio-therapist taught me some useful exercises and I was also included in electro-therapy sessions and after a month or two I was pretty much ok.
    But a few months after I completed my treatment I was doing some physical work where my problems actually begin. While working (mostly lifting disabled people) I felt nasty pain in my more central then lower back, that several weeks later begun to move down. And in about 3 or 4 months after starting the initial pain, it went down to my lower back and was sometimes moving slightly to the right and sometimes more to the left side. Mostly I felt pain when I was sitting and wanted to get up and the pain got more intense while just sitting. Also while walking but less intense. This type of pain lasts about 4 or 5 months. At that time I did every day my exercises for my back (not for sciatica). But after that the pain vanished and I thought it was over. But instead the whole thing moved down to my buttock and to my right leg that sometimes go down all the way to the foot. Most nasty pain is in the morning or when I seat to long. Some days are better and some days are worse, but I can walk, I can do pretty much everything except sport activities and hard physical work. I feel I can control the pain quite well by doing sciatica exercises.

    So now we finally got to my questions. And they go like this:

    1. Regarding to the tests you showed us in video I consider my problem is more like “piriformis syndrome” than a “nerve compression” issue. In your video you recommend to begin with exercises that work on nerve compression first. I am doing both types of exercises, mostly because I feel that exercise that work on the piriformis muscle suit me better and make me feel a lot better. Beside your exercises I am doing the one I found on the web (from dr. Paula More – http://www.youtube.com/watch?v=_DkD_PNMnFk ) and I would like to know do you think is it ok if I do both types of exercises? Or is it better I don’t mix them together?

    2. My second question is related to the feelings of coldness in my feet. As far as I am concerned I was never a person who was bothered with cold feet and that kind of problems. I am very rarely ill and I am used to tolerate quite extreme weather conditions. But now I find out that since this pain got in to my leg, that I feel more often coldness in my both feet. Can this be related to the sciatica and if so how to begin to solve the problem?

    3. My next question is do you think it is possible that patients with sciatica issues can be involve in sport activities again such as jogging, soccer, skiing and mountaineering? If answer is yes, when it`s best to start practicing it?

    4. And finally are certain exercises for general back problems helpful or maybe even harmful for patients with sciatica? If so, could you tell us what kind of exercises are not appropriate?

    Thanks again for your answers and I hope my questions and my story didn`t take too much of your time.

    All the best to you Dr. Best and thanks for your work 🙂

    Gregor

    • Dr. George Best

      Reply Reply February 15, 2013

      Hello Gregor,

      In answer to your questions:

      1. The exercise in the video link you sent is fine to do. It does essentially the same thing as the seated piriformis test/stretch shown in my video. You can do either version or both, whichever you prefer. While your major symptoms may be coming from the piriformis, the history you gave suggests a strong possibility that there is a disc protrusion causing some nerve compression / irritation as well (which in turn may be causing the piriformis tightness). For this reason I recommend you do the McKenzie exercise as well.

      2. The coldness in your feet may very well be associated with the sciatica. In addition to the nerve compression itself giving the sensation of coldness even when the feet are in fact normal temperature, the nerve irritation can sometimes cause reactions in the autonomic nervous system which controls things like blood vessel dilation and constriction and thereby effect the circulation in the feet. If the coldness is related to the sciatica, resolving the sciatica will likely resolve the coldness as well.

      3. People who have had sciatica can usually return to at least some sports. High-impact activities like running, jumping, or skiing moguls are less likely to be tolerated, but sometimes people can resume even those types of sports if they otherwise take very good care of their backs. With any heavy exercise or sport, it is best to wait until all of the symptoms are gone for at least a few weeks and then start back very slowly, doing only what seems very easy the first few times. If things go well then you can gradually build back up to your normal intensity, backing off as needed if symptoms develop.

      4. Besides the high-impact activities discussed, powerlifting or other extremely heavy weightlifting is certainly not ideal, but with excellent form and control when lifting, even that can usually be tolerated in many cases. The main thing to watch out for is any exercise in which you bend the upper body forward at the waist while standing or sitting. For example, straight leg deadlifts, “good mornings”, and rows done without a chest support are very hard on the lower lumbar discs and tend to cause problems. The same thing goes for yoga and stretching exercises – avoid anything where you bend the upper body forward at the waist when sitting or standing. For example, the hamstring stretch in which you are standing and bend your upper body forward and try to pull your chest toward your legs is bad, but if you lie on your back and pull your legs toward your chest, that’s fine.

      I hope this is helpful for you.

      Dr. Best

  • Gregor

    Reply Reply February 15, 2013

    Thanks for your quick response. It`s helpful.

    G

  • Chris Soper

    Reply Reply March 19, 2013

    Hello Dr. Best,

    Over the years, I have been told by various medical professionals and even my tailor that I have one leg 1/4″ shorter than the other. None of them has ever shown any great concern about this but after watching your video, I wonder if this is causing or contributing to my low back, hip, leg and knee pain. The pain is worse in the knee but starts at the hip and extends to just above the ankle. The pain is in the front of the leg and at its worse is a burning sensation.The leg is also partially numb and somewhat weaker than the right leg. I also have pain between the hip and sacrum area. I have seen my family doctor, physio therapist and osteopath and I am to have an MRI in ten days time. They all believe it is sciatica but I think it is something else since I have had problems with my knee since high school. It often gives me pain and feels unstable frequently. I appreciate your comments.

    Chris

    • Dr. George Best

      Reply Reply March 20, 2013

      Hello Chris,

      To start with, if the pain is in the front of the leg, it is not sciatica, since the sciatic nerve supplies the back of the leg. There could be some involvement of the femoral nerve due to causes similar to those of sciatica. It’s difficult to say without being able to examine you, but the description of your symptoms sounds to me more like muscle reaction to joint dysfunction in the sacroiliac, hip, and/or knee joints.

      Your leg-length inequality is not severe, but over time it will result in uneven wear and tear on the supporting structures and could predispose you to the type of problems you are experiencing now. In most cases leg length inequality is “functional”, meaning that the bone lengths are equal, but due to mechanical dysfunction and uneven muscular contraction the pelvis tilts to give the appearance of a short leg, and this definitely goes along with issues in the sacroiliac joint. It is quite possible that you do have an actual bone-length difference, and if that is the case (best-determined by X-ray measurements), you might benefit from using a heel lift in your shoes to compensate for the difference.

      I hope this is helpful for you.

      Good luck!

