UKH

I've been suffering from sciatica for 12 weeks now .

I've been to the Doctors,  had a physio course proscribed , had drugs to help with the pain and been signed off work for 2 weeks before now .

It's improving slowly . I've gone from being unable to walk to just rolling the dice each time I perambulate .

No real cause that I can detect as to why I started.   I'm totally sick of it.    I keep wondering if I'm ever going to be able to climb mountains again .

Absolute agony and a very debilitating.  

Anyone have any good stories about recovery to keep my spirits up ?

Please 

AP

I've had it for no discernible reason. A few weeks of it, building to a climax where I really struggled getting out of bed and putting my pants on (standing on the affected leg impossible). Got some advice from a sports therapist, did a few exercises, but basically it just went away. Occasionally get the odd twinge of it, but haven't had a full recurrence.

I guess it's got some sort of anatomical explanation where something or other presses on the nerve, and I guess that some therapy that realigns things would work. Or it'll hopefully just go away by itself (uninformed speculation alert!) as your body rearranges itself so something or other no longer presses on the nerve.

Thanks Jon , This is my hoping .

If not I'll be back to the Dr if it gets unmanageable. 

I think it should be a well-justified expectation, not just a hope. When I was looking into it, I didn't see anything about intractable sciatica striking down otherwise healthy people out of the blue, forever. Don't think that's a thing as far as I know.

Do you have any idea on the underlying cause - is it your lower back for example (e.g. bulging or herniated disc) or potentially muscle impinging in the nerve (glutes for example) ?   Different exercises for the underlying cause help significantly  in my experience where I had a lower back herniated disc problem ('Treat your Own Back' by Robin McKenzie was brilliant in my case).  I still follow the exercises most days as part of on-going prevention

Cheers

 I sometimes have a slight pain in the very very lower right back , not that often though .  It's more leg and hip pain in this case.

The physio suggested it was my glute that was cramping up and causing the pain .  It's doing this less and less presently but was very bad a points.

I can still bend well  and even do Halasana yoga poses and so don't tend to think it's anything like a herniated disc problem.

I'll second this but you don't need to fork out for the book which is a very long winded way of saying the doing back extensions (look this up) is very good for lower back disc related problems and often works for sciatica.

My mum thought she had sciatica and rheumatism which turned out to be MS. So if it's definitely sciatica think yourself lucky. There you go, that should cheer you up

My Dad (63, if that's any bearing) suffered for a few weeks with it last August, similar to another posters description of not being able to get out of bed or dress himself at the worst point. He saw a physio and had it massaged to try and ease things then he was given some exercises and stretches and has been doing them everyday since then. The pain eased after a couple weeks of doing the prescribed exercises, he continues to do them to strengthen and keep things supple. The only thing he gets now is a twinge in his ankle every now and then, no longer has the debilitating shooting pains from his buttock that traveled down the leg. 

Hope it clears up soon.

Thanks .

I do think myself lucky in many respects.   Could be a lot worse.

Once every few months I put my back out (due to an old injury), it sounds like as you describe.

It recovers over a few weeks then is fine for months on end until I next "trigger" it.

Don't know if that helps or not

I wrote my experience in this thread:

https://www.ukhillwalking.com/forums/rock_talk/managing_a_back_injury-731591?v...

It took a while, but I'm back to pretty much normal. Long walks would be my number one recommendation. Even if they were painful/uncomfortable, I would feel a bit better the next day.

Thank you for that. 

Some good advice there.

AP

I had it really bad a few years ago and my doctor gave me painkillers and suggested physio which didn't help but cost a fortune. Someone suggested something called Bowen Technique and that fixed it in one session and has fixed a bad back every time I've had one since - I highly recommend it. 

Keep moving (so far as you can), and keep your spirits up: it'll ease in time. When it does, keep doing whatever exercises you've been given: the objective is to build up the supporting core muscles.

What drugs are you on?

None now but Ibuprofen.   They help marginally.

The Dr wanted to give me Amitriptyline but was hesitant because I'm on fluoxetine .  After some thought she gave me 28 doses ,  it was lovely ,  made me feel lovely and sleep like a baby.

Had the feeling it would mess me up long term,  

Oh right. Amitriptyline really helped me. The effect was weird: the agonising leg pain was more-or-less completely masked, and replaced by a 'tingling' effect. So the underlying problem was still there, but the pain was masked, and I could finally walk again. Magic!

