Sciatica
ugh... lower back issues again, but now one-sided with aches / nervy pain / cramping-like feelings in various parts of right thigh. Started when I did squats a little over a week ago with very light weights. I can only sleep in one position - with knees bent on my side with right achy leg on top, and that, not very well. When I stand up from sitting or lying, it gets really bad, and I kinda hobble from one chair to the next or back to bed. It's only relieved when I sit or lie. YUCK!! Went in to urgent care on Monday (here in Phoenix for Thanksgiving) and doc said sciatica and gave me pain / anti-swelling / muscle relaxant pills. So far, it's really not getting any better. So... what is your experience with this??
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I went through a lot of suggestions for stretch and strengthening, and eventually I learned which ones were working for me:
- Tailor's stretch: sitting on the floor, heels together, pushing knees to the floor 30 seconds, dynamic stretch
- Sit up's, 30 slow
- Single-legged hip raises: lie on back, one knee drawn up, other leg straight out. Keep that leg straight and aligned with my trunk, I push my hips up using the bent leg (heel on the floor). 20 times each is hard work!
- Single legged side leg lifts, focus on feeling the upper part of my butt work. I do this once x 30 with straight leg, once x 30 with a bent leg.
- Clam shells, again feeling small muscles in my butt working. 30 x 1 each side
- Single leg semi-squats, 30 each leg.
- Runner's hamstring stretch, calf stretch, quad stretch
This takes me about 25 minutes each morning. It also seems to help with the recurrent upper hamstring tendonitis I was getting from 2014-2016.It's probably a good idea to get checked for any bony impingement on the nerve, which takes imaging studies. Since the nerve primarily comes out of the immobile sacrum, I doubt that a Chiropractic adjustment will have much effect. But therapeutic massage to the gluteal area might be useful.
To catch you all up, I had X-rays and MRIs w/ and w/o contrast of lumbar and then hips (and let me tell you it was NOT fun having to lie still on my back with legs stretched out for 30-40 minutes at a time; I almost bit my tongue off, trying to switch my attention from my back/leg to my tongue!!) FiNALLY, got a diagnosis of L4/5 far right lateral herniation. My physical medicine doc walked me thru the MRI and said a piece of disc had basically broken off and nestled itself right on the L4 nerve; it was in a weird enough position that she did not want to try any epidural shots and recommended I see a neurosurgeon and sent me off with pain meds. I was lucky to get into see a neurosurgeon in a few days, and he said it was really up to me, my pain tolerance, and patience whether I wanted surgery or not. He also kinda put the fear of god (and opioid addiction) into me! I really didn't know what "opioid addiction" was; of course knew the term, but me???
For various reasons - he went on vacay 2 days later; couldn't get in to see another neurosurgeon for a 2nd opinion for weeks; and I was scared of back surgery - one week led to another to another, and finally around beg of Jan, the pain started to diminish, I backed off the pain meds, saw the neurosurgeon again on 1/8, and decided definitely no surgery needed. He referred me to PT, so I'm now trying to get an appointment sooner than later with a good sports-oriented PT who really knows the lower back. I've got an appt w/ someone highly referred, but it's not til 2/5, with a good chance of getting in sooner off the waitlist.
Right leg is still pretty tingly and weak, ie, trying to mock run at home, the leg/knee feels like it could buckle, so I'm nowhere near able to run. I wasn't able to walk more than 5 minutes til a week or so ago and now am able to walk ~20ish minutes without a limp, but on the slow side and with a leg that just feels weird, like it's asleep.
Oh, and my physical med doc wanted me to get a bone density scan; just got those results back and I have osteoporosis with a T-score of -3.1 and Z-score of -1.9 for the lower lumbar, T-scores btw -1 and -2 and Z-scores of -.2 and -.5 for the various hip measurements. Yeah, I had to google "osteoporosis" and it kinda scared me!
Sorry for the ramble... here are my questions to the team:
- Anyone reco good sports-oriented PTs in the East Bay area? Closer to Pleasanton, the better, but will drive for highly reco'd PT.
- How the heck do I get out of this lazy funk? I really could sit on my trainer now, go for walks, maybe swim, yoga (with care), but I've literally done nothing for 2 months. I had to cancel 2 IMs - AZ and now TX, so don't have a race on the books til Nov (Long Course Nat'ls). Would appreciate any motivation you can throw my way!!!
- If anyone has had this similar diagnosis or if you docs out there (Robert Sabo??) can chime in, how long will this tingly weak crap last? I'm def thankful the pain is gone, but I want to get back to my normal self!!
- What about this damn osteoporosis thing??? I'm following up w/ my primary doc soon, but dang, I am starting to think that maybe, just maybe this 30+ years of running, marathons, all distances of tri including multiple Ironman has some correlation with my current issues! Could that be??
All for now. Thanks for reading...- When I was forced onto the couch by spinal cord damage in 2010, the motivation was always there from day 1. It never occurred to me that I wasn't going to start doing stuff as soon as possible, like slooo-oow walking with a feeding tube and neck collar, completing a 5K after 3 months as literally the BOPer - back there with the folks walking dogs, wearing fanny packs, smelling the flowers (my poor wife had to shuffle/amble along with me while I struggled to break an hour). I was already signed up for an IM, which kept me focused from day 1. I'd suggest taking it one step at a time, literally, but commit to keeping a record of whatever it is you are doing each day to improve your situation. At the start, for me, that meant writing down how many calories I was taking in, progressing to how many minutes I was able to walk, how many laps I could handle in the pool, how many minutes I could slow pedal on the trainer before quitting. It was all very humbling, but having a target 6 months out, and watching the improvement in the daily diary literally starting from the flat of my back was encouraging. I was amazed at how quickly the running, in particular came back.