      Dr. Best

  • jim gibson

    Reply Reply March 22, 2013

    The doctors have not yet determined what the cause of my leg pain is . I am going for an MRI on the 28 of march . I have had 2 separate accidents resulting in 7 damaged vertebrae 3 broken ribs and a fractured collar bone. Naturally I tend to think of these as the culprit of my Sciatica symptoms. Now however I will get my foot checked out as over the past year I have experienced a lot of pain that seems to come and go on my right foot
    Thank You for the heads up in this area

    • Dr. George Best

      Reply Reply March 22, 2013

      With the types of injuries you’ve had it would certainly not be unusual to also have one or more bulging discs that could produce sciatica. Foot and ankle dysfunction is quite common in auto accidents and is often overlooked in favor of the more obvious injuries, so it is definitely a good idea to get that checked out as well. Good luck!

      Dr. Best

  • Naresh Kumar Bansal

    Reply Reply May 20, 2013

    As per my latest MRI dated 14th May 2013, result is as “PIVD at L4-L5 with secondary moderate to severe canal stenosis. Pls. advise accordingly.

    • Dr. George Best

      Reply Reply May 20, 2013

      I suggest you start with the basic self treatment methods found in the free ebook. If you do not already have it, you may download it at:

      http://www.sciaticaselfcare.com/basic-sciatica-exercises/

      With more severe cases like yours, it may take several weeks to get maximum improvement, but if you are not noticing significant reduction in symptoms within one to two weeks, it may be necessary to consider surgical treatment at some point. If that does become necessary, in most cases “minimally invasive” surgery is usually the best option. It is done through small incisions using a scope and it allows for trimming away the bulging disc and other tissue from around the nerves without cutting a lot of muscle or resulting in a lot of post-surgical scar tissue. Hopefully that will not be necessary, but it may be an option in your case.

      Good luck!

      Dr. Best

  • Jerome Rosen

    Reply Reply June 9, 2013

    Thank you Dr. Best for your very informative videos.

    I have had lower lumbar disk-related problems, primarily in L5-S1 area for many years. My biggest problem is sciatica (right side). It’s chronic and I believe it’s piriformis-related as opposed tp ‘true sciatica.’ (I learned the difference from you.) I never thought of a possible linkage between foot problems & sciatica until I watched “The Feet & Sciatica.”

    I have a condition in my left foot diagnosed by a podiatrist as Morton’s Neuroma (between the 3rd & 4th inner spaces). It’s always painful when I walk. Is it possible that it could be a contributing factor re my sciatica? I am planning to have surgery to correct the neuroma.

    Thank you.

    P.S. I’m 75 years of age & otherwise in reasonably good health.

    • Dr. George Best

      Reply Reply June 9, 2013

      Hello Jerome,

      It’s quite possible that your gait has been altered somewhat in response to the pain from the neuroma and this may be contributing to your sciatica issues. After you have the neuroma removed and the foot is healed up, it might be a good idea to have a physical therapist, chiropractor, or orthopedist take a look at your gait to make sure you don’t need gait training to correct any abnormalities that may have developed. The disc issue you mentioned may also be a factor, even if there’s not major nerve compression because even mild irritation of the nerve can in turn cause excessive contraction of the piriformis. For this reason, I’d suggest trying the McKenzie method per the instructions to see if that helps your recovery, even though it seems like the piriformis is the major issue.

      Good luck!

      Dr. Best

  • Jerome Rosen

    Reply Reply June 11, 2013

    Thanks again for the quick response Dr. Best. I just wish you had an office in Southern California…

    • Dr. George Best

      Reply Reply June 11, 2013

      Glad to help. Take care, Jerry.

  • RAJAN

    Reply Reply October 6, 2013

    Sir, My daughter of 12 years has “FLAT FOOT”, and is using arched foot wears . But since she is very small , she has not begun feeling any pain any where now. My question is ,
    1. Can she be cured !?
    2. Will there be a resultant mechanical imbalance in the upper links like knee, hip, etc !?
    3. Your recommendations please sir !!!

    RAJAN.

    • Dr. George Best

      Reply Reply October 8, 2013

      Hello Rajan,

      I can’t help but get the impression from the tone of your question that you may have been unduly frightened by a health care provider or orthotics salesperson regarding the effects of flat feet. While flat feet (also called fallen arches) will cause some added mechanical stress on the body, it’s not the type of problem that tends to be severely damaging or disabling by itself.

      Although there are exercises that can help restore the arches, my advice is to simply stick with the arch supports. Wearing shoes most of the day diminishes neurological stimulation of the muscles in the feet that stabilize the arches. It is very difficult to overcome this with exercises, so although the arch supports don’t correct the problem, they do a very good job of compensating for the problem and minimizing the mechanical stress on the body that it causes.

      One last suggestion is to try not to worry too much if and when your daughter resists wearing the arch supports. The shoes that the supports fit in are not always the most attractive and while your daughter at the age of 12 may not yet be too fashion-conscious, there’s a good chance that she will become fashion-conscious in the next few years. If this occurs, she may not want to use the arch supports. Fear not, because eventually she’ll probably realize at some point that she feels better when she wears them and will start wearing them again (but it may take some years). Like I said, the damage that flat feet can cause is usually not a big deal, so while it’s better to use the arch supports, it’s not too critical if she chooses not to.

      Good luck!

      Dr. Best

  • Philgood

    Reply Reply October 15, 2013

    Dr. Best, the information on your site has been extremely helpful. You helped me discover that most likely i have true sciatica, and steered me away from trying methods that may exacerbat my condition. In the past few days of doing the McKenzie exercises I have gotten tremendous relief, However, sometimes upon standing up after resting, and taking a few cautious steps, the pain shoots right back down my leg. What can I do?

    • Dr. George Best

      Reply Reply October 16, 2013

      If it’s only been a few days since you started the exercises, the first suggestion I have is to give it some more time. Depending on the severity of the underlying problems it can take several weeks to reach a point of maximum improvement. Since you’ve had a lot of improvement in just a few days, your recovery probably won’t take very long as compared to what some people go through. Just to give you an idea, a typical treatment program with a physical therapist for this type of condition is 6 to 8 weeks. The basic rule of thumb I have is if things have improved overall in any two week period as compared to the previous two weeks, you’re on the right track and the recommendation is to continue what you’re doing. It is not unusual to have some ups and downs from one day to the next, so you’re looking for a trend of improvement over a period of several days.

      Sitting places the spine in slight flexion, which tends to cause the disc to bulge more into the space the nerve occupies. When you first stand up and the spine goes into slight extension, the combination of the increased bulging of the disc and the slight narrowing of the nerve canals that occurs with extension will temporarily increase the pressure on the nerve. Once you have been up and around for a little while, the disc bulge gradually decreases again and the space around the nerve opens up. It is somewhat different when you’ve been lying down, but the effect is similar. When lying down, the disc has less pressure on it than when weightbearing and will often take in fluid. The increased fluid volume will then cause increased bulging when you first sit or stand up, and it takes a few minutes of weightbearing for it to go back down again.

