sciatica, who is with me

i've known i've had sciatica for a couple years now, but it was only yesterday that a doctor gently interrupted my story of numbing paint to say "let me tell you right now - i am diagnosing you with sciatica". this is the second acute episode i've had, and the first time i went to see someone about it. i'm defining "acute" as even worse pain than the normal background pain, and enough to make my whole left leg and foot, down to the toes, go almost completely numb, and it's too painful to sleep. i'm on day 2 of a mild course of steroids (6 days, tapering down from 24g on the first day to 4g on the last), and they don't really help so far. :(

the first time around, a couple months ago, i was freaked out but when the numbness started to subside and there were more frequent periods of non-pain and non-numbness sprinkled in, i decided to just tough it out. ("toughing it out" is something i'd like for others to talk about, when it comes to this kind of thing). the nerve pain down the leg and foot subsided after a week, but the numbness continued for another month or so, so i had to kind of hobble into work there for a while. but eventually i got used to having a slight hobble, and i continue to drum in a few bands (in one of them, as loud+fast as i can) and recently starte playing baseball on weekends again (in my head, i try to channel 1988 kirk gibson).

the second acute episode started 2 nights ago.

baseball aside

i am happy to say in what may be the last swing of my life, i absolutely clobbered a baseball as hard as i am capable of hitting it, the kind of sweet perfect contact i had not experienced since i on a youth team. i am a thin person so my hardest ever hit ball resulted in a solid double over an outfielder's head, not a home run, but it still ruled. no joke, just before it happened, i announced "this is going to my last ever swing". it would have been better had the next pitch been the one, but it was over my head so i let it go by. the next pitch was absolutely perfect, right down the middle (we try to groove it to each other in practice) and i gave it my hardest swing and kablammo! it didn't hurt, either! but it was a stand-up hobbling to second double.

it's basically a repeat of what happened the first time, except now it's happening again just 2 months later (month and a half? realizing i need to start tracking how often these happen :( ), and it's playing out just the same way, and i don't want to be hobbling even harder. i went to the doctor and they gave me the diagnosis i mentioned above of sciatica, which is something i've known about and tried to deal with for at least a few years. but these leg-numbing events are new and really trouble me, and i don't seem to be fully recovering - i'm never back at 90%, let alone "100%", which i realize is an impossible concept and one which is always in the rearview mirror (unless you're into kurzweil shit) - i don't know... clearly i'm just rambling now!

anyway, sciatica, who is with me, who deals with it, what are your yoga stretches, and is there a branch of painful science fiction called sciatica

*pain

I had a really bad bout of it in my early 30s after a back injury, nerve pain when standing/walking, used a cane sometimes, etc. The only thing that really helped was serious core strengthening and time. Things were never the same afterwards (I stopped running), but I was happy with a baseline of no pain and generally able to do stuff (hike, play drums, etc).

Had a flare on the other side recently after doing squats with weights after not doing it for awhile, and it freaked me out because I imagined months of recovery time. But after stupidly ignoring and pushing through for a few days, I started taking it easy (not bending over and being careful how I move/lift things), and I think it will be back to normal in a few days.

yeah i’ve had an on-off relationship with this for a couple of years after doing the stupid and dangerous activity of bending down to tie up my shoelaces.

core strength and stretching keep it at bay but still get the odd twinge.

i don’t think “toughing it out” is… meaningful? i mean in one sense you don’t have a choice - it’s going to be painful and you’re going to have to endure it. in another there are things - quite long term things as Jordan says - you can do to help improve the situation, or at least create the conditions that are most likely to improve the situation.