I had sciatica a few years ago, it would get worse through out the day, especially sitting down. It gave me a bit of limp. Eventually trying to get comfortable to sleep at night was difficult. 

I went to the NHS physio and she would give me a few exercises to try and then a follow up for reassessment. Each reassessment the pain was similar but exercises changed, I guess there is a protocol of elimination they work through. Also when you strengthen something else then there is the next weak link in the chain to find.  Then we found I had very weak glute medius muscles. 

Lie on your side and do a clam shell with your knees, I could do about 5 pressing against her hand.  She said I should be able to do 50.  One week of basic strengthening them and it was gone. 

Stick with it, hope you find your silver bullet. 

It's a great drug ,  I could well see how it could become addictive personally.   

Some good advice here.

https://www.runnersworld.com/uk/health/injury/a28585522/sciatic-nerve/

I suffer from regular sciatic flare ups when I overdo my training and fail to stretch and rest properly. 

Excellent , thank you .

I had a bouldering fall and cracked my back on a rock. I managed to finished the session of sorts, after the pain went off but had problems since early April - low back pain, sciatica, hip pain, hamstring cramps, unable to run. Some of this was the injury, some referred pain from tightness elsewhere.

Things that have helped - sports massage (erector spinae was REALLY tight) this was the single best improvement. Ibuprofen initially to tackle the swelling that I *think* was impinging on the sciatic nerve. Getting mobile as soon as I could, walking if nothing else. GP physio/neural  assessment to work out structural issues. Clamshell exercise (hips, glutes). Superman planks (core possibly 'switched off' as back was so tight). General stretching and mobility. One legged balance stuff. Climbing and keeping an open mind. It's been a long road but managed a 3 mile run last night, painfully slowly but still.

Yours might/likely to be entirely different but might give you some ideas. Get help before things set in? I'm lucky in that I have a couple of mates in sports therapy/physio, so able to tap into them a bit.

Don't be too hard on yourself, I was, doesn't help. Good luck!

Suffered badly from it 6 years ago for about two months. Walking was fine but could not sit or lie down. Very, very tiring and debilitating - a really bad time. Had NHS physio with no real results until a different physio was at the clinic one day (who I knew, and had climbed with😃 ) suggested acupuncture and that she would do it. I was a bit sceptical but willing to give anything a go by this stage. After the first session, there was a huge improvement and after the third it was gone and not a twinge since. All on the NHS. 

After reading the replies and advice last night I tried some clam shell exercises,  as these hadn't been suggested by the physio at all.

I found that lying on my left side and doing the exercise I could only do less than 10 before fatigue and tiredness set in.   not so much cramp as just extreme fatigue of the muscle .

Afterwards this seemed to give me some relief from the effects.  

I've been doing some sets of them since finding this out and I can now do between 15-20 before I have to stop.

It's generally easier to get around today at work , I'm still getting the unpleasant buzzing and numbness in my shin but it' improving .  

I'll definitely be adding this one to the silver bullet list .

Thanks for everyone's input.

AP 

Definitely do not despair. I had it probably worse than you are describing about five years back. I ended up bed bound for a week on mind bending pain killers and signed off from work for a couple of months. 

I was fairly swiftly allocated for surgery to excise the offending disc and was duly admitted to the ward and prepped for the operation. However, in the Pre op consultation it was agreed that the pain had subsided sufficiently to make intervention not worth the risk. I went from strength to strength and it totally went away and I have had no problems since. Full return to all aspects of work and leisure. Including climbing, load carrying, a lot of trail and fell running. Anything really and with no reservations.

ln my case, quite possibly yours too, it is a fact of life that a scan of the spine of most middle age men will show discs splurging out all over the place. If they are not touching the sciatic nerve than it’s not a problem. That is what causes the pain and an operation would have been just to trim back that disc so it would not impinge on the nerve. In my case it was nothing to do with “putting my back out” or weak core muscles. Just the ebb and flow of wear and tear 

i had physio in the early days to try and stem the advance of the pain and it did not help for me. I fail to see how it could have any influence on a prolapsed disc. I don’t stretch, never have done, and am 55 years old and very active. It appears that the discs just decide to shrink back, dry up a bit or whatever and the issue goes away.

In my case it was a matter of just cracking on as soon as it allows and keeping active and as normal as possible. 

I found these really helpful as well.