      Anyway, from what you’ve said, it sounds like you just need a bit more time to recover, so for right now I don’t have any new recommendations besides to continue what you’ve been doing.

      Dr. Best

  • Tim

    Reply Reply December 9, 2013

    Great information regarding the correlation between the foot arch and sciatica. I’m 37 and have had foot pain for 20 years after aggressive exercise, and sciatica associated with an L5 S1 herniation for 10 years (microdiscectomy 2 years ago). I was told a few years ago that I had high arches which was the source of my discomfort at my toes. Could that also be associated with the disc herniation? Typically my sciatica and low back pain begin with right side hip pain. Thanks for the info!

    • Dr. George Best

      Reply Reply December 10, 2013

      Hello Tim,

      Lower back problems are more commonly associated with fallen arches than high arches, but I suppose it is possible that your arch issues might have participated in the development of the disc herniation.

      Dr. Best

  • Rajesh Dontamala

    Reply Reply January 3, 2014

    Dear Dr George,

    First of all thank you very much for your videos and support for patients with sciatica and lower back issues.
    I was met with a motor bike accident direct collision with a huge truck direct hit to my right patella and blown up my right knee cap and also femur shaft fracture in sep, 2006 for which my doctor implanted plate screws into my thigh bone and a couple of wires for patella. The fracture was well cured and all plate, screws and wires were removed from my leg two years of post opp. But i gradually started pain in my left side of lower back after surgery for which my doctor said that was because of strain. As i use to get that pain when i was in stress or strain, i took it easy and never look at it so serious. But as the pain never went off i visited my doctor for the same issue on 22/11/2013 for which he asked me to take a MRI scan. I was diagnosed with disc bulge with posterior tear at L5-s1 and also very slight sign of disc bulging at L1, L2, L3, L4.
    I worked in a warehouse for couple of months while i was doing graduation where i had to lift weights contineously and had to bend but i left that job recently.
    Could you please help me out with options to solve my problem or the steps and exercises to take for my issue.
    I also want to know whether i have This discs problem because of my work or of my surgery to right knee and femur saft. I believe it is because of surgey as i use to not put more pressure on my right side of my body and shifted that pressure onto left side which caused me disc bulge on left side.
    I am really sorry for such a long comment.
    Your suggestion will be helpful to me and much appriciated.
    Thank you.
    Rajesh Dontamala
    26 years male.

    • Dr. George Best

      Reply Reply January 3, 2014

      Hello Rajesh,

      There’s really no way to say for sure what caused the disc problems. They may have been initiated in the accident, they could have started as a result of the uneven stresses on the spine following the knee surgery, or they may have started developing long before you even had the accident. There’s simply no way to know.

      With regards to treatment, my suggestion is to start with the methods in my free ebook, focusing particularly on the things for disc-related problems (although the treatments for the piriformis may provide some help as well). If you do not already have the ebook, your may download it from this link.

      Good luck!

      Dr. Best

  • Rajesh Dontamala

    Reply Reply January 5, 2014

    Thank you doctor. I will follow the book. Rajesh

  • Ann

    Reply Reply January 26, 2014

    Very well presented information.

    • Dr. George Best

      Reply Reply January 26, 2014

      Thank you for your comment!

      Dr. Best

  • Ani

    Reply Reply February 1, 2014

    Hi Dr.,
    I too had similar issues,but not sure what it is.From last few months i feel something weird in my foot(@sole),its like some nerve is pulled at bottom of my foot.Then sometimes i noticed a nerve comes on top of knee (feels as if something stuck thr).Last week while i again getting nerve on knee,i sat in squat postion suddenly and felt some nerve movement in my calf muscle,since then i am getting mobile like vibration feeling in my left calf,which moves sometimes to thigh.It is not painful,feel like something is being pulled.FYI– i sit in from of computer for long hrs,so thinking it might also be one of the causes.
    I have gone through ur videos and started doing mkenzey excercise.Please throw some light on my situation and guide me.
    Thank u for all ur videos !!

    • Dr. George Best

      Reply Reply February 1, 2014

      From your description, I don’t think you have sciatica. My best guess without being able to examine you is that the primary issue is in the foot. Most likely you’re having some collapse of the arch and that’s causing plantar fasciitis (inflammation of the supporting tissue on the bottom of the foot) as well as causing some rotation of the knee and abnormal stress on the calf muscles. I’d suggest you try getting some arch supports as a starting point and if that doesn’t help, then I’d recommend seeing a sports chiropractor to have the joints in the feet and legs checked out as well to evaluate the spine just in case the problem is coming from there.

      Good luck!

      Dr. Best

  • Greg Poston

    Reply Reply February 27, 2014

    How does this video apply for flat feet? My flat feet never have given me any problems. (And didn’t do me any good in avoiding the Army draft — they took me anyway!)

    • Dr. George Best

      Reply Reply February 27, 2014

      Fallen arches and flat feet are basically the same thing. Even though your feet don’t bother you, the flat arches do place extra mechanical torsion and stress on the structures above as discussed in the video.

      Dr. Best

  • Jim Houck

    Reply Reply April 2, 2014

    What an amazing person and doctor to spread such wisdom and beneficial information to the world, FOR FREE. How seldom do we see this in American medicine? Nice work, doctor. I’m very impressed with your right-minded thinking and experience.

    • Dr. George Best

      Reply Reply April 2, 2014

      Thank you very much, Jim!

  • Vanessa

    Reply Reply November 5, 2014

    I had never had any back issues until I had my son 2 years ago. I have a horrible pain that runs from my lower back through my buttocks down my thigh & calf & into the arch of my foot. The dr. Told me it was my sciatica. He gave me a few exercises to do but due to my trashed knees I am unable to do them. I ice nightly I have been on anti inflammation meds & pain meds for months & I am always in pain. Please any ideas would be appreciated. Thank you. ..

    • Dr. George Best

      Reply Reply November 5, 2014

      I’m guessing you found this page from a direct link and haven’t been through the rest of the site since you didn’t mention trying any of the methods here, so I recommend you start with my free ebook which can be downloaded from the link on the right side bar of this page: http://www.sciaticaselfcare.com/basic-sciatica-exercises/. The McKenzie method shouldn’t be too much of a problem with bad knees. The piriformis stretch might be, but you can modify it by reaching behind the knee and keeping it less-bent than is shown in the instructions (the main thing is bringing the thigh across toward the opposite shoulder, and this can be done without bending the knee a lot).

      Dr. Best

  • Liz Galo

    Reply Reply November 25, 2014

    I do wear over-the-counter orthotics, and only buy shoes with good arch supports. So, although I am 68, and have increased shoe size by 1/2 a size, I feel I have good arch support.