It was v bad a few years ago and is better but not ignorable now. just the other morning i caught it the wrong way and it hurt like billy-oh.

anyway lots of sympathies to you z_tbd and anyone else affected. it is truly a pain in the ricker.

was just coming back to respond to jordan, good to hear from you too fizzles!

can i ask you to share, if you want, your go-to exercises for core strength and stretching? do you have a plan? i started putting together one last night with 10 minutes of stretches i can do in the morning and in the evening.

also, i know this will differ from person to person, but do you still have "events" where the pain gets especially excruciating and the leg/foot goes numb for a few days? that's what i'm dealing with now, and it's been two especially bad ones now in the last few months. but i'm hoping to strengthen my core enough so that i can at least reduce these acute episodes or make them go away completely.

zac I hope you're not carrying a wallet in your rear pocket.. I've been carrying mine in a front pocket for several years now

my sympathies. I had a bout of this during covid lockdowns when I was wfh full time and barely getting out of my chair - at one point the inflammation was so bad, I needed a steroid injection for the pain which stretched from my lower back down the back of my thighs.

as alr mentioned, there really isn’t much else to do about it other than regular core strengthening and stretching but it doesn’t have to be particularly complicated or time consuming.

This routine was my fave when I started (and i recommend a lot of her videos - many of them don’t have any talking, just nice, short, easy to follow stretching workouts).

https://www.youtube.com/watch?v=2eA2Koq6pTI

I mostly just did this and 30 mins of walking a day, a few mins of planking if I could manage it, and it pretty much subsided after. have rarely had episodes since. I’ve been stretching a bit more recently though now that I’m pregnant and terrified that I’m gonna have another big flare up once I reach the 3rd trimester. :/

my right side is fucked, i'm certain this is behind it but don't have an official diagnosis. I have other messed up things on the side that may be contributing (some rotator cuff damage from a fall, some hip/hamstring pain), I think something about those irritations has caused my body to shift and exacerbated a nerve problem. it flares up once a month, was somewhat at bay when I could make it to the gym every day but now that I'm working again that's out the window.

I never had numbness, just pain. And after the main long recovery I never really had random events, unless I did something to make things angry again.

For exercises I was doing planks on my forearms for at least 30 - 60 seconds and working up to more, side planks, bicycles and leg lifts on my back once things had calmed down.

Also I don't know who needs to hear this but as my PT wife taught me, surgery is not a good idea if your goal is the cessation of pain, it's at the very least a toss-up whether it will help (and by the time you recover from it, maybe time & exercises would have done equally well).

zac I hope you're not carrying a wallet in your rear pocket..

uggggggggggh i did for such a long time uuuuuuugh

but also, one of my legs has always been slightly longer than the other, and one of my feet is slightly larger than the other. i've always been a bit tilted

roz, thank you for the video! i will definitely check it out and give it a try soon, perhaps tonight. also, you mentioned:

I needed a steroid injection for the pain which stretched from my lower back down the back of my thighs.

see, i'm on the roids now, but oral, and tbh they're not doing much. i have immense, pulsing throbbing pain going right now from my lower back (left side) all the way down the thighs, calves, down the left side of the foot, all the way to the pinky toe. and i'm on day 3 of the steroid course. i fear that next time this happens i'll be on the injection path, to see if it works better

it sucks because i'm part-time/hourly and i don't get paid leave and i'm underwater on everything financially, so i have this pressure to return to work asap. everyone at work is being super cool about it, zero pressure there, but i wish money weren't a factor

leg lifts on my back

I've read (in YT comments, so take with a massive grain of salt) that supine leg lefts aren't great especially for people with back issues and so their benefits aren't worth the risk.

I've gone through two separate sessions of PT for sciatica, and what seems to me to provide the most help was massaging the area (in conjunction with strengthening exercises). My particular issue was that the muscles had gotten used to being tight and squeezing the nerves in the region. Finding the right spot(s) was the trick though (i.e. I might have knots in different places every day), but I'm on a (black) foam roller + lacrosse ball routine that I do about 5-6 nights a week which seems to mitigate the worst pain.

The weather also plays a pretty big role in how much pain I feel, besides just cold = more pain. I tend to get cold feet esp. when I sleep, so I usually curl up into a ball when I'm in bed, which means my lower back doesn't get to relax as much, I think?

"I've read (in YT comments, so take with a massive grain of salt) that supine leg lefts aren't great especially for people with back issues and so their benefits aren't worth the risk."

That's correct if you are not practiced already, its a load on the lower back. But start with lifting the thigh and bend at the knee. Do a few of those first before you straighten the leg.