In addition to them I found the following series of exercises really helpful. They certainly highlighted a difference in my right and left glutes.

http://www.octopusclinic.com/videos/37-wall-ball-stage-1-standing/

http://www.octopusclinic.com/videos/38-wall-ball-stage-2-knee-bends/

Hi,

I suffered with it on & off over the years but a couple yrs ago had a very difficult and long episode lasting about 6months. I tried everything.. stretching, physio, chiropractor etc. The docs had me on some very nasty nerve pain drugs & i was bed ridden for much of it. Now a lot of how this came to be was that i had a scan and was told i had a herniated disk. This led me to believe that there was serious damage & the fear led to more pain creating a loop that was hard to get out of.

What i didnt know but wish i had earlier..was that disk herniations are very common, in fact most people would show that they had them on a scan and its really not worth all the worry (and pain).

What eventually helped was learning to relax.. de-stressing.. and moving as much as possible. I am now bouldering and falling without difficulty and have been for two years since my episode. I have very occasional flare ups but i know i just need to take it easy for a few days and let any inflammation calm down.

If your pain is quite recent i’d say maybe take some anti-inflammatories initially (but not for too long) just to get moving.. and walk as much as possible. Maybe leave the stretching and stuff til things loosen off unless you find one that helps you to relax

That was all very long and rush typed but the main thing is to not worry, relax and move as much as poss.. it will go away  

This might be helpful:

https://www.tamethebeast.org/ 

I got what was described as Pilates (in my mid 50s) by the local physio.  Nothing specific really targeted it, just a combination of things and more movement.  At one point, I could barely get my socks on!
My conclusions were:
Possible cause by too much exercise e.g. too much sitting in a fixed upper body position on a bicycle, or too much long distance walking upper body strapped into a ruck sack.  Think about varying it.  Too much sitting at a desk and a computer screen.
Also, Pilates helped me a lot to discover muscles and stretching that I'd forgotten about, and needed reviving.  I do Pilates regularly now having started it and find it really useful.
It recurs if I'm not careful with certain movements/positions, so am careful to avoid the triggers
YMMV

I suffered for many years, to the extent that sciatica was an improvement,  I eventually found an osteopath who worked it out and would clunk me back into line every six months or so.  I then started riding a road bike and found that that helped a lot and 'shuggled' my spine into line, but every now and then I would look at my feet and realise that that day they were a very long way away.  then one day, I was riding my bike stood on the pedals and there was a very heavy clunk from the base of my spine - enough to make me panic - I though it was either very very bad, or good - turned out to be the latter.  Then, a got knocked off my bike by a car and landed arse first on the pavement.  I was in the middle of nowehere and sat at the side of the road for hours until an ambulance turned up and I was carted off to hospital with a suspected fractured pelvis.  Eventually, no fault found and I was booted out into the night, feeling as though I had been kicked by a cart horse.  Essentially, I've not really had a problem since.  I can recommend most of this, but not the last part.

i have had two bouts of it - feels like it will never go and is miserably agonising. It did go however, something just clicked in my back one night in bed. physio etc could never work out what caused it but i was doing a lot of road running at the time and i think extremely tight hamstrings may have been the cause so that may be worth considering?

Some varied advice going here, some good and some less so. I see a lot of people with symptoms similar to yourself and the important thing to remember is it will pass and you will get back to normal. Trying to stay confident and persevere with staying active and mobile is the hard part.

Unfortunately no exercise is a silver bullet and anything can work for anyone, but keep trying different things and you'll find something that helps. Stick with that. What works for one person might not work for the next person (we're all different). Walking is probably the most underrated exercise we do. 

There are a lot of things that can impact on neural pain, so have a think about your broader lifestyle. The most common things I consider to have an impact are: stress (the biggest!), poor sleep, change/increase in sedentary behaviour, poor diet, low mood. 

Be very cautious about who you see/take advice from. There's considerable research that shows being exposed to harmful language ("discs slipping out of your back" etc) has a negative impact on outcomes. The same is true for unnecessary imaging. A diagnosis of back pain +/- leg pain shouldn't be a sentence to needing "maintenance" treatments with a chiropractor (or similar) for something that is most likely to improve on its own accord. 

Amitriptyline sits under the umbrella of neurogenic pain relief. It can be very useful in reducing your neuro symptoms to allow you to move more/function. Discussion with your GP, pharmacist and possibly physio should be the only place you seek advice on this sort of medication. There are alternatives to Amitriptyline and this is a discussion to be had with your GP.

There also isn't always a structural cause behind neuro pain, as strange as that sounds. There's a lot more to pain that a structural cause and tissue damage.

Altogether it sounds like your doing great. Keep trying to stay positive and active. Try lots of different exercises and narrow this down to the ones you feel are helpful and persevere.

Hope this helps.

My sciatica came in worsening cycles over many years. Eventually it just didn't recover. Severe wear and tear to spine diagnosed by MRI with spinal stenosis in lumbar area. Drugs ineffective. Unable to walk or stand. The good news? Lumbar decompression surgery works. I still have a "bad" back that surgery can't cure, but the worst symptoms have gone. I hope yours doesn't get to this stage, but if it does ...

A cautionary tale... After herniating a couple of discs stacking flat pack sheds when I was about 20 I searched high and low for some kind of cure. I tried an A frame contraption that swung you upside down - result - agony. I also went for some back street acupuncture where they pulsed an electric current through the needles - result - some proper discomfort! Both of these were instigated by my mother, who on reflection, has little time for things to heal naturally and may even have had a spot of Munchausen by proxy. Go easy on yourself!

I once had sciatica that made walking pretty from for month or so. An osteopath put it down to my piriformis muscle being in spasm and irritating the nerve. He stuck his thumb in it very hard to relieve it. Now if so feel it coming on I sit in a hard ball and ward it off successfully.

Thanks for your post. I have been unable to walk properly (ie Groucho Marx style, less cigar) or lie flat in bed since June 1st due to electric shock pains from my right hip. Assumed it was related to lots of walking followed by a gentle indoor bouldering tumble onto my back,  followed by a fastish 5k followed by 16 miles of hillwalking the next day followed by an hour or so pulling up weeds on the bank holiday evening. My chiropractor has tried his best in 2 visits but only slight improvements. The internet has been my friend, I have been able to rule out disc problems and facet joints, and been told about the scans that would find faults in most 70 year olds,  and the risks of any sort of operation. The NHS site suggests most sciatica goes away in 4 - 6 weeks, so far so no great difference, but you post gives me some hope that this might be true. The only activity that does not hurt is indoor biking but I'm not sure that I don't pay the price afterwards!

To the OP, good luck - keep posting further improvements to cheer me up!

PS - the pain shoots down the hip that was replaced 4 years ago so at least I know how to limp properly. At 2 weeks after the operation I was walking quite well...

Here's an update.  

Since doing those clam shell exercises I posted about I've come on leaps and bounds (forgive the pun) .

I've been religiously doing the exercise whenever I've felt the need , so several time over the course of the day this weekend .

I've gone from being able to do less than 10, back up to over 50 . The real relief comes at the far stretch and I've felt the odd, click and such in the back and hip.

I had no painkillers all weekend and yesterday was almost completely pain free .

Hopefully I'm on the way to mending .

AP

I had it (by the sounds of it not as badly as you) when I ruptured a disc. 

Cat & Cow pose, nerve-flossing and stretching my (incredibly tight) hamstrings seemed to sort it. I'm sure your physio has already recommended those things anyway but if not, the flossing exercises are here:  youtube.com/watch?v=GPPtVFmI4kA&

glad to hear the clam shells are working out for you!

A progression from the clam shell the physio gave to me was isometrics against a wall or in a doorway.  Stand side on to the wall.  Raise the wall side leg up, so the thigh is parallel to the ground. Push raised kneed into the wall as hard as you can. Swap sides.  

like this guy

https://www.youtube.com/watch?v=PpPp6mP5emY&ab_channel=JamesDunne

Never heard of that before now.  Interesting idea, feels nice to perform and it's so simple.  

Thanks.   

Ah that's great! Yeah it helped me I think. The nerves are all connected and I like to imagine it's like a bike brake cable in a sheath. By doing that exercise you're loosening it all up so it can run smoother. 

Yes I think the name itself even has a placebo effect .  It sounds painful and extreme whilst being gentle and effective .  

I am continuing to improve and so I've  have actually cycled into work today.

Still a intermittent buzz and pain but we're getting there.

AP

That's the greatest comeback since Lazarus. Pleased to hear it.

Ignore if the question is intrusive, but don't suppose it was pregabalin/Lyrica?

Yep, Gabapentin

Just to reassure you: amitriptyline isn't addictive.  I can understand your doctor's hesitancy about prescribing it with your other meds, but I expect they only prescribed you a low dose (10mg?) to take at night.  If it helped to reduce the agonising pain and keep you moving, then I'd say continue it for a bit longer.  Once the sciatica has settled down, then you can stop it.