    However, I have had one chiropractor and one DO tell me my right leg is longer that my left. The DO took careful measurements, and then gave me a 3mm gel insert for the heel of my right shoe. I have two more appointments with the DO, but is that a reasonable track to explore. (I have a herniated L5 disc on the right side, that sent electric pain to my toes the day it happened, and paralyzed the right toes. Now they are 50% better, but the leg is weak and the thigh and glutes are atrophied.) Liz

    • Dr. George Best

      Reply Reply November 25, 2014

      Hello Liz,

      Evening out the leg length may or may not help with your symptoms, but it is a simple fix if it is helpful and so I recommend you give it a try. Depending on the cause of the leg length difference (for example, a congenital difference in bone length versus a loss of joint space in the knee and/or hip joint due to degenerative changes), your body may be adapted to it, so the heel lift might even increase your symptoms temporarily.

      With the improvement in your pain, it sounds like you are on the right track. The loss of strength can take some time to recover from – muscles take a lot longer to build up than they do to lose strength and mass after a neurological loss. All you can do is try to be patient and consistent with your rehabilitation.

      Good luck!

      Dr. Best

  • Andrew

    Reply Reply January 3, 2015

    Dr Best,

    I’ve been suffering with lower back pain for a number of years and have ruptured L4/L5 and L3/L4. The level of discomfort got significantly more uncomfortable following the birth of our first child 2.5 years ago, where I would flex my spine to put her to sleep in a travel cot, which was almost down at my feet!
    I have tried several therapist and more laterly have been a bit more successful in managing the level of discomfort that I have been experiencing.
    I was a very active sportsman and find my situation very frustrating. The therapist that I have recently been seeing has advised me that he thinks that I sit down too much as I have a desk job but I have recently ordered and sit stand desk that I hope will deliver some further results. I’m following a hip flexor stretching program and have included some of the stretches that you recommend, pulling the leg towards you and across.
    Is there anything else that I can be doing? I’m determine to get get back to some level of regular exercise and manage my back so that I can lead a relatively normal life.

    • Dr. George Best

      Reply Reply January 3, 2015

      Hello Andrew,

      You didn’t mention doing any of the McKenzie exercises, so if you have not gone through the testing procedure and started using the position that best centralizes (or, if you only have low back pain and no sciatica, reduces) your symptoms, I recommend you do so. Frequent use of the McKenzie exercise (see my free ebook for the full instructions – if you don’t have it, you may download it from the link on the right sidebar of this page) at first can improve things faster than anything else when the symptoms are disc-related.

      You described your discs as “ruptured” and that terminology gets used very loosely, even among doctors. In terms of treatment decisions, it’s very important to distinguish between ruptured and bulging/protruding. Bulging / protruding discs typically respond well to conservative (non-surgical) treatment methods such as exercises, but actual ruptures usually require surgery for good long-term resolution of symptoms. If the disc is actually ruptured, you’ll usually see the term “extruded” or “extrusion” or perhaps “sequestered” on the imaging report. If one or both of the discs are actually ruptured, my advice would be to consult with a surgeon who does some type of minimally invasive procedure. This is done through small incisions using a viewscope and the ruptured disc material is removed. In most cases this will bring about major symptom relief within a few days and most patients can resume normal activities within a week or so. You still have to be careful and continue taking preventive measures, but you’re likely to do far better than trying to manage an actual disc rupture with exercises.

      If there is not an actual rupture of the discs, I’d also suggest consulting with an experienced chiropractor. Physical therapy does a great job with soft tissue and muscular conditions, but if there are joint dysfunction issues that have not been addressed, recovery will be limited and/or delayed. Physical therapists will often work on joint issues, but often in a much less direct way than is typical with chiropractors. I have seen many patients who have undergone several weeks to several months of physical therapy with slow progress improve dramatically with one or two chiropractic treatments. In my practice I incorporate deep tissue massage techniques along with joint manipulation and if you have not had any deep massage work in your therapy, I would highly recommend that as well. Stretching is important, but in many cases there are focal areas of muscle contraction that create a lot of pain and these “knots” usually do not fully resolve with stretching alone.

      If you have further questions, let me know.

      Good luck!

      Dr. Best

  • John Kerwin

    Reply Reply February 11, 2015

    Hi Dr Best I had really bad sciatica 10 years ago & was in bed for 3 months & a year before I was back to normal except for a stabbing pain in by big toe every now & again. Fortunately it only happened now & again when I was walking. Now it has returned with varied sensations from a dull ache to a burning pain which comes & goes with changing my body position usually but not always. Is there a particular exercise I should use or avoid, can you advise. I do the stretches most mornings as soon as I get up. I’m concerned that I may be about to get a repeat of severe sciatica which I want to avoid at all costs. At my age I think I’d prefer to die than go through all that again.

    • Dr. George Best

      Reply Reply February 12, 2015

      Hello John,

      Without knowing more specifics about the underlying problem, about the only thing I can suggest is to follow the recommendations in my free ebook (if you don’t already have it, you may download it from: ). You didn’t say how old you were, but given what you did say, I’m guessing you’re probably somewhere past middle-aged. If that’s the case, new disc protrusions are relatively unusual, so the culprit is probably more of a degenerative or inflammatory issue, or it could be muscular (piriformis or gluteus minimus). It would still be a good idea to test the various positions for the McKenzie exercises (discussed in detail in the ebook), but if it’s a degenerative issue, you’ll probably do best with one of the flexion positions. If things don’t improve over the next few weeks, it would probably be a good idea to look into having an MRI or CT scan to evaluate things and give an indication of what your best treatment options are.

      Good luck!

      Dr. Best

  • Ravik

    Reply Reply September 3, 2015

    Hello Dr.Best:

    I had first symptoms of sciatica pain on the left side of my body back in 2009.I had consulted a doctor back then who had suggested some stretches which i have been doing almost regularly since then and that has helped me out a lot.However, he could not identify the exact cause of it.I have realized much later that i have almost flat feet and would like to know if that has been causing my sciatica pain.I do stretches and exercise 4-5 times a week (cardio & weights)now and play racquetball.
    Should i use any arch support/special type of shoes on a regular basis,any specific exercises to help prevent injury in general,are deadlifts/T-bar risky for me ?
    I need your valuable suggestions regarding these please.

    Regards:
    Ravik

    • Dr. George Best

      Reply Reply September 3, 2015

      As discussed in the video, flat feet (unstable arches) can be a factor in sciatica because they cause compensations in the body that place added stress on the lumbar spine. General “off the shelf” arch supports are usually helpful to some degree and custom-made orthotics will maximize the arch position and minimize mechanical stress while providing what’s typically a more durable product than the generics. My personal preference for custom supports is the Footlevelers line of orthotics, most often dispensed by chiropractors.

