Piriformis Syndrome

Piriformis syndrome is an uncommon neuromuscular disorder that is caused when the piriformis muscle compresses the sciatic nerve. The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk, shift our weight from one foot to another, and maintain balance. It is also used in sports that involve lifting and rotating the thighs -- in short, in almost every motion of the hips and legs.

The sciatic nerve is a thick and long nerve in the body. It passes alongside or goes through the piriformis muscle, goes down the back of the leg, and eventually branches off into smaller nerves that end in the feet. Nerve compression can be caused by spasm of the piriformis muscle.

 

Piriformis Syndrome Signs and Symptoms

Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time. Most cases of sciatica, however, are not due to piriformis syndrome.

Piriformis Syndrome Diagnosis

There is no definitive test for piriformis syndrome. In many cases, there is a history of trauma to the area, repetitive, vigorous activity such as long-distance running, or prolonged sitting. Diagnosis of piriformis syndrome is made by the patient’s report of symptoms and by physical exam using a variety of movements to elicit pain to the piriformis muscle. In some cases, a contracted or tender piriformis muscle can be found on physical exam.

Because symptoms can be similar in other conditions, radiologic tests such as MRIs may be required to rule out other causes of sciatic nerve compression, such as a herniated disc.

Piriformis Syndrome Treatment

If pain is caused by sitting or certain activities, try to avoid positions that trigger pain. Rest, ice, and heat may help relieve symptoms. A doctor or physical therapist can suggest a program of exercises and stretches to help reduce sciatic nerve compression. Osteopathic manipulative treatment has been used to help relieve pain and increase range of motion. Some health care providers may recommend anti-inflammatory medications, muscle relaxants, or injections with a corticosteroid or anesthetic. Other therapies such as iontophoresis, which uses a mild electric current, and injection with botulinum toxin (botox) have been tried by some doctors. Using the paralytic properties of the botulinum toxin, botox injections is thought by some to relieve muscle tightness and sciatic nerve compression to minimize pain.

Surgery may be recommended as a last resort.

Prevention of Piriformis Syndrome

Since piriformis syndrome is usually caused by sports or movement that repeatedly stresses the piriformis muscle, such as running or lunging, prevention is often related to good form. Avoid running or exercising on hills or uneven surfaces. Warm up properly before activity and increase intensity gradually. Use good posture while running, walking, or exercising. If pain occurs, stop the activity and rest until pain subsides. See a health care provider as needed.

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Acupuncture Benefits Sleep, Reduces Stress

Acupuncture successfully improves sleep quality and reduces both stress and depression in the elderly. Published in Neuroscience Letters, researchers made this determination based on a randomized, placebo-controlled study. The researchers note that “the rigorous methodology employed in this study ensured the reliability of the results concerning the improved sleep quality and relaxation effects involved with acupuncture during aging.” 

Acupuncture significantly improved the Pittsburg sleep quality index (PSQI) scores, indicating substantial sleep quality improvements. In addition, beck depression inventory (BDI) and the perceived stress scale (PSS) measures demonstrated significant clinical improvements. True acupuncture demonstrated significant positive patient outcomes for improvements in sleep quality and reduction of both depression and stress. The researchers note, “No significant changes were observed in the placebo group.” The researchers add that the strict controls employed during the study “demonstrate the real effects of acupuncture.”

Acupuncture was applied to elderly patients in a hospital outpatient setting. Licensed acupuncturists applied the acupuncture needles while patients rested in a supine position on a stretcher. Acupuncture was applied at a rate of twice per week for a total of 25 minutes of needle retention time per treatment session. Each patient received a grand total of 10 acupuncture treatments. Sterile disposable acupuncture needles were applied to acupuncture points:

  • SP6 (Sanyinjiao)
  • LI4 (Hegu)
  • ST36 (Zusanli)
  • LV3 (Taichong)
  • PC6 (Neiguan)
  • Ex-NH3 (Yintang)

Manual needle stimulation was applied to the needles frequently during each acupuncture treatment session. For the placebo-controlled sham acupuncture group, acupuncture needles were applied to areas of the body not associated with classic acupuncture points as defined by Traditional Chinese Medicine (TCM). In addition, the placebo-controlled group’s needles were applied to a superficial depth without needle stimulation.

The acupuncture point prescription choice was similar to a prescription in a related study. The researchers note that Sun et al. used acupuncture points including ST36, SP6, PC6, and LV3 in an investigation of acupuncture’s effects on major depressive disorder (MDD). The researchers note that Sun et al. “found similar antidepressant effects of electroacupuncture (EA) as compared to fluoxetine-treated patients.” Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant medication. It is also known by its trade names including Prozac and Sarafem.