Whatever you do, don't let them prescribe tramadol: that really IS difficult to come off and interacts with fluoxetine more than amitriptyline does.

(trust me - I'm a Pharmacist)

Unfortunately I only had 28 tablets of Amitriptyline so I've no more to take .

Although I'm still suffering with the sciatica , just not quite as badly right now.

This suggests potential for abuse in some cases.

https://www.addictioncenter.com/stimulants/antidepressants/elavil-addiction...

"Professionals generally consider antidepressants to be non-addictive; however, there is evidence that Elavil addiction is possible. Elavil depresses the central nervous system, and some people find these effects to be desirable, which can lead to misuse. An individual might abuse Elavil in order to feel relaxed, mildly euphoric, or sedated. Chronic use of the drug can then cause physical dependence; a person that was simply taking a higher dose of Elavil due to pain can become accustomed to the presence of the drug in the system and effectively develop a dependence. In time, dependence can lead to addiction if left unchecked."

I wouldn't take it I'm very aware of its potential to mess people up.

AP

I've been on the stuff for 18 months now.  Seem to have avoided most of the side effects, but I do seem to get a few of the notorious mood altering ones.  You had (have?) any issues in this area? Again feel free to ignore...

1 - you can ask your GP for another prescription.  It's standard practice to prescribe 28 days supply, particularly when something's just being tried.

2 - If you're taking the amitriptyline to relieve the sciatic pain, then you're not addicted.  If you're taking it for other reasons, then I'd be concerned.  I have had people taking amitriptyline for yonks who have come off it with no withdrawal effects (they weren't addicted).

Ok , thanks for that.

I may ask them again if it gets totally unmanageable , presently I'm managing OK , it's just not much fun as it's so intermittent and randomly effecting different areas of the leg throughout the day. 

It's very frustrating being a lot better but not right.

AP

I suffered for several years with bouts of sciatica trying physio and chiropractors taking meds and even acupuncture. Nothing eased it. 

Incredibly my condition was ‘cured’ ( almost, I still have little relapses) by a visit to a podiatrist for a bunion. She examined my feet, legs and spine and came to the conclusion that my posture was out of line due to being flat footed and that translated to a increased pressure on parts of my spine where the sciatic nerve lay. Orthotics and some yoga exercises specifically for lower spine have made my life so much better. That was several years ago and if I could ever meet that fantastic lady again I would thank her with all my heart, the difference she made was so great.

one funny aside was coming home from work on my motorcycle, a Suzuki 600 so not a small thing, and my back went into spasm I was in loads of pain and knew that I could not bend my legs to put my feet down on the ground if I had to stop, such was the pain of the spasm, amazingly I managed to ride my 20 mile commute without being stopped by anything but when I got home I tried to move my feet off the pegs, no too much pain, eventually I managed to pull up alongside a lamp post and leaned against it. Lots of shouting brought out a neighbour who helped me put the kick stand down and he then lifted me off the bike.  I then knelt on the ground in full leathers whilst he got my wife to bring some codeine phosphate which after about 15mins kneeling in the street eased the pain enough that I could crawl into the house. It was about 2hrs before I was numb enough to get my leathers off. 

I've now come to the conclusion that the issue is caused by Piriformis syndrome and not a back issue .

https://www.spine-health.com/video/piriformis-syndrome-video

This is it down to a tea especially the spasming of the muscle and the location and symptoms.

I've been exercising accordingly to try and alleviate the symptoms , managed a bike to work yesterday again.  It irritated it a fair bit but today is more manageable .

AP

I've now come to the conclusion that the issue is caused by Piriformis syndrome and not a back issue .

https://www.spine-health.com/video/piriformis-syndrome-video

This is it down to a tea especially the spasming of the muscle and the location and symptoms.

I've been exercising accordingly to try and alleviate the symptoms , managed a bike to work yesterday again.  It irritated it a fair bit but today is more manageable .

AP

Glad to see you managed to diagnose piriformis - I had to dismiss it as the symptoms and responses did not fit well enough. I reckon I have spinal stenosis, not unusual at my age, and the exercises are starting to help - along with a lot of sitting around! Biking has never been a problem, indoors or out (60k yesterday at a good pace) but yesterday evening was my first walk - 2k in about an hour, frequent stops for rests and stretches. Managed to stay in bed all night, although didn't get there until gone midnight. Still twinges but not the full-on electric shocks which lasted the first ten days or so. A bit worried going forward that this could recur at any time, will have to give it significant local testing before venturing into the back-of-beyond again...