      With regards to exercises, deadlifts and T-bar exercises are risky for anyone and are particularly risky for anyone with a history of back problems or sciatica. If they are done with perfect form, they’re not so bad. But doing them perfectly every time, especially if you’re tired or distracted, is the tricky part, and even a minor break in proper form makes them very dangerous for the lumbar discs. The main thing to keep in mind with exercises is to avoid anything where you bend forward at the waist from a standing or sitting position unless the upper body is somehow supported.

      Dr. Best

  • Paul S.

    Reply Reply February 19, 2016

    Hi Dr. Best — I stumbled upon your website the other day and have spent a good couple hours going through your posts. I love the stuff you are saying! I have been dealing with mild low back pain, throbbing pinching in my glute, and then burning foot pain — for just over a year. I’m 46 and was an active triathlete, but I didn’t have the best nutrition, and I didn’t have a foundation of strength. On top of it, I sat at the computer all day and had no core strength. It’s no wonder I’m injured. I have had extensive imaging done, and doctors say my back looks good for my age. But then some chiropractors tell me that a minor bulge in the back could be a larger bulge when you are seated or standing. Have you seen cases like this where imaging looks good, yet weird sciatica and biomechanical issues exist? Thank you!

    • Dr. George Best

      Reply Reply February 19, 2016

      Hi Paul,

      Actually it’s very common for imaging to show little or nothing that is the definitive cause of a patient’s symptoms. With regards to disc protrusions specifically, as the chiropractors told you, how much protrusion is present when lying down is sometimes much different from what occurs in an upright position, so for patients whose symptoms mostly occur when upright, I try to get an upright MRI done if at all possible. The other common issue that creates a discrepancy between imaging findings and the patient’s symptoms is motion. To give you an analogy, if you look at a car while it’s parked, the wheel alignment may seem fine, but if you look at the same car while it’s moving, you may see the wheels wobbling all over the place, completely misaligned. The same thing occurs when looking at the spine. A static X-ray or MRI shows the spine in a single position, usually a relatively optimal position of standing or lying straight, so a lot can be missed regarding possible causes of symptoms. By the time someone reaches middle-age, there’s usually some degenerative change or clinically unimportant “abnormality” that doctors can point to and proclaim it to be the problem, but in my experience, diagnosing based solely or primarily on imaging findings is pretty unreliable except in cases of overt pathology with clear neurological and/or biomechanical compromise.

      Dr. Best

      • Paul S.

        Reply Reply February 20, 2016

        Thanks for your reply, Dr. Best. Your info gives me reassurance I’m on the right path to pursue this further. I’m impressed how well you respond to questions — I think it will be worth it for me to sign up for your membership. 🙂 Thank you.

        • Dr. George Best

          Reply Reply February 20, 2016

          You’re welcome, Paul. Let me know if you have further questions.

          Dr. Best

  • Sabir

    Reply Reply March 8, 2016

    Hello doctor,
    I suffer from a pains right down the left foot ankle.I went to see a doctor and he prescribed some pain relief medicines.the pain continues.after a second visit he asked if I have sciatica.I replied from time to time.my question is a pain down the ankle resulting from a torsion can be emanating from a back pain?thanks.

    • Dr. George Best

      Reply Reply March 8, 2016

      It is possible that ankle pain might be radiating from the low back, but if you suffered a torsion injury to the ankle, I would say there’s probably a problem in the ankle itself. Actual sciatica does not usually skip the leg and go straight to the ankle. Individual nerve roots from the low back can cause radiating pain just to the ankle, but usually back pain will also be present in those cases. So again, I think the ankle itself is probably the problem. Many times with ankle torsion injuries, one or more joints can become jammed or misaligned, and most medical doctors are not particularly well-versed in assessing or treating such issues. My suggestion is to get checked by a sports chiropractor or osteopathic doctor who is experienced with extremity problems. As long as there’s no ligament or other significant soft tissue damage, it’s probably something that can be corrected relatively easily. Good luck!

      Dr. Best

  • Sklee

    Reply Reply May 2, 2016

    Can the sciatica nerves problem of the foot affect the sensation the soles of the fèetc?

    • Dr. George Best

      Reply Reply May 2, 2016

      When sciatica extends to the foot, it can cause symptoms such as burining, tingling, electric shock sensations or numbness. But symptoms in one or both feet without symptoms higher up in the leg(s) is usually not from sciatic nerve irritation. If only the feet are involved, and especially if it’s both feet, it’s more likely to be some type of peripheral neuropathy (such as from diabetes) or possibly due to spinal stenosis impinging on the spinal cord and producing a condition called myelopathy.

      Dr. Best

  • Brenda

    Reply Reply June 17, 2016

    I have just the opposite issue…. I have been diagnosed with Plantar Fasciitis. I got custom orthotics for my shoes and my Sciatica has flared up.

    How long before it quiets or will it?

    • Dr. George Best

      Reply Reply June 18, 2016

      There are too many variables to be able to answer your question. If you only developed sciatica after you started using the orthotics, I would recommend discussing the issue with the doctor who provided the orthotics. It is possible that they are not fitted quite right for you and may be causing alterations in your gait that are causing irritation of a pre-existing disc condition and/or piriformis syndrome.

      Dr. Best

  • Juan Herrera

    Reply Reply June 18, 2016

    Hello Dr.,

    A little off the subject but related to my foot. I noticed the the arch on my left foot had started to fall about 8 years ago. I first started noticing that my arch would cramp up out of nowhere which caused severe temporary pain. Now I have pain all the time.
    Most recently, on the same foot I have notice that I lost noticeable strength in the last three toes. I am not able to push off, and the tips seem floppy. The pinky toe is the most noticeable because it flops over to the left as if the were double jointed. Have you ever encountered this in your practice, and is it related to my falling arch?
    I did have a fractured 3rd L/H metarsal about 18 yrs ago and have been diagnosed for my lower back pain with mild anterior wedging of T12 and mild disc narrowing L4-L5 & L5-S1.

    Any help is greatly appreciated as I have been to a pediotrist and he has recommended exercising my toes.

    Thank you,

    Juan

    • Dr. George Best

      Reply Reply June 18, 2016

      My guess is that you’ve altered your gait over the years due to the pain and it has resulted in weakness of the toes. You may also have some joint dysfunction/misalignment in the foot that could be either a cause of the pain, or an effect of the aforementioned gait alteration. Assuming that there is not some sort of neurological loss producing the weakness, exercising the toes should help. I would suggest consulting with a sports chiropractor (one who is experienced with working with extraspinal joints – not all chiropractor are) to have the joint alignment and motion evaluated, as it is a potential issue and not something that most podiatrists are trained to evaluate.

