Sciatica treatment

Afternoon All

Here are all my current woes. During the Lyke Wake Race on July 11th I was forced to retire with a pain that began in my butt and subsequently spread down the outside of my entire leg eventually grinding me to a halt. It's not what I would call excruciating pain but it's enough to force me to stop running. My GP diagnosed sciatica and recommended physio. After waiting over 3 weeks for NHS physio I decided to go private and have received three half hour sessions of 'manipulation' to date. Apparently the problem stems from stiffness in my lower back and I'm working on loosening that up at the moment. I'm managing to get out on the mountain bike regulalry and have slowly built back up to 3x25 min hill runs per week. However the niggles in the same areas still seem to persist. My frustration at not being able to do 'proper' fell running is now beginning to boil over. I've never suffered from this condition before and would like to hear advice from others who may have had similar complaints. Does it ever fully disappear or am I now stuck with it? Should I take pain killers and just run with it? Should I simply ignore the pain and just get out there and tough it out?

Yours very frustrated

Smoggy

Smoggy - you are not alone!

One of the key things in dealing with many back problems is focussing on building up your core strength. As my phsio put it, its like putting scaffolding up round a frail building! I suffered from back problems, including sciatica for years, including one time where I couldn't run for six weeks. Generally though I put up with it until it just got too painful too often. After cutting back on hilly runs for several weeks (particlalry downhills), and combining this with a fairly intensive programme of core stability exercises (i use a stability ball 3 times a week which focusses on the whole core area). After a few months of this I've now been largely pain free for many months and am back running at my best - it's also helped give me a bit of a six pack too!

Cheers for your thoughts Stumpy.

I'll question my physio about core stability when I see him next Monday. Likewise, I also notice that the problem seems worse after a descent.

Find a way or make one.

Smoggy

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Originally Posted by stumpy

core stability exercises (i use a stability ball 3 times a week which focusses on the whole core area). After a few months of this I've now been largely pain free for many months and am back running at my best - it's also helped give me a bit of a six pack too!

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in my experience of sciatica this is key

it depends what's causing it - in my case two prolapsed discs - but developing the inner core muscles so they support the base of the spine, as recommended by my physio, did the job

Having v strong abs is not core strength, it's actually taking those out of the equation and getting the little muscles around the spine to strengthen and react when they're needed

how you do it is another Q: if you can tuck your core in (think trying to hold back a piss) while jogging, that's a great exercise

think I'm lucky cos it takes extreme exercise to aggravate my sciatica now - running is fine

but it can be a right bitch

Strangely, my physio hasn't discussed the 'holding back a piss' option. Thanks for your suggestions, some interesting ideas that I'll discuss with my physio on Monday.

Cheers

Smoggy

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Originally Posted by smoggy

Strangely, my physio hasn't discussed the 'holding back a piss' option. Thanks for your suggestions, some interesting ideas that I'll discuss with my physio on Monday.

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heh, well he / she might not recognise that particular exercise - but it's the one that contracts the pelvic floor - like when you (*ahem, ladies*) draw in your balls.

this is a good little summary of core stability here

but we're getting ahead of ourselves maybe cos not all sciatic pain is caused by disc problems - but it's the most common cause. (Doesn't mean it's permanent though, some disc faults heal themselves.)

this is what BBC has to say on sciatic pain

maybe see if your physio can organise an MRI scan, which might reveal what the cause is? Have you had any sort of accident or jarred your back recently?

in answer to your other questions - anti-inflamms like diclofenac are usually prescribed to treat sciatic pain. I find they help. You might be OK with just ibuprofen. I've run a couple of races dosed up on diclofenac and co-drydamol: probably not the best idea, but it worked.

Icing the base of the spine also helps - cos that is where the nerve is being irritated even though the pain goes down the leg.

And keeping moving and active is usually recommended but be careful with rotating exercises - where you are twisting around your spine - and stuff like sit-ups / crunches.

hope this helps

Smoggy, not necessarily sciatica that causes your complaints... From what you describe and how it came on, I am more inclined to go with tight hamstrings/tight lower back/tight piriformis...

