amyjenner: October 16, 2019, 1:11am
42 yr old female, married, nurse, mother of 2 grade school kids. Medium athletic build. Thin, muscular not skinny.
Sciatica originates from the left piriformis and runs down to the back of the knee. Occasionally the foot is affected
w pain/numbness. Pain has been 8-9/10. Her low back and leg are super tight. It started after a chiropractic
adjustment of the sacrum. She has been on prednizone for 10 days and finished the course 2 days ago. Is now on
prescription ibuprofen. She worked today, and the pain is high at 4.15 this afternoon 8/10. Had an xray that showed
a narrowing of the L5 S1 foramin and it is not clear why it is so aggravated now.
Slp: easy to fall asleep but will often leap out of bed an hour later afraid she has forgotten something. Has to run
through all the things in her mind to go back to sleep. Also, sleep talks. this pain is making sleep challenging
because its hard to find comfortable position.
Symmetry average.
skin: sl dry, likes to oil
thenar: flat
Heel: flat and dry
dig good. avoids dairy dt bloating/constipation
Menstrual: PMS monthly +4. On a low dose BCP. No clots or cramps. Has varicose veins +5 which will sometimes
ache with menses
Emotion: tends to irritability +5
T: puffy, sl red, red tip, sl scallop, v. distended sublinguals +6, thin coat
Abd: warm, tight rectus, empty in Lower bow tie area
Channels involved: BL, GB
AEP: BL
Kidxs: Pain, varicose, distend sublinguals
GBxs: Sleep disturbance (busting out), irritability,
SIxs: dry flat heel, empty bowtie
STxs: flat thenar
BLxs: sciatica pain, responded well to HT+
tx 1: HT+ rt, and SI+ rt
Pain down to 2/10 and lasted 24 hours
tx 2: 4 days later, now off the prednizone 2 days pain at 8/10. Did HT+ rt and SI+rt. brought the pain down
significantly. I added SI lft and it came down to 2/10.
movement much easier, able to put shoes more easily.
Here is the question: On palpation, HT and SI are the only channels that had any impact. I have used them both 2x.
What next when I see her thursday?
Any thoughts much appreciated.
Shanlarson #2October 16, 2019, 2:31am16/01/2024, 12:07BL line sciatica – Qiological Community
https://forum.qiological.com/t/bl-line-sciatica/690/print2/4
I m curious if you ve tried BL +. With an acute injury in my practice I ve actually sometimes toggled between both
channels. Also she does seem to have some heat signs. Red tongue, warm abdomen and I think talking in her sleep
is interesting because excessive talking is HT xs. It makes me wonder even though it s in her sleep there is the need
to communicate.
Just my 2cents
Jeffrey: October 16, 2019, 12:47pm
@Shanlarson I m curious if you ve tried BL +. This sounds like a reasonable channel to me as well, channel alone
gives enough clinical weight to me. good luck, please post your next steps.
KristinWisgirda: October 16, 2019, 2:42pm
I like @Shanlarson and @Jeffrey s idea of UB+.
Tight rectus suggests possible internal dryness, even though she isn t skinny. With her dry skin, the wetness of
UB+ might benefit, along with the obvious channel involvement. It might be interesting to palpate the midline of
the midline specifically to reevaluate this H/UB zone for relative warmth and tension.
The red tongue tip, if it is clearly redder than the tongue body, also gives weight to GB excess.
Let us know how she does. Thanks.
KristinWisgirda: October 16, 2019, 5:20pm
Even though the pain originates at the piriformis, examining the back shu, visually and through palpation might
give extra info as well.
amyjenner: October 16, 2019, 11:15pm
Red Tongue is GB xs, huh. i was thinking heart heat/xs. I haven t tried the BL channel yet. It didn t do anything
when palpated and HT did. It helps to know that this might be an instance to toggle between the 2. I hadn t thought
of that. Also tried palpating PC and didn t get a change either. I will take a look at the shu points and try to keep all
you suggestions in my head! Thanks so much, I will let you know what happens.16/01/2024, 12:07BL line sciatica – Qiological Community
https://forum.qiological.com/t/bl-line-sciatica/690/print3/4
KristinWisgirda: October 17, 2019, 2:31pm
amyjenner:
Red Tongue is GB xs, huh.
Red tipped tongue is GB excess. The red tip is in contrast to the color of the rest of the body. If the whole tongue is
red, you are right to think heat.
amyjenner: October 17, 2019, 11:23pm
Today she came in after a couple rough nights of not being able to get comfortable. She had had an MRI as was
waiting on results. The Pain was 5/10. She was feeling emotionally done , crying a lot. She had started a new anti
inflammatory medication- meloxicam.
I palpated the aep s and found that everything from L1 down was stiff and board like. The abdomen was warm with
tight rectus and I could push my fingers between the muscles of the mid line and it would bow but I wouldn t say it
was saggy. Perhaps because of having children it was a little separated.
After palpating points to see what had an impact, I settled on BL+. The pain came down to a 2/10 within a couple
of minutes. I added PC+ and the pain was gone completely. After 20 min, when she got up and moved around, it
was about 1/10 mostly just tight and only sl burning. As we were wrapping up, her Dr. called with the MRI results.
Disk herniation L5/S1.
Ryan_Gallagher: October 20, 2019, 10:12pm
Amy, I m wondering what your process of palpating Sa am points is like. Which points on a given channel do you
choose? Do you press in the direction of tonifying/reducing? Are you looking for pain relief upon palpation? Have
you found this to be a helpful tool?16/01/2024, 12:07BL line sciatica – Qiological Community
https://forum.qiological.com/t/bl-line-sciatica/690/print4/4
amyjenner #10October 20, 2019, 11:38pm
I m just using the tonification point on a given channel. So, PC9, SJ3, HT9, SI3 etc. I ve been using to help
differentiate which channels might be involved and which affect the situation more. I have only found it useful
with pain. I am looking for relief/change in the pain on palpation. I m not pressing in any direction just using the
tonification point. I have found it helpful to narrow down the options.
hope that helps
Jeffrey: October 21, 2019, 8:54pm
amyjenner:
As we were wrapping up, her Dr. called with the MRI results. Disk herniation L5/S1.
perfect opportunity to UB+!
Often L4/L5 presents (laterally) on GB channel, L5/S1 often presents on UB (posteriorly)
adambroder: November 16, 2019, 8:44pm
KristinWisgirda:
Tight rectus suggests possible internal dryness,
Could you still say this even though adding damp (dairy) causes bloating and constipation?
KristinWisgirda: November 17, 2019, 5:35pm
Absolutely, patients present with mixed pictures all the time. Clinic is HARD but thankfully sometimes we get
lucky