      Good luck!

      Dr. Best

  • Kabeer

    Reply Reply July 25, 2016

    Hey doctor
    Am i have painful pain in my back,glute thight knee and foot mostly the pain is more painful in the lower back,glute and knee I can’t sit for more than 20mn without pain coming i like standing,walking rather than sitting it pain me most while sitting in the car mostly in my glute and very sensitive to hand touch in the thigh.Any help please

    • Dr. George Best

      Reply Reply July 26, 2016

      First of all, please allow a little time to receive an answer to any questions you post. I answer all questions personally and it may take me a day or so to get to it. Repeatedly requesting a response only slows the process down.

      Anyway, from the description of your symptoms, my best guess is that you probably have a disc protrusion in your low back. I suggest you start with the methods in my free ebook. If you have not already downloaded it, you may do so from this page:

      http://www.sciaticaselfcare.com/basic-sciatica-exercises/

      If you do not get significant improvement with the methods in the ebook within 1 to 2 weeks, I would strongly recommend being evaluated by a doctor, and probably have an MRI to evaluate the situation and determine the best course of action.

      Good luck!

      Dr. Best

  • Michael O

    Reply Reply August 14, 2016

    Great video. I think my latest, bad and persistent, relapse into sciatica was caused in part by wearing sandals without arch supports. I had usually been using Finn Comfort insoles in everything – shoes, rubber boots, slippers for about 10 years. Having been pain free for about two years (I think thanks to daily Yoga and time on the inversion table) I got overconfident. Built a deck that involved lifting 16 foot lumber and swiveling it to get it sawed and in place. And wore regular sandals. I’m currently two days into the exercise and icing recommended in your e-book. Thanks.

    • Dr. George Best

      Reply Reply August 15, 2016

      You’re welcome. The lifting, bending, and twisting involved in building the deck probably contributed to the flare-up as well, but the better the arches are supported, the less problems you are likely to have.

      Dr. Best

  • Bethany M

    Reply Reply September 30, 2016

    Hi,
    Had an L4/5 s1 building disc from 16 years ago. Siatica used to come and go, recently acted up again. Started PT about 8 weeks ago, doing Macenzie method and other strenthgnen exercises. Had a recent MRI , showed some mild edema and some progression of building disc same area. Other nothing too significant. Was getting better in PT but know developed sharp nerve pain on bottom of foot. Pain when walking and also when having a bowel movement. Also, when I press on my buttocks I get the pain on the bottom of the foot. Could this be piriformis muscle , my PT says he thinks mostly muscular . Confused because was getting better? Help please!!

    • Dr. George Best

      Reply Reply September 30, 2016

      The problem could be the piriformis and/or gluteus minimus muscle, but there could be direct nerve involvement up around the bulging disc as well. In either case, a number of things can cause flare ups in symptoms, ranging from stress, to increased amounts of sitting, to even dietary factors (sometimes foods can trigger inflammatory reactions in certain people and it can be difficult to determine what it is that’s causing the reaction). If you had initial improvement with your PT, chances are they will improve again. A lot of times it’s a matter of overcoming the “bad” activities that aggravate the back like prolonged sitting with more frequent use of the McKenzie and other exercises that have been helpful.

      Good luck!

      Dr. Best

  • Aleshanee

    Reply Reply October 1, 2016

    I’ve had sciatic flares for over 3 decades now. Usually, my first response is my inversion table and lower back stretches and the flare usually lasts 3-4 day. Currently, I’m having an extreme flare that has lasted 6 weeks! I have been bedridden for 4 of those weeks because the pain is unbearable. I’ve been to the emergency room twice, screaming for relief. The medical community has let me down. I haven’t been able to get appointments for neurologists, orthopedists or even pain management until many weeks from now. I’m undergoing acupuncture, which helps relieve the pain some, but my gait is really messed up. I’m shuffling like an elderly person. This ordeal has left me psychologically scarred with depression and hopelessness. My chiropractor isn’t even helping, and I’m at a loss as to what is going on and what else I can do. Walking, sitting or standing is impossible for any length of time, like more than 30 seconds. I’m at my wit’s end.

    • Dr. George Best

      Reply Reply October 1, 2016

      You didn’t mention what, if any recent diagnostic imaging has been done or what the results were, so I’m going to assume that you have not had a recent MRI. If that’s the case, I’d say that would be the first step to get an updated evaluation of the potential underlying cause(s) to give an idea of what your treatment options are. In most cases, a chiropractor can order an MRI and you can have it done and get the results within a few days. Depending on the results of the MRI, you may be able to get an expedited appointment with a specialist if needed. So, my recommendation is to see if your chiropractor can/will order an MRI for you ASAP. In the meantime, you can try the methods in my free ebook and hopefully that will help to some degree. If you don’t already have the ebook, you may download it from this page: .

      Once you have the MRI results, if you have further questions, feel free to contact me.

      Good luck!

      Dr. Best

      • Aleshanee

        Reply Reply October 1, 2016

        Sorry, yes during one of the emergency visits, they did an MRI. They spotted the pinch in the L5-S1. They told me to visit my family doctor, who tried to do a muscular injection that didn’t work. He has referred me to specialists, who have a long waiting lists so I’m confined to lying flat with pillows supporting my lower legs. He prescribed Gabapentin, which doesn’t do much in pain relief. I have tried to do some floor stretches and every time I do the nerve pain increases. My mind is crazy from the constant agony and the frustration of getting no help. I have to resort to crawling to get to the bathroom.

        • Dr. George Best

          Reply Reply October 2, 2016

          Depending on the specifics and severity of the MRI findings and where you live (the following strategy usually doesn’t work in Canada, UK, or other countries with a National Health System), your family doctor might be able to get you in to a specialist sooner. In my experience with cases that needed faster intervention, when I called the doctor I was referring to personally (or at least spoke directly to his/her office manager) and explained the situation, I’ve usually been able to secure a much faster appointment for my patients who were in dire need – in some cases, same day appointments with doctors with a 3 month or longer waiting list (and as a chiropractor, I don’t exactly have such high status in the medical community that they’d be bending over backwards just to make me happy). That would be something to inquire with your doctor about.

          In the meantime, my original suggestion to try the methods in my free ebook stands. Just be sure to carefully review and follow all of the instructions for the McKenzie method, especially regarding testing for the ONE position that best centralizes the symptoms (explained in the directions). In addition to using cold packs as directed in the ebook, I also recommend you either try over the counter anti-inflammatories (such as ibuprofen or naproxen), or talk to your doctor about possibly getting a prescription for some type of anti-inflammatory. In many cases, inflammatory swelling is a significant contributor to nerve compression symptoms and anti-inflammatory medication often works much better than pain medication in such cases.

