I developed sciatica this past week, after seeing the physical therapist for a bulging disc issue which came on in June. She had previously been doing an excellent job relieving the associated muscle spasm. I told her about a niggling spot and she did deep tissue work for about 15 minutes. Next morning, I knew immediately that it was sciatica.
It rapidly progressed and on Friday I saw a physiatrist. He gave me a nerve blocker and while it’s still very uncomfortable, it’s at least bearable for now. I’m having an MRI on Tuesday.
I’m wondering what works to resolve this.
Is there a way to “untrap” the nerve?
Are there any tried and true stretches or exercises?
I’m seriously considering getting an inversion table, as I’ve heard it’s a good way to decompress the nerve.
I bought a TENS machine, which is at least a good distraction. I use Voltaren, and take acetaminophen and ibuprofen. I’m really worried because in less than two weeks I’m due to fly across country and will have to do a lot of driving. It’s a trip I can’t postpone.
I know there’s no quick fix, but I’m hoping people who have experienced this might have other suggestions.
Twenty year sufferer here. I think what worked for me was not underestimating the emotional component. I realized very early on that the more tense I was, the more aggravated the symptoms became. I’m not a doctor (though I’d love to play one on tv), but IMO you are in a fight or flight crouch right now and it will take some period of time for that to pass. And, although no two cases are exactly alike, my first spasm did require an ambulance trip to the emergency room. Today, I’m happy to report that I am pain reliever free. In the long run, exercise helped a lot. Try something fun. I was able to take up where my old tap dance teacher had left off and it did wonders for my heel-toe tendons. YMMV.
Let us know how things go. You are a dear member of the community.
Yes. It’s called microdiscectomy and it’s very successful. I’ve ruptured 3 discs an had one decompressed.
Here’s the thing. Most of us old enough to have kids in college have some disc bulge somewhere. It’s easy to link the dermatome your pain is in to a disc, but it can be a red herring.
“Sciatica” is a generic term. There are other things besides discs that impinge on the nerve. Some of them are soft tissue like piriformis syndrome and psoas syndrome, and can be hard to diagnose. Immobile or hyper mobile sacroiliac joints can cause similar pain too.
You’re right to start with a physiatrist as their first and only motivation isn’t surgery.
If you didn’t have an acute event though, I’d be leery of surgery for the time being. As my neurosurgeon is fond of saying, “no surgery, is the best surgery.”
An EMG, which your physiatrist can likely do, will tell you if it’s dangerous or not (muscle denervation). Beyond that, it’s finding the actual cause and treating it appropriately. Even if it is a disc, steroid injections can often get you through. The body will ultimately resorb it. Surgery is considered when the pain is unrelenting and unbearable, or if you have denervation potential and risk losing your calf.
Had a bulging disc and sciatica and ended up with the surgery @eyemgh mentioned above. No more sciatica but several more issues relating to the surgery, which yoga, movement and lifting weights have helped a lot with.
My sciatic pain was awful however - I actually couldn’t stand up or walk for longer than a minute without my foot going numb and shooting pains down my leg. I was commuting into the city at the time, and had to ensure I always got a seat. Really messed with my head. I had various treatments, but none worked like the surgery.
Agree on the fight or flight and reaction in the body. Avoid anything too hard on yourself, including deep tissue massage - I never have that now. Gentle movement that doesn’t make the pain worse, and some light/ subtle breathing exercises.
When I suffered from sciatica (it actually landed me in the hospital), my chiropractor recommended yin yoga. Yin is a very passive form of yoga, not at all the aggressive pretzel type, where you hold poses for a substantial amount of time, in order to allow muscles and tendons to truly stretch and release, while slowly breathing through the release. It’s used a lot for physical/sexual trauma victims, and the version I do is 100% done on the floor, and with props (a rolled towel under my neck for support, etc.) - While this isn’t the woman who trained me in yin, this video is a perfect example of a yin yoga session, and I think she is an excellent instructor. You’ll note she hardly even moves at all, over the 75 minutes (she does, of course, but it’s slow and non aggressive) - the position at around the 45 minute mark is “the” one that releases all the sciatica tension for me…but it takes 45 minutes of other movements to get there. While it may be a bit like watching paint dry, I highly recommend watching it in its entirety and then following along. Initially I could only do it on my bed (which is fine), and now I’m able to do it on the floor, but I use a tumbling mat vs a yoga mat (more cushy). I hope it is something you’ll try.