Just to simplify things for easy understanding: the sciatic nerve runs through your pelvis and the muscles there can press on it, causing the pain down your leg. It will go away with specific stretches of butt, lower back and hamstrings.

Obviously, I can't diagnose you properly without actually seeing you and taking a proper history, but check it out with your physio... if you get no response from your physio, pm me and I can give you some stretches that may help, but... with a disclaimer! As I haven't actually seen you...

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Originally Posted by ZootHornRollo

Having v strong abs is not core strength, it's actually taking those out of the equation and getting the little muscles around the spine to strengthen and react when they're needed

how you do it is another Q: if you can tuck your core in (think trying to hold back a piss) while jogging, that's a great exercise

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That's a very good point ZHR - the core stability exercises I do work both the innner and outer muscles front side and back. My physio actually said that part of my original problem may have resulted from just doing ab crunches without any balance elsehwhere....

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Originally Posted by stumpy

My physio actually said that part of my original problem may have resulted from just doing ab crunches without any balance elsehwhere....

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aye likewise here

Thanks ZHR, I am definitely keeping active (I'd go insane if I didn't.) Thanks for all the info you've posted, very helpful.
Hanneke - it's really interesting what you say. Before I attended my first physio session I did a lot of reading around and was more inclined to believe that the problem was piriformis syndrome (but what do I know!), given that the pain always begins in my butt and is consistently the most painful area. I'll let you know what the outcome of my next appointment is.

Many thanks

Smoggy

just returning to this thread, cos my sciatica has come back with aveangeance - but I'm sure it's through lack of running: I've not done much since Tanky's Trog and it's just set in since then.

Lesson: got to keep moving!

Not sure if anyone has mentioned this but I had it for years and was told posture was important (especially if you sit at a desk or in a car a lot). Mine improved enormously when I got a new car with a decent lumbar support in the seat. In fact it has virtually gone now so a big raspberry to the GP who told me to give up running 10 years ago when I asked him about it!

I had sciatica for ages and despite lots of physio it never really resolved the problem. I then tried a chiropractor, who also used acupuncture and it was a revelation. Cured it in 3 or 4 sessions. Also gave me some simple exercises with tennis ball that cures it when ever i feel it coming back.

Mark

just had a really bad dose during and after a 4-hour run on Saturday. Really made me think I might not be able to train up to a Bob Graham attempt. :mad:

It laid me low very badly a couple of years ago - at the time I put it down to nearly falling during a race and jarring something in my back as I just caught myself (would probably have been better to hit the ground as events turned out). Very sore, physio and strong painkillers eventually more or less sorted it but I have never quite got back to running as well as I was during that race. Following on from an earlier point at the time I was told to avoid cycling during my recovery as it could aggravate the lower back muscles.

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Originally Posted by msjhes2

I had sciatica for ages and despite lots of physio it never really resolved the problem. I then tried a chiropractor, who also used acupuncture and it was a revelation. Cured it in 3 or 4 sessions. Also gave me some simple exercises with tennis ball that cures it when ever i feel it coming back.

Mark

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i have been doing those exercises with the tennis ball. been waiting days to get it back tho'

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Originally Posted by Man from Del Monte

i have been doing those exercises with the tennis ball. been waiting days to get it back tho'

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I am a new member & i Operate as a clinical sports therapist in Ulverston south i am a former cumbria county runner, I will will be glad to give any injury advice on the forum. contact 01229 480 422 if you need help.

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Originally Posted by injury advice

I am a new member & i Operate as a clinical sports therapist in Ulverston south i am a former cumbria county runner, I will will be glad to give any injury advice on the forum. contact 01229 480 422 if you need help.

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Thanks for the offer!

I'm looking for advice. I injured my back recently and now have sciatica trouble. Pins and needles on the sole of my foot and little toe wich I understand means a slipped disc. Also feels sore where I see the piriformis area is! Also back of my thigh feels really painful when I stretch the leg out - not much then! All this on my left leg, right is fine. The physio advice I've had is to lie on my front and push up which I've been doing regularly but doesn't seem to be working. Take your best shot!

Also, wondering on this type injury whether an osteopath is better tha a physio?