The researchers add that electroacupuncture “had a faster onset of action, better response rate, and better improvement rate than fluoxetine, indicating that acupuncture can be a good intervention method for ameliorating psychological distress and depressive symptoms, thereby promoting relaxation and well-being.” Although there were similarities to Sun et al., the sleep researchers employed manual acupuncture stimulation whereas Sun et al. employed electroacupuncture. This contrast demonstrates that both electroacupuncture and manual acupuncture have therapeutic value in the treatment of depression. 

The researchers note that additional studies are required to investigate the effects of acupuncture on the process of immunosenescence, the process of immune system of deterioration due to aging. 

They cite research demonstrating that “adequate sleep helps fight infection and improves immunity after vaccinations” and “increased sleep duration was associated with increased number of circulating immune cells.” The current study demonstrates that acupuncture benefits sleep in the elderly. This suggests potential benefits to overall immune system function. As a result, the researchers call for studies to investigate the impact of acupuncture on immunity in the elderly.


For more information:
http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1439-acupuncture-benefits-sleep-reduces-stress

 

Heart Benefits of Massage Therapy

Many already view massage as an important approach to relieving muscle pain or as a means to relax. However, working with a qualified massage therapist can also play a significant role in improving cardiovascular health as evidenced by a growing body of research, according to the American Massage Therapy Association (AMTA).

Massage therapists share the goal of all health-care team members – providing customizable, personalized care to help clients or patients reach and maintain their best health. Incorporating regular visits to a massage therapist into an individualized care plan can relieve stress (a major contributor to heart problems), lower blood pressure and lead to a decrease in recovery time following a cardiovascular procedure. [Watch: Dr. Brent Bauer of the Mayo Clinic discusses the cardiovascular benefits of massage]

A multitude of recent research shows a direct correlation between massage therapy and improved cardiovascular health. In a 2013 study in the International Journal of Preventive Medicine, researchers concluded massage therapy could serve as an effective intervention in controlling blood pressure in pre-hypertensive women. The study showed that the immediate results of lowered blood pressure lasted up to 72 hours after massage.

A separate study in the same publication had similar findings; those that received regular Swedish Massage Therapy over a period of four weeks had significantly lower blood pressure than those who did not have a massage.

The American Heart Association (AHA) warns against the risks of high blood pressure, which can lead to cardiovascular issues including stroke, heart disease and kidney failure. With proactive management of high blood pressure, individuals can lower their chance of developing these conditions.

"Most clients think of massage therapy as a useful approach for managing back pain or promoting relaxation, but there are other benefits to massage that improve overall health, particularly when it comes to the heart," said Nancy M. Porambo, president of the AMTA. "Many see tremendous outcomes from introducing massage into their cardiovascular rehabilitation routine, as this Research Round-up shows."

A qualified massage therapist can play an important role in the health-care team for individuals dealing with cardiovascular issues, high blood pressure or increased stress levels, the association said. Individuals should consult with a qualified massage therapist to determine the best massage therapy approach for their specific needs.

By meeting or exceeding state training requirements, ascribing to a code of ethics and participating in continuing education, qualified massage therapists are appropriate additions to any wellness regimen; able to create specialized approaches based on individual conditions, fitness and goals, the AMTA said.

- See more at: http://www.massagetherapycanada.com/research/studies-highlight-heart-benefits-of-massage-therapy-2464#sthash.UeEwesGY.dpuf

Want to Improve Your Willpower?

While it makes sense that meditation would be linked to greater willpower, who'd have thought procrastination could also do the trick?

One of the key parts of our culture at Buffer is a focus on self-improvement. We each pick an area to improve on each week and share our daily progress and challenges, making it a social, supportive way to adjust, create or change our habits.

There’s still a lot of work to be done for self-improvement to be effective, though. I’ve been through a bunch of different improvement focuses in the last few months, including positivity, running, reading more and learning French. Each one has been fun to focus on, but it’s hard to keep more than one new habit going at a time—partly because it takes so much willpower.

What willpower is and how it works in the brain

Kelly McGonigal, PhD, and author of The Willpower Instinct says willpower is a response that comes from both the brain and the body.

The willpower response is a reaction to an internal conflict. You want to do one thing, such as smoke a cigarette or supersize your lunch, but know you shouldn’t. Or you know you should do something, like file your taxes or go to the gym, but you’d rather do nothing.

The prefontal cortex (that section of the brain right behind your ) is the part that helps us with things like decision-making and regulating our behavior. Self-control, or willpower, falls under this heading, and thus is taken care of in this part of the brain.