Work the angles. 45, to 60 and so on, till 90.

"I've read (in YT comments, so take with a massive grain of salt) that supine leg lefts aren't great especially for people with back issues and so their benefits aren't worth the risk."

That's correct if you are not practiced already, its a load on the lower back. But start with lifting the thigh and bend at the knee. Do a few of those first before you straighten the leg.

Work the angles. 45, to 60 and so on, till 90.

I was wondering about that, it's been so long that I can't really remember the stages of exercises (definitely did a lot of foam rolling at one point too, but I think you need to be a little careful with that too?).

Xp

definitely did a lot of foam rolling at one point too, but I think you need to be a little careful with that too?

Maybe it depends on the flavor of sciatica you've got? Like if it's mainly because of muscles, it should be ok?

xyzzzz__'s advice is good ... also, if you're not used to doing leg lifts there's a tendency to arch your lower back, which defeats the purpose. It's best to do them slowly and make sure your lower back stays fully in contact with the floor through the whole movement.

The dead bug might be an easier core exercise early on; you're not swinging your limbs as much so it's easier to move slowly and keep your back flat:

https://hw.qld.gov.au/wp-content/uploads/2015/07/29_M_WIP02.gif

I'm in the club. My first real flare-up was about 10 years ago, from, I think, carrying my first kid around but it could just have been cumulative from years of bad posture. I do regular stretching and seems it have it largely under control. Swimming is brilliant for me.

I went on a long walk today and, sitting here typing (laptop on, er, lap), I can feel it down my whole left side, from mid-back to my big toe (particularly along the outside of my left buttock) - a bit like a nearly-taut elastic band, waiting to be pulled tight and twanged.

what seems to me to provide the most help was massaging the area (in conjunction with strengthening exercises). My particular issue was that the muscles had gotten used to being tight and squeezing the nerves in the region. Finding the right spot(s) was the trick though (i.e. I might have knots in different places every day), but I'm on a (black) foam roller + lacrosse ball routine that I do about 5-6 nights a week which seems to mitigate the worst pain.

I was functionally disabled for half of 2023 because of my first attack. I knew something was happening bc I had numbness and tingling and an itch on the bottom of my foot for no reason for MONTHS in advance, but I ignored all the signs until I couldn't walk more than a few feet. In my case the side effects were almost worse than the sciatica, because as someone said above, my calf muscles had been in spasm for SO LONG in response to the nerve issues, that they kept seizing up and I would need to stop and stretch in public (I live in NYC so walking is LIFE and you can't go anywhere without it, I was a mess).

I got PT for a month or two, I have a very inflexible back which is always good for surprising the therapists with how far I can't move. It's gone now but I still use a massager on my calves for cramps.

I tried the Theragun once and found it to be incredible for getting to those pain points. Recommend if you have an extra $200 lying around.

It's been my experience that recovery feels like a slow centralizing of the pain, ie it covers a smaller and smaller area until it's eventually localized and then goes away. Is that true for y'all?

brad c that gif/stretch is where i would like to be again, hopefully in a month or two. wish i had done more stretching and exercising like that while i could! right now i am a little worried (i know i am overworrying, i think) that i'm going to have to get surgery. the steroids just don't help, i'm taking the max amount of ibuprofen + tylenol (alternating) that i can, but on day 4 of the current throbbing/numbness episode, it just feels worse than ever! hoping to turn the corner soon.

It's been my experience that recovery feels like a slow centralizing of the pain, ie it covers a smaller and smaller area until it's eventually localized and then goes away. Is that true for y'all?

i will pay special attention to this as it happens, but yes, i think that's right, except i'd say "concentrating" instead of centralizing, just because for me the core source of the pain is the lower back, so the pain kind of flows downward from there, beats the shit out of the outside of my left thigh, finds a nook and cranny in the back of my left knee and punches a wall, jackhammers down the calves and then drops a tingling numb bomb on the outside of left foot. eventually, the pain and numbness will draw back toward the hip in reverse order, hitting all the same landmarks. meanwhile my right leg is there like a control group, watching in horror what can happen to it for no particular reason

z, sorry if I didn't see this, but have you done PT?? I won't say that it was magical or anything but it did show me that how I was standing was contributing to the problem, and also the massage element of it was great for unlocking some of the adjacent affected spots. (I was dumping all my standing weight into my lower back instead of lifting from the shoulders/ribs. I still do it but not as much and I correct it when I catch myself. More PT/strength training would no doubt be even more helpful.)

Similarly it never occurred to me that I should engage some muscles when standing, like engage my core/don't slouch and bend knees slightly and use leg muscles rather that putting all the weight on the ligaments. I mean I constantly forget, but it's good to think about sometimes.

Anyway sorry dude, that's really rough. And yeah my understanding surgery is just not necessarily the answer to nerve pain, should be a last last resort.

Yoga will teach most of that. For example, in Tadasana (basically standing straight) you need to engage the thigh muscles to lift your kneecaps up and be on your heels.

In my practice I am trying to undo years of sitting on chairs where you can slouch and not use the feet properly, legs or core.

was just coming back to respond to jordan, good to hear from you too fizzles!

can i ask you to share, if you want, your go-to exercises for core strength and stretching? do you have a plan? i started putting together one last night with 10 minutes of stretches i can do in the morning and in the evening.

Apologies for not coming back sooner z_tbd - and that sounds really nasty, my sympathies. Initially, there were a lot of supine leg lifts and stretches (as described above) to get over the worst of it, since then it's mainly been muscle building, with kettle bell swings bar far the best for me and swimming always good, but I'm super wary of applying what worked for me to other people's situation, as I'm not a medical expert!

fizzles, no apologies necessary at all! i don't think i'm close to kettle bell swinging right now but that would be a good milestone/marker in the future if i cross it!

in slightly electric news, my partner surprise purchased me a TENS 7000 (which is a wonderful product name to say out loud), which is a little unit which sends electrical pulses through these little sticky pads. it's all very Brazil product design (which i love), 1980s version of a dystopian future, multiple dials that do the same exact thing. i've been using it for about 20 minutes and i gotta say, while it's on at least, it feels pretty good! if nothing else it certainly distracts from the pain, almost covers it up. walking around, i feel looser and more natural and "full" (rather than brittle, as i often feel). we'll see if the effect lasts after i turn it off in a few minutes, though.

Sometimes it can be useful to distract your spinal cord from its defensive reactions while you go through movements which strengthen normal posture etc. I have a good massage therapist who coaxed me back to normal-ish posture after a series of injuries left me in a sort of warped, locked-off state which aggravated spinal issues. I went from "look at this MRI, you will need surgery within six months or risk permanent loss of function" seven years ago, to "OK I'm happy to tackle this six hour challenging hike" this year.

i think my sciatica is relatively mild, it hasn’t debilitated me and i wouldn’t describe the pain as acute, but it still sucks. comes and goes every few months and i feel like it’s getting worse each time. no idea if it’s helping but the one thing that feels like it’s “hitting the spot” is the piriformis stretch

Definitely a good one, you may be one of the ~20% of folks whose sciatic nerve passes *through* the piriformis muscle, so if it's chronically tight the nerve is always compromised.

that's very interesting... will have to ask about that next time i talk to a doctor

one other thing i'm curious about. when i do the exercise in the gif that brad c posted upthread

https://hw.qld.gov.au/wp-content/uploads/2015/07/29_M_WIP02.gif

my left hip does a little "pop" each time my left leg goes down. not painful at all, but i can feel it. kinda curious if it's related as the sciatica is on my left side. left is also the side i wore a wallet on for many years. i ditched a wallet years ago and now just keep a small money clip with a couple bills and cards in it, but now i'm wondering if even that is too much!

I believe that implies there's an imbalance of tension around the hip joint, like there is a chronically tight muscle that pulls the hip off course while it's straightening so the joint pops out a little bit.

Missed a trick not calling this thread “sciatica, who’s got my back”

It is very rude to make someone lol on this thread of all places *holds lower back*