Sciatica

daisymack

Now I finally know what everyone is talking about when they complain about sciatica! For the past few weeks my left hip/glute has been tightening up on me. The main symptom is that when I stand and try to extend my left leg out straight in front of me, I get a sharp pain in the middle of the glute when I reach about 45 degrees. The left hamstring feels unusually tight, though I can get back full flexibility after working on it for a bit. I've been rolling and tennis balling the glute and the front of the hip (thanks to Leigh's super helpful website). Not much luck so far. This week I read the forum post on nerve flossing, which proved to be quite helpful in that those exercises seemed to pinpoint my problem.

In the past two weeks I've started to have tingling and numbness radiating down the back of the leg and it's recently extended to the outside/bottom of my foot. The numbness is very faint - I wouldn't really notice it except (and this may sound strange) when I'm shaving my legs I can notice the loss of sensation as I move the razor around. The tingling is worse when standing. In the past two days I've started to feel the sensation that my calf is weak, although I can't appreciate any true weakness - it's just that sensation you get when your leg has fallen asleep and is slowly getting feeling back, if that makes any sense. I don't have radiating pain, aside from the sharp pain upon extending the leg. 

I can bike and run without any pain. I have a history of low back pain on the left side, and initially this felt like an exacerbation of that problem. Increase in low back pain (though not to this extent) happened last OS too (probably a switch to 100% biking on the trainer and working the hard intervals in aero). 

So, my plan is to continue working on the stretching and digging out the glute and hip with the tennis ball. I'm also going to start adding back in some core exercises that I learned in PT (theraband, lunges, squats, planks and the like). Finally, I'll probably head to my ART guy after the holidays.

My question to the peanut gallery is, should I take a break from training completely to see if that helps? Is this an ortho visit or can I deal with this solo? Should I try icing the glute?

Thanks!

Leigh Boyle

Ms. Suzanne....you're going to want to hit the ortho for this one. way too young for nerve symptoms however faint they may be. get in and get checked to make sure that all is clear in your back (they will likely do an xray and MRI to check out disc space etc). They'll also evaluate reflexes, sensation, strength to see how much a nerve pinch there is.



Best case- it's being pinched somewhere down in the muscles versus up in the spine. in that case, ART/massage will get you back on track. best to play it safe and be sure before you waste a ton of cash or make it worse.



In the meantime, okay to train. just be careful--> increased numbness/weakness = cut out intensity, but okay to train easy. increased pain and numbness = rest.

torontoquads

Hey Suzanne,

Be very careful with this. I had the same progression as you this summer and then suddenly woke up completely cramped up, unable to stand. I was then hospitalized in Germany for 3 days and crammed with pain killers. Once I made back home to Canada, it took two weeks of heavy pain killers to able to walk well and then another 6-8 to get rid of the numbness/tingling. When it goes bad, it goes bad fast. See a good physio now and get a full regimen of stretches. Sorry if this sounds scary, but you can turn it around.  I'm 8 weeks into the Nov OS without pain! 

Best wishes,

Elly

daisymack

Thanks guys! I've had xrays of my back a couple of times in the year in relation to the low back pain (last one a year ago, I think) and all were normal. But I'll try for an appointment next week. I also talked to my mom the nurse, who said, basically, "You dummy, try some NSAIDs." Oh.

Interestingly, I rolled and balled and stretched (again) last night before bed and woke up this morning significantly better. I can now extend my leg and hardly feel any pain, although I do get a small tingly shoot down my leg. The hamstring suddenly feels quite norrmal. So perhaps all I've been doing over the past few days/weeks is actually working. That, or posting to this forum is magical.

I'll keep you posted...

GSmith821

Sounds alot like my bouts with Piriformis Syndrome.  I've been suffering with that on and off for years now.  I've had 2 separate bouts that lasted months in which the pain down my leg was so bad I could not stand up straight.  Finally diagnosed through an electromyography study (6 inch needle into piriformis muscle to see the electrical activity) and was then able to really get a grasp of the stretching and massage I need to do regularly.  There is a certain precentage of people who will have their sciatic nerve go through their piriformis and cause radiculopathic pain or sciatica.  Most piriformis syndrome suffers have localized back/hip pain...but not me!  It was miserable, I still feel it, occasionally, and still cannot stretch my left hammy that well.  The crazy thing is all of my bouts go away fairly spontaneously...meaning, I start to feel better and then in a week or so when the spasms let up, I feel pretty good.  Its been a crazy ride for me!

I hope whatever it is, it gets better for you

Kevin Walter

Suzanne,

I'm a neuro-spine surgeon. Like Leigh suggested you should probably see a physician just to get this checked out, either a well trained neurosurgeon like myself, or one of those fly by night ortho guys Most likely they will order an MRI of your lumbar spine, although insurance companies won't generally pay for this unless you have been through a formal PT program and had at least 6-weeks of NSAID therapy (or have profound weakness, debilitating pain, can't walk, etc). On the MRI we will look for any evidence of nerve entrapment, such as from a herniated lumbar disc. Even if there is a herniated disc on the MRI compressing the S1 nerve root, I probably wouldn't recommend any surgery since your symptoms appear to resolve, improve with rest. If the MRI is relatively normal (no one's MRI is completely normal anymore, everyone has some degree of arthritic change) then most likely the diagnosis is piriformis syndrome like George suggests. X-rays are not particularly helpful in the lumbar spine for most patients with routine problems such as yours since they don't show soft tissue.

Like Leigh says, it should be safe to train as long as your symptoms aren't too bad. I would avoid sitting for long periods of time or spending a lot of aero time hunched over on the bike. Sitting tends to be the most aggravating position for both lumbar radiculopathy and piriformis syndrome.

Hope this helps!

Kevin

daisymack

Update: X-rays of my back were "pristine" but, based on symptoms, the ortho thinks I probably have a small disc bulge between L5 and S1. He's thoroughly unconcerned with it and says he won't even bother with an MRI because the symptoms are so mild. I have a short course of steroids to try to shrink it and instructions to keep on training per normal and maybe just cut out some of the running.

Thanks Leigh for getting me into the doc, and thanks for everyone's advice!

Barbara Spitler

Glad your x rays were fine! Hope you are feeling better soon, Suzanne!

daisymack

Jeez Kevin, I should've just stopped by for a consult when I was home over the holidays in Spencerport!

First day of steroids done. Uh, wow. Feeling a bajillion times better already. This morning I bent over to pick something off the ground and felt...nothing!

 

Leigh Boyle

awesome news! glad things are minor and that you got some good meds to speed up the healing process.