          Good luck!

          Dr. Best

  • Edmund

    Reply Reply October 20, 2016

    Dr. Best, this is exactly the problem I have! Do you have any recommendations for treatment or even a referral for someone who can treat this in NYC? Thanks!

    • Dr. George Best

      Reply Reply October 20, 2016

      Hello Edmund,

      The most practical approach is usually to get fitted for orthotics. I have had good results over the years with Footlevelers and they are a popular brand among chiropractors. While I don’t have a specific provider to recommend in your area, I suggest you contact Footlevelers (http://www.footlevelers.com) for a list of local doctors.

      Good luck,

      Dr. Best

  • Cory

    Reply Reply November 11, 2016

    Dr. Best,

    2 years ago I developed sciatica down my right leg that resulted in pain in my foot along the S-1 nerve from heel to toe(s). I ended up having a microdiskectomy L-5/S-1 because of nerve root impingement which did not help and just recently had my L-5/S-1 vertebrae fused. The sciatic pain down my leg has subsided but I still have pain in my foot that increases the longer I stand and walk around. I have noticed that the muscle tissue from the front right side of my foot to my heel is plagued with small knots, I believe now that they are the left over damage from 2 years of my S-1 nerve being impinged upon due to a herniated disk.

    My question is: how do treat what seems to be muscle tissue that has been knotted up and scarred from 2 years of nerve root impingement?

    I have found some relief with (self)dry needling and massaging the area but I would like your take on it. The more I stand up and walk around the more inflamed each of these little knots becomes and the pain is unbearable.

    • Dr. George Best

      Reply Reply November 11, 2016

      Hello Cory,

      I suggest you see a chiropractor who works with foot issues (not all do). In addition to the soft tissue knots, you may have some areas of joint misalignment or dysfunction that is contributing to your symptoms. If so, then getting the joints corrected will make it a lot easier to get the soft tissue problems to settle down. It might also be worthwhile to have some professional massage therapy on your foot to help get you past the worst of the restrictions and make it easier to manage it on your own.

      Good luck!

      Dr. Best

  • Chris Gigliotti

    Reply Reply November 17, 2016

    Doctor,

    I am a bit confused with what I saw on the You Tube Video and so I am submitting a Comment for your response.

    I have fallen arches and did get some arch supports (not professionally sized by a Doctor) that I have been wearing in my shoes for a few years now.

    My confusion is that the heels of my shoes are wearing out on the Outside Edge of each shoe. (Not the inside edge of each shoe as the You Tube Video describes.)

    Question: Could my Arch Supports possibly be TOO HIGH OF AN ARCH and causing my walking gait to be causing the above phenomenon??
    (My knees do not hurt but I do have lower back issues and wonder if there is something I should consider doing to help my lower back situation somewhat.)

    Your response would be greatly appreciated.

    Sincerely,

    Chris Gigliotti

    • Dr. George Best

      Reply Reply November 17, 2016

      Hello Chris,

      I’m not sure which video you’re referring to, but the most common situation is for the heels of shoes to wear faster on the outside edge. A small amount of wear on the outside edge is not really a concern, but if it’s significant on relatively new shoes, it may be a sign of foot pronation, which is commonly associated with inadequate arch stability/support. So, in answer to your question, it is unlikely that you have too much arch support. Even with good arch support, people who tend to pronate will still usually have some increased wear on the outer edge of the heels of shoes, and that wear tends to accelerate as time goes on (the tilting of the shoe leads to more stress on the outer heel). Because of this, it is important to monitor one’s shoes and replace or re-sole them before significant wear occurs and it produces undue mechanical stress on the body.

      Dr. Best

  • Sabrina

    Reply Reply January 11, 2017

    These are all my symptoms!!!! I am a bartender, on my feet all day! Can you sugges some in soles for my shoes???

    • Dr. George Best

      Reply Reply January 11, 2017

      The best would be a custom-fitted orthotic such as Footlevelers available through many chiropractors or orthotics from a podiatrist (the semi-flexible type with some built-in shock-absorption are preferable to the rigid type in my opinion). Custom orthotics are usually in the $300-$500 range (it pays to shop around because there can be a big price difference for the exact same orthotic from one clinic to another), but they will work better and far outlast any generic insole I know of. That said, if you need something more budget-friendly at least in the short-term, almost any of the off the shelf insoles with arch support will probably help. Dr. Scholl’s Custom Fit system was very popular as a way of getting semi-custom orthotics initially, but I’ve seen some complaints recently about their durability (specifically the Custom Fit line, not Dr. Scholl’s in general). At the price (about $50 a pair), I think you’re better off going with a higher grade of custom orthotics and just use an off the shelf insole in the meantime if you need to save up for the custom ones.

      Good luck!

      Dr. Best

  • Sabrina

    Reply Reply January 14, 2017

    Thank you so much Dr best. Is this burning in my feet something I have to live with for the rest of my life or is there something I can do to heal the nerves in my feet….the pain wakes me up out of my sleep. I take gabapentin and also a cream with gapatetin in it…I’m just completely miserable. Im 45 with a wonderful grandson, and I don’t want to suffer from this forever.can you provide me with something I can do? Thanks Dr Best!

    • Dr. George Best

      Reply Reply January 14, 2017

      Hello Sabrina,

      You haven’t said what your diagnosis is, or if you’ve even really been diagnosed. All too often doctors will just write a prescription based on symptoms without really making an effort to determine what the problem actually is. With what information you have provided, I don’t think what you have is sciatica, but more likely either plantar fasciitis or some type of peripheral neuropathy in your feet. If there is confirmed peripheral neuropathy (documented by some sort of neurological testing), I would recommend being checked for diabetes as well as Vitamin B12 and Folic acid deficiency. Many cases of peripheral neuropathy are “idiopathic”, meaning that no cause can be determined. In those cases, drugs like gabapentin are the common medical treatment, but I’d suggest looking into acupuncture or possibly magnetic insoles as a means of decreasing the symptoms. If the problem is plantat fasciitis, the symptoms will typically be worst after a prolonged time off your feet and will gradually decrease once you are up and moving around. Plantar fasciitis typically responds well to the use of orthotics, as well as massage and chiropractic manipulation of the feet and ankles.

      The prognosis for recovery really depends on what the problem is. Most likely your symptoms can at least be greatly improved if the problem can be identified and properly addressed.

      Dr. Best

  • David Daddona

    Reply Reply January 14, 2017

    I had formed inserts made in August 2016..Was supposed to go back to Doc after a few weeks if adjustments were needed. Due to other family issues, never made a return appt.Inserts were a Godsend for about 2 months, but I started having issues with my left foot.This past week, I started having issues with a heavy leg at times and tingling in the back of leg, with knee pain..Went to family Physician, and he diagnosed Sciatica.I know I need to call my foot Doctor, but til I get appointment, are there exercises I could do? Should I stop wearing my inserts til appointment? Something elseto use til then? Thanks!

