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C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 103 In clinical practice, I am not a proponent of disease labeling and find that pep-talking clients does more to improve therapeutic outcomes than focusing on a perceived pathology. For example, discussing X-ray findings such as a herniated disc often plants dramatic negative images (the nocebo effect) that may cause the client unintended psychogenic harm. However, in this therapist-oriented article, I feel compelled to include a "fly-by" on sciatic pathology and symptomology to demonstrate how I was able to reduce neural inflammation and sciatic entrapment pain caused by an L4–L5 central disc protrusion. A 2016 Journal of Neurosurgery study suggests a good prognosis for those of us suffering our first bout of sciatica. 1 In fact, the study's authors found that 60–80 percent of sciatica sufferers report a spontaneous resolution of the leg pain in six to eight weeks, but there is a catch: the odds of this spontaneous pain relief depend on the type of disc problem that caused the pain in the first place (Image 2). The researchers discovered spontaneous regression in 96 percent of subjects with disc sequestration, 70 percent with disc extrusion, and 41 percent with disc protrusion. The disc protrusion illustrated in Image 3 is the exact type that has plagued me the past eight weeks. Notice that the distended disc nucleus is still encapsulated, but it's shoving the annular fibers against the spinal cord. Surprisingly, my MRI was completely clean other than this innocent-looking little disc bulge. The medical community's opinion about the puzzling onset and severity of my symptoms is that the impaired disc had probably been asymptomatically dormant and was triggered by awkward hospital-bed positioning. The downside to this type of disc protrusion is that, left untreated, statistically only 41 percent of people with this disc problem heal themselves. The upside is that I was a bit smarter with the low-back situation than I was with my knees. Resolution of the unrelenting pain came from a combination of myoskeletal bodywork—to align, decompress, and flush inflammatory agents from the lumbar spine (Image 4)—and corrective nerve-mobilization exercises, designed to release entrapments along the entire length of the sciatic nerve (Image 5). As my sciatica improved, the burning, stabbing, and muscle spasticity slowly began to leave my legs and move to the low back. This is a common sign of sciatic healing, which was further enhanced by the addition of a variety of playful exercises, meditation, and improved nutrition. Note 1. A. El Barzouhi et al., "Prognostic Value of Magnetic Resonance Imaging Findings in Patients with Sciatica," Journal of Neurosurgery: Spine 24, no. 6 (June 2016): 978–85. Erik Dalton, PhD, is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, Dalton has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit www.erikdalton.com. 3 4 5 L4–L5 central disc protrusion compressing the spinal cord. Paul Kelly performs a MAT decompression pumping routine on the author to flush inflammatory agents. Sciatic nerve mobilization techniques—stretch and floss—helped the author improve his sciatica.