To be effective at controlling our urges and making sound decisions, the prefontal cortex needs to be looked after. That means feeding it with good-quality food so it has enough energy to do its job and getting enough sleep.

How willpower gets depleted throughout the day

McGonigal points out that one of the most replicated findings about willpower is that it seems to be finite—that is, we only have so much and it runs out as we use it.

Trying to control your temper, ignore distractions or refuse seconds all tap the same source of strength.

We can look at willpower like a muscle—it can get exhausted by overuse, but just like our physical muscles, there are some researchers who believe we might be able to strengthen our willpower by training it.

How to increase your willpower

Okay, we know that we only have so much willpower and as we go about our day, stress and normal self-control depletes our resource. Let’s see what options we have for increasing the pool of willpower we have to draw from.

1. Increase your capacity for pressure: Learn how to manage stress

To start with, we need to manage our stress levels, says McGonigal. Being under high levels of stress means that our body’s energy is used up in acting instinctively and making decisions based on short-term outcomes. Our prefrontal cortex loses out in the battle for our energy when high-stress is involved.

McGonigal says that stopping to take a few deep breaths when we feel overwhelmed or tempted can be a great start in managing our stress levels and improving our willpower.

2. Encourage yourself to stick to your plan

To make it even easier, it appears that self-affirmation can even help you to have more self-control when you’re running out, according to a study published in the Journal of Personality and Social Psychology. A good example of this is the difference between telling yourself "I can’t" and "I don’t." Taking back control of the situation using the phrase "I don’t" has been shown to be more effective at helping you to stick to your plan and break bad habits:

Every time you tell yourself "I can’t," you’re creating a feedback loop that is a reminder of your limitations. This terminology indicates that you’re forcing yourself to do something you don’t want to do.

So try telling yourself that you don’t do that bad habit, rather than punishing yourself by saying "I can’t."

3. Get more sleep to help your brain manage energy better

McGonigal also says getting enough sleep makes a big difference to how efficiently our prefrontal cortex works:

Sleep deprivation (even just getting less than six hours a night) is a kind of chronic stress that impairs how the body and brain use energy. The prefrontal cortex is especially hard hit and it loses control over the regions of the brain that create cravings and the stress response.

Luckily, McGonigal also cites studies that have shown we can make this work in our favor by ensuring we get enough sleep:

When the sleep-deprived catch a better night’s sleep, their brain scans no longer show signs of prefrontal cortex impairment.

And if you’re wondering how much sleep is enough, here’s a rough guide: one of the most acclaimed sleep researchers, Daniel Kripke, found in a recent study that "people who sleep between 6.5 hours and 7.5 hours a night, live the longest, are happier and most productive."

4. Meditate (for as little as eight weeks)

Meditation has also been linked to increasing the reserve of willpower we have available, as well as improving attention, focus, stress management, and self-awareness. McGonigal suggests this can even give fast results:

And it doesn’t take a lifetime of practice—brain changes have been observed after eight weeks of brief daily meditation training.

5. Better exercise and nutrition: The most ignored route to higher willpower

Another great way to train the brain, that is often easily ignored or undervalued, yet can make you a lot more resilient to stress, and thus boost willpower, is regular physical exercise. Both relaxing, mindful exercise like yoga and intense physical training can provide these benefits, though McGonigal points out that we’re not sure why this works yet.

As I mentioned earlier, what you feed your body affects how much energy the prefrontal cortex has to work with. This is why nutrition is so important:

Something as simple as eating a more plant-based, less-processed diet makes energy more available to brain and can improve every aspect of willpower.

Not only will exercise and good nutrition improve your willpower, but they’ll make you feel better as well. Exercise in particular is known for making us happy by releasing endorphins:

These endorphins tend to minimize the discomfort of exercise, block the feeling of pain and are even associated with a feeling of euphoria.

6. Postpone things for later to gain focus on what’s important now

Postponing something you really shouldn’t have can be effective if you’re trying to break a bad habit. In Willpower: Rediscovering the Greatest Human Strength, Roy F. Baumeister explains that people who tell themselves "not now, but later," are generally less tormented by the temptation of something they are trying to avoid (his example is eating chocolate cake).

A treat for you, since you waited this long

One last thing. You might have heard of a famous experiment using marshmallows to test kids’ willpower. What happens is a child is left alone in a room with one marshmallow for an undefined period of time. If they can resist eating the marshmallow, they’re rewarded with a second marshmallow at the end of the experiment. If they eat the marshmallow before time is up, they only get that one.

Written by Belle Beth Cooper

For more information:
http://www.fastcompany.com/3032513/work-smart/6-scientifically-proven-ways-to-boost-your-self-control