    • Dr. George Best

      Reply Reply January 14, 2017

      Hello David,

      If the inserts were working well for 2 months, it’s unlikely that they’d suddenly become a problem. I don’t think there’s a reason to stop wearing them unless your symptoms seem to improve when you’re not wearing them. With just the innformation you’ve provided and without being able to examine you, I’d say that your symptoms are most likely coming from the lower spine and/or pelvis area. My suggestion is to try the self-treatment methods in my free ebook to start. You may download it from the link on the right sidebar here.

      Good luck!

      Dr.Best

  • Selby Myers

    Reply Reply January 23, 2017

    Doctor,
    I am very impressed to find a doctor who understand the interconnection of the foot and sciatic pain. I was about an hour in composing the development of my Odyssey from foot pain through hospital treatment, inpatient therapy, outpatient therapy, two neuro surgeons, disc stabilization, an epidural shot, referral to a physiatrist, another steroid shot into my hip, opioid medicine, and most lately an MRI of my pelvic region.
    My e-mail draft somehow disappeared, much before I could conclude it. I even forgot to mention early visits to my chiropractor and two massage therapists. Long story short, I received only very short help from each massage. The drug–Nucynta–is the first opioid I can tolerate but it is outrageously expensive!
    My Richie brace isn’t effective because it is constructed with Velcro straps, the least effective method for fastening a brace I have seen. So I have newly recurring left foot pain. I may still have surgery.
    I am a complicated patient. I have type two diabetes, hypothyroidism,slight kidney impairment, enlarged prostate, knee replacements,and hypertension–all conditions addressed successfully. Until last year, I attended aquatic exercise class three times each week, walk my dog, work a small vegetable garden, and am reasonably active.
    With my genetic history, I should live another two decades. But I have trouble with hip pain and impaired mobility. Hopefully my physiatrist will solve my hip pain. What do you advise about my left foot and ankle?

    • Dr. George Best

      Reply Reply January 25, 2017

      Hello Selby,

      You didn’t say what the issue is with your foot and ankle other than pain, if you’ve even been given a diagnosis. Given the other health conditions you mentioned, the foot and ankle issues may be a primary problem – in other words, an issue directly in the structures of the foot and ankle. The symptoms may also be secondary to sciatic nerve issues and/or your diabetes. So, I can’t provide any suggestions without knowing more specifically about the foot and ankle.

      Dr. Best

  • Jyoti

    Reply Reply June 5, 2017

    Hi! My name is Jyoti. I suffered a lot of pain in my hamstring and buttocks a couple of months ago, the doctor advised to get a MRI. The report revealed that I have a mild disc bulge at L5-S1 junction. I have been doing back exercises as advised by the doctor religiously but the pain doesn’t seem to go away. It has reduced significantly a couple of time but then increased again. I do not have any pain in my back. I also don’t have any pain while sitting. It only comes while standing or walking. Please help.

    • Dr. George Best

      Reply Reply June 5, 2017

      Mild disc bulges often produce no symptoms at all and my thought is that the disc bulge may not be the source of your symptoms at all. The fact that you only have the pain while standing or walking actually sounds more like a sacroiliac problem to me. My suggestion is to consult with a chiropractor to get the joints checked out. Chances are it is something that can be corrected relatively easily.

      Good luck!

      Dr. Best

  • Jyoti

    Reply Reply June 6, 2017

    Thank you so much Doctor. So far I am being treated for the disc bulge only. I have had sciatica for over 2 months now. Can sacroiliac also cause sciatica like pain?

    • Dr. George Best

      Reply Reply June 6, 2017

      Yes, misalignment or dysfunction in the sacroiliac joint often causes reaction in the piriformis and gluteus minimus muscles, both of which can produce symptoms similar to sciatica.

      Dr. Best

  • Laura

    Reply Reply June 29, 2017

    Hi Dr. …I had a ligament injury in the knee that I now know developed from collapsing arch (the arch itself is higher than on healthy foot, but dr says I have collapsed arch from looking at forefoot etc). I developed nerve pain in foot and up leg to knee. Was walking on crutches because of knee problem, but compounded everything by developing a disc issue from crutches and wear and tear. MRI showed a protrusion and l4/5. My knee was healing so I ditched crutches, but still suffered sciatica pain. PT gave me McKenzie exercises which got rid of that pain in leg. My problem is my arch differences in my two feet and pronating was giving me tendinitis in anterior t and posterior t tendons of the one foot. So I was fitted with custom Eva orthotics with arch support. For years I had been wearing softer off the shelf (air plus) 3/4 length with a bit of arch support. The change from the softer to harder insole with is putting pressure on sole and giving me nerve pain under my foot radiating up to knee and am feeling some muscle weakness in leg again so it’s a vicious cycle with sciatica coming back or just plantar f being irritated? Should I ditch insoles? My sciatica or collapsing arch led to inability to stand on toes so I can’t afford to have more muscle weakness. But the tendinitis is horrible in posterior and anterior tibial tendons without arch support. Ultra sound showed minor inflammation in these tendons, but thickness and pain makes walking difficult. Thanks for any advice.

  • Laura

    Reply Reply June 29, 2017

    Let me add..worked in daycare on my feet all day, lifting children etc, so it seems as if the bulging disc may have triggered the knee and foot issues. But I distinctly remember feeling something in my back give while using crutches for knee problem..so it’s a case of chicken or the egg for the origins of my three issues:). My main concern is my foot right now..I used to walk miles every day and since all of this happened in March, I can only manage 500 meters at a time because of tendon pain.

    • Dr. George Best

      Reply Reply June 30, 2017

      Hello Laura,

      I suggest getting a second opinion on your foot issues. It definitely sounds like the orthotics you currently have are not right for you. Some people can’t tolerate the relatively rigid orthotics at all, and sometimes it’s a matter of them not having been properly fitted by the prescribing doctor, but whatever the reason, it sounds like the ones you have are not appropriate for you. If possible, I suggest seeing a sports chiropractor, as an assessment of the alignment and function of the joints in the foot and ankle, as well as the stability of the arch would probably be helpful. Most sports chiropractors also provide custom-fitted orthotics, and usually use a semi-flexible type that provides support as well as shock-absorption, which I think you’ll find are much more comfortable than the EVA type. If that’s not available to you, you may ery well be better off going back to the off the shelf inserts you were using before, perhaps going to one with a bit higher arch support if available.

      Good luck,

      Dr. Best

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