Thanks

Give me a ring its the best way to talk you through advice and treatment, sonds to me that the Piriformis has contacted and has squeezed the sciatic nerve this will tighten the hamstrings and will cause pain around L,4 L,5 across upper Glutes down the Sacro iliac joint

Forgot to mention Could be a number of reasons for pain under foot numerous nerves that can react and cause pain, The main thing is to isolate the problem
& what is causing it do you wear orthotics have you seen a podiatrist for biomechanical assessment & Gaite analaysis.
Many people Go to Osteopaths for this problem, and its not the right treatmentat at times its to Bolistic & harsh and it contracts the muscles that are causing the problems even further. I do rate Many Osteopaths and know there are many great ones, but feel this problem needs soft tissue releasse & remedial massage & gentle stretching and possibly if there is a Biomechanical imbalance Properly made Orthotics

Cheers for that, will give you a bell.

again in agony for the latter half of my Edale Skyline recce on Saturday

just can't take anything over three hours at the moment: couldn't extend my right leg so had to shorten my stride dramatically, just made it very hard work and energy-sapping, even just lifting the foot to hop over small obstacles like boulders, hummocks etc.

And you tend to get a lot of those in the fells ...

Give me a ring in the clinic ask for dave 01229 480 422 sciatic nerve is gettting pinched by Biceps fimoris, semimembranosus, semitendinosus at the origin where all three start at the ischial tubirosity the uotward hip rotators especialy the piriforms tighten and get tierd after long runs then the onset of this starts a contraction of the hamstrings not allowing full extension give me a ring

I suffered with sciatic pain all the time for a couple of years before my back finally 'went' whilst playing rugby. I'd been to physios etc. and had acupuncture both before and after this, each time getting a different diagnosis. I eventually had an MRI scan which found the cause to be two breaks in a lower vertebrae, leading to the spine slipping forward and squeezing the disc onto the sciatic nerve. Proposed solution was to pin vertebrae together but whilst procrastinating over this, I did a stack of lumbar raises, using vertebrae to squeeze disc back away from sciatic nerve, as well as improved my core and posture as others have mentioned. As a consequence I was back running within a couple of months and the only problems I encounter are some stiffness in my back ... although I've given up the rugby, especially as I played in the front row.

I found that the closer I got to knowing the cause (and for me seeing the evidence on the MRI scan helped), the more I felt in control and able to deal with it positively.

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Originally Posted by Homeward Bound

I suffered with sciatic pain all the time for a couple of years before my back finally 'went' whilst playing rugby. I'd been to physios etc. and had acupuncture both before and after this, each time getting a different diagnosis. I eventually had an MRI scan which found the cause to be two breaks in a lower vertebrae, leading to the spine slipping forward and squeezing the disc onto the sciatic nerve. Proposed solution was to pin vertebrae together but whilst procrastinating over this, I did a stack of lumbar raises, using vertebrae to squeeze disc back away from sciatic nerve, as well as improved my core and posture as others have mentioned. As a consequence I was back running within a couple of months and the only problems I encounter are some stiffness in my back ... although I've given up the rugby, especially as I played in the front row.

I found that the closer I got to knowing the cause (and for me seeing the evidence on the MRI scan helped), the more I felt in control and able to deal with it positively.

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HB, that's encouraging.

Got it bad at the moment - it seems to have moved to a new level, where I can hardly jog down the towpath. Feels like my whole hip / thigh unit is encased in a strait-jacket.

Physio thought I might even have a stress fracture in the hip somewhere but it's looking to me like my prolapsed disc has suddenly got worse. Probably need another MRI to get to the bottom of it.

It's funny how you ignore the injuries section when everything is going well. Sorry to hear about your woes ZHT and hope you get sorted asap. If there's one thing I've learned about scitatica it's just what a frustrating condition it is, there doesn't seem to be that much rhyme or reason to it. Mine lasted about 8 months some days bad others not so bad. Woke up one morning and it wasn't there anymore. However I do know that if I'm relatively inactive for a few days the niggles show themsemves again, which is a worry as I proper knacked me knee up in The Guisborough Grunt Race the other night - ho-hum. Good luck with it.