I can’t say that mine is that bad but three things that helped me were dropping some weight, using a roller/stretching, and buying an expensive ergonomic chair. Worth every penny.
Go through a round of PT. Fixes it for this time and gives you the exercises to keep it stable. I slack and just a few days of my PT exercises fixes immediately back up. I’ve had it for almost a decade now and have only had one bad flare up.
Once you’re stable, nearly everyone will tell you to stretch your hamstrings. Tight hamstrings however are a symptom and not a cause for most of us. Until recently, this was not recognized. The body stabilizes itself however it can. When primary stabilizers fail, secondary stabilizers take over. That has downstream ramifications. The culprit for back pain is typically poor glute activation. They get inhibited by overactivation of the hip flexors, typically from sitting. This is something Stu McGill coined “gluteal amnesia.”
Don’t do anything radical (chiropractic, long yoga poses, etc.) until you KNOW a diagnosis. The pain is a symptom of something else. Chiropractic manipulations and long yoga poses can exacerbate disc ruptures. I know a guy who was adjusted for back pain and rolled out of bed onto the floor the next morning paralyzed. He had to have an emergency decompression.
This is a tip for men with minor sciatica issues… remove wallet from back pocket before driving. When my husband was in his 30s, he was vexed by sciatica pain on one side. Somebody told him to try driving without a wallet in his back pocket… and I’ll be darned, he has been mostly without sciatica pain for 30 years. It seems a wallet can cause hip skew. (Ha…no jokes about his “fat wallet” - it had mostly credit cards and photos, not cash)
I have a displaced disc that impinges on the sciatic nerve. PT helped tremendously. Definitely get an MRI so you know exactly the problem. My PT gave me some great stretches that I still do routinely, along with core work. Gentle touch Chiropractic (BGI type) also helps a lot.
I have found before getting out of bed in the morning it helpful to pull my knees up to my chest and lift my head to stretch out my back. Also, sitting in a chair and leaning forward with head and shoulders between the knees. I hope you find relief.
DS had a herniated disc and his PT recommended stretches for hip flexors-- like the one where you lie on floor and make a figure 4 with your legs --, glutes and hamstrings. He said a lot of back pain and asymmetry come from tight hips, glutes and hamstrings.
I wouldn’t recommend this until you know what’s going on, but most folks I know who have had back issues have found relief, and later – a good maintenance program – this way.
And yes, if you can have a little routine you do before you get out of bed (I have one for a different joint!) , it really helps.
Hope you are feeling better. Chronic pain is so exhausting.
I had a horrible bout with sciatica. It took a long time to resolve, and patience was necessary. I did a lot of stretches designed to open my hips, as well as gentle yoga designed for people with back issues. I also paid very close attention to my posture when driving - driving really aggravated it, and I had to make sure I wasn’t compressing it by sitting wrong. Ditching my heavy purse and wearing a lighter purse on the opposite shoulder also helped a bit. I suffered for a couple years, but it eventually went away without medication or surgery.
I had sciatica for 20+ years, If I sat down for a couple of minutes it always went away, but eventually came back when I got back on my feet. If I walked at a brisk pace it was not as bad----of course, leaving my wife behind was an issue!
Then about 5 or so years ago it mysteriously vanished!!! I don’t know why, I do NOT want to know why, just couldn’t be happier.
I am not interested in surgery at this point. I’ve had back issues for years, and sometimes I’ve had flare ups, but it’s always been muscle spasm. This is my first bout of sciatica. If I can get a steroid epidural, I will take it because I can’t imagine being able to drive or do my work well if it keeps up like this.
My instinct right now is that physical therapy (and me actually doing the exercises) is a good idea, but I also am open to other ideas. I think gentle yoga might help, but I don’t have an exact diagnosis yet, so I guess I should avoid new stuff until I know more. The doctor told me to keep my appointment with the physical therapist tomorrow. I don’t want to accuse her of doing this to me, but I’m not sure how to tell her that what she did ended up hurting me.
I just PM’d you. Feel free to reach out if I can help more.
ETA: Honestly, as a PT, I’d want to know if something I did flared someone up. I strongly suggest just being upfront with her. “When you worked on my back last time, it felt good while you were doing it, but the next morning I woke up with sciatica.”