- Part of my issue did involve pain related to neurological cause - really weird, scary pains. Like the strange tingly electric shock which went down my spine every time I raised my arms above my chest while walking or running, etc. When I realised nothing evil was coming from it, I just kept going. Nerves are funny things - the pain is real but also imaginary - it is literally all in your head, as your brain tries to make sense of the garbled messages coming from the nerve. At least, that's what I tried to convince myself, that I wasn't actually internally on fire. And nerves take a LOOOONG time to return to whatever the new normal is going to be after being "insulted" by something like a disc - like 6-12 months long.
- Osteoporosis is a risk from both age and reduced body fat. If you're a female over 50, your BF% is below about 20, and you are not stressing your bones with weight lifting or walking up and down hills, you're facing a triple whammy and all the Calcium in the world won't help. Gotta consider ways to stress the bones via exercise and replace the missing estrogen. There are lots of options, but best discussed with MD like gyn or endocrinologist.
Good luck - staying positive will be the hardest part of the journey.The osteoporosis needs to addressed. Genetics, low estrogen, low energy intake, lack of weight bearing or weight lifting all can contribute to it. I have osteopenia. Not surprising. Many of my clients also have osteopenia and or osteoporosis. The meds advertised to treat this are not effective in remodeling despite advertising. Calcium alone is not the answer. You need the co-factors that shuttle calcium into the bone, adequate K2, Magnesium, Vit D .
There are a ton of studies on the various forms of K2 but to keep it simple try Innovix Labs Full Spectrum Vitamin K2.
It can't hurt to take 400 mg magnesium glycinate and 1000 IU's Vit D.
I started slowly and soon advanced to swimming 500yds, biking easy on the trainer (no aerobars) for 30 min, and counting steps. The irritated nerves produce false sensations of pain... and make their supported muscles prone to spasm, contributing to the pain. Movement (ie light training/walking) seemed to help me as much, or more, than stretching. Rapid movements (standing up or rolling over in bed), and careless or excessive stretching, caused spasm and setbacks... but I learned how to avoid that, and things became less volatile. Each muscle is affected in its own way, and easy, flowing movement (required practice in all my life activities) seemed to give them practice in working together and avoiding the spasm and pain. Luckily, swimming, biking, and even running should be “easy, flowing movements” if done properly, so triathletes are in luck... although running involves a little more muscle tension due to impact and lift. Of course, “Flowing movement” declines with fatigue, particularly while running. Unlike an overuse injury, the pain caused by movement, while uncomfortable, is not specifically a sign that one is causing damage. That said, any assymmetrical movement pattern will eventually cause muscle inbalances. I am currently working with a PT who can objectively identify strength and flexibility inbalances that are the result of years of inattention to gait assymmetry and poor stretching... made worse by disuse due to weakness from the nerve damage, and unconscious guarding (limp) caused by asymmetrical discomfort. Inattention to core strength and poor posture will always require more attention than they used to. I find that changing position frequently when sitting, standing, or lying is helpful.
This November, when I went down again, my experience of recovery in 2016 kept me from picturing life in a wheelchair... but I was pretty convinced that my running career was over. Coach P sent me a compassionate and positive video chat that confirmed that there was hope. I had a good swim yesterday (open turns with slow, smooth flexion/extension at the walls) and completed several 8 min bike intervals at a reduced FTP. I’m still counting walking steps. We need to be patient in return to running... since that muscle weakness/inbalance thing will cause lots of other issues. Coach P suggested parole (based on good behavior) from Run Jail using the 8 week Return to Running Program in the Wiki once I’m ready.
Back issues are confusing, frustrating, and vary from day to day. In my case, depending on activity (or too much sitting, lifting, or standing), they can pop up out-of-the-blue and be gone an hour later. Swimming often reults in fleeting pain/numbness/tingling somewhere in my leg... only to disappear several laps later, and reappear somewhere else. Despite this, I have never found that this irritates my condition later in the day. I agree with @Sheila Leard regarding the seriousness of osteoporosis a d a T-score of -3.1. That’s probably mostly genetic. The fact that you have run multiple marathons and Ironmans, is a powerful predictor of your potential recovery and future healthy aging.
Julie, you can be in Miami next November. @Al Truscott will be there. @Joe Hallatschek, who is currently in Run Jail, is representing Team EN M55-59 at Aquabike Worlds, and planning to return to the USAT Multisport Championships. If my running comes around, I may enter the Triathlon... but a strong Aquabike would be a fitting goal. PS: I’m using my entry to IMAZ as a carrot to encourage good behavior.
@Al Truscott - always, always learn so much from your words of wisdom!! You and John for sure give me great hope that this can be overcome with much patience. I can see myself doing that 1 hour 5k in the next few months! Might be kinda nice... for sure, meet a whole different crowd of racers! And I meet all the criteria for osteoporosis! Guess I need to gain some weight (check!); get friggin' SERIOUS finally with a safe, progressive weight-lifting program and embrace the hills!
@Sheila Leard - thanks a ton for the info on other co-factors to consider in addition to calcium. All I've heard so far from my physical med doc is 1500mg calcium daily, BUT also to follow up w/ primary care doc to get a full plan of attack - scheduled for 1/29. I see you're in Folsom, CA; hope to meet you one day!! I also see you and Al chatting a lot about zwift Sat rides... I can't wait to join the fun! My hubby gave me a Tacx Neo for my early Dec bday (in prep for many long zwift training rides leading up to IM TX ... ah well
@John Culberson, wow... you and I seem like we have very similar issues! OMG, weren't those MRIs awful??? Thank you so much for sharing your experiences... I really must be patient and trust that things DO improve, which as you've learned (and me too in the last week
Again, thanks a ton to you all!!
It'll be great to see you on Zwift! I've never had so much fun on a trainer.
Hang in there. This too shall pass.