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Originally Posted by smoggy

It's funny how you ignore the injuries section when everything is going well. Sorry to hear about your woes ZHT and hope you get sorted asap. If there's one thing I've learned about scitatica it's just what a frustrating condition it is, there doesn't seem to be that much rhyme or reason to it. Mine lasted about 8 months some days bad others not so bad. Woke up one morning and it wasn't there anymore. However I do know that if I'm relatively inactive for a few days the niggles show themsemves again, which is a worry as I proper knacked me knee up in The Guisborough Grunt Race the other night - ho-hum. Good luck with it.

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thanks a lot smoggy

I went for the MRI, and sure enough it looks like I've developed a second prolapsed disc in the last year or two

not surprising really, considering that military fitness sessions and fellrunning are both pretty hard on the back

seeing a spinal consultant / surgeon soon, who will hopefully be able to tell me what if anything can be done on a semi-permanent basis - I have heard you can have epidural-style injections for instance

but as you say, it come and goes of its own accord - it's just when it came back the other week it was worse than ever

I suffered from piriformis syndrome last year and sitting down was painful. Driving was the worst thing. I had some remedial massage (who diagnosed it) and that was a great help. think mine started with a fall onto my hip during a race. It will get better!

Can anyone describe the tennis ball exercises? I had a bad spell with my back for a week or two which isn't so bad now but still have bad sciatica which isn't reponding to my usual stretches so it's doin me ead in. Ta.

Ow.

L4/L5 is sticking out again.

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Originally Posted by Mud

Ow.

L4/L5 is sticking out again.

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yep know that feeling

Hi,can anyone give me any idea how to relieve sciatica?i've had it for the last month,it runs down my left leg,most of the pain is in the back of my thigh,it's so painful.I'm still running but am reduced to a walk as the pain is so sharp at times:thunbdown:Sometimes it goes all the way down to my foot.Are there any exercises I could try ? Grateful for any suggestions.

I've had something similar down the right leg for 4 years, caused by a trashed right glute impinging on the nerve. Tried various stretches, but gradually the neural impingement has led to the right quad wasting away and other muscles compensating for its absence. This led to an off-balance developing causing further injuries (calf tear, sore knee etc). Also a right pain on long car drives.

I had about a dozen painful physio sessions (pointy elbow of a 14 stone bloke in the glute and acupuncture) to free it up. Now in the process of re-building muscle in the right place.

Wish I'd paid good money 4 years ago to fix it, rather than hoping for it to mend itself.

Piriformis syndrome could be a cause, loads here: http://forum.fellrunner.org.uk/showt...ormis-syndrome

I have suffered with it off and on for years. I went to a physio a couple of years ago and got all these exercises. It is all about strengthening up the lower back muscles to keep things stable down there. Do a Google search for them and you will find loads.

When things are bad I get disciplined to do them but needless to say when feeling OK my motivation to do them wains. I have almost constant very low level pain, but surprisingly enough running does not effect it.

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Originally Posted by pip

Hi,can anyone give me any idea how to relieve sciatica?i've had it for the last month,it runs down my left leg,most of the pain is in the back of my thigh,it's so painful.I'm still running but am reduced to a walk as the pain is so sharp at times:thunbdown:Sometimes it goes all the way down to my foot.Are there any exercises I could try ? Grateful for any suggestions.

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Hi Pip,

best thing is to see a physio or massage therapist to work out if if its soft tissue compressing the nerve or bones that are entraping them. if its soft tissue thats causing the pain then massage and focussed stretches will be the way to get relief....if bones then you might need a bit of manipulation (but I'd still recommend massage as well). Most cases of sciatica do tend to be soft tissues, particularly the piriformis muscle which overlays the sciatic nerve (or in a small percentage of people actually has the sciatic nerve running through the muscle). if the muscle is tight it compresses the nerve and you feel pain. as others have said, there are loads of stretches you can find on youtube, but nothing beats someone actually working on the tissues with trained hands.

best of luck getting this sorted,
Lynne

http://www.amazon.co.uk/Treat-Your-B.../dp/0959804927

At this stage this is the only money you need to spend.
regards
Mark

Thanks for the replies,I'm going to try the stretches and see how I get on,also have a go with the tennis ball.:thumbup: