Sciatica – Piriformis, Hamstring syndrome, or SI issue?
Relevant info and history
-34 yo male, 185 lbs, 5’ 10”
-HS football (cornerback) and HS track (sprints, long/triple jump)
-Hamstring tear (can’t remember which side) freshman year in high school practicing handoffs for 4x100 relay
-Sedentary lifestyle essentially since graduating HS (2004).
-First low back tweak was chicken fighting in the pool with my gf on my back (2006, 20 yo).
-Engineer with desk job since 2008.
-Purchased a mint 2004 Mustang Cobra with an extremely stiff clutch in Jan 2009. I live in Houston (re: traffic).
-Unexplained right knee pain for a few months around 2010.
-Low back pain, sciatica, and hip pain came on suddenly with no perceivable causation in May 2013 (began on the right side, then after six months switched to the left side and has persisted on the left since Nov 2013).
-Sold the Cobra. Got a car with an automatic. Sad day for me as a car guy, but I literally couldn’t drive it anymore due to the pain.
-PT through an outfit called Airrosti within 2 months of initial symptoms. Typical PT treatment: introduced me to foam roller to roll out glutes/hams, glute bridges, hamstring towel stretches, etc. No help.
-Proceeded to go to neurologist to get an EMG, but nervous system checked out fine for lower limbs. Also did an MRI, x-ray, and bone scan. Prescribed codeine, but that did absolutely nothing for the nerve pain.
-Ortho said I had 4-5mm bulging in L4/L5 and L5/S1. No other issues.
-Neuro then recommended I see a rheumatologist. Rheum checked me for spondyloarthropathies but no markers for any sort of autoimmune diseases, recommended NSAIDs (meloxicam).
-Dr. of naturopathy was next on the list. INFLAMMATION!!!1!1!! Cut essentially everything out of my diet except veggies, fish, and chicken and spent a shit-ton on supplements. Lost a ton of weight (down to 160-ish) but as expected, another dead end.
-Got pissed with the system and spent the next several years in and out of depression about being in pain forever. Sometimes I’d do NSAIDs overdose for a few weeks, sometimes not. In that time, found several short-term fixes that usually revealed themselves as placebos – lacrosse ball releases, foam rolling, stretches, Anat Baniel method, bodyweight exercises, etc.
-Work got me a Varidesk in Dec 2018, which helps. However, right heel pain/burning can be an issue by mid day.
- Both hips pop LOUD every morning, and will pop throughout the day. This feels good, but seems strange.
-Throughout the day I am able to crack my SI joint by placing clenched fists between my bent knees and squeezing. This also feels pretty good.
-Pain will inexplicably reduce or disappear every once in a while. Sometimes after a walk. Sometimes for no reason at all. These “pain-free” episodes are rarely more than an hour and don’t happen with any regularity.
-Soft chairs are out of the question. I prefer a hard, plastic chair to a big cushy couch as this slows the onset of pain in a seated position.
-Friend introduced me to SS Dec of last year. Began presses and deadlifts only at first, not having a rack. Began the full program January 2, 2020 after purchasing a squat rack.
-Squat has gone from 85 to 170, Press (1.0) from 25 to 85, Bench from 85 to 110, Deadlift from 70 to 135
Most days, and I mean 360 out of 365 days for 7 years, I feel pain primarily in the left hamstring and high, deep left butt cheek near the top of the sacrum, with occasional left calf involvement. Sometimes it’s in the left outer butt cheek, and rarely the left knee is involved as well. Sitting always aggravates it, so I usually end up standing at work most of the day. Being startled can take the pain from a 2 to a 6 in an instant. Sudden jolts of motion (e.g. tripping, missteps going down stairs) will do the same escalation of pain. Highly tense situations (even intense movies) or other stressors can affect it. If the pain gets intense enough, the lower left back also begins tightening up. In general, I don’t feel a tremendous amount of pain in my lower back. I’m an extremely violent sneezer, but unless the pain is already bad, that doesn’t usually cause a sudden onset of symptoms, but it can.
Lifting helps. A lot. Post workout I feel great. I’ve actually noticed a sort of going back in time for the radicular symptoms. The day after I lift, my right side is actually the side that’s experiencing pain/radiculopathy. However, when the pain is on the right side, the right knee seems to be where the pain resides. Then, the next day, back to left side hamstring, butt pain.
I do not experience pain during squats and I loved them even back in HS. PR at 17 yo was 335 when I weighed 165.
Deadlifts felt fantastic for the first month (when I was only doing deadlifts and presses). But progress stalled quickly after introducing the other two lifts. When I got to about 120, I would feel pinching (assuming radiculopathy) in my right inside heel. The next day I would feel a 4-6 paint in my right hamstring. I haven’t felt any pinching like that on my left foot. I switched to deadlift PRs on 1st and 5th workout, with 80% deadlift on the 3rd, and RDLs on workout 2/4. This seemed to help the radicular pain. I’ve got a garage gym, with about 1-1/8” slope so standard deadlift setup is a little tricky.
Any help would be appreciated. The program and book are fantastic and I’m hoping I’m just early enough in the program that the impending strength will help put all of this behind me.