Dealing with Sciatica

[cervicornis]

I've got a question for those of you who deal with sciatica. Specifically, disc-related sciatica and not the type that might be due to a piriformis issue. I have an S1-L5 herniation and acute pain in my butt/hip/leg. Just resting for now but I would like to return to training as soon as the pain is manageable.

Do you train through the pain? Do you find that your sciatica responds positively or negatively to heavy work? If you can't handle heavy loads, do you find that some light, higher-rep work offers any benefit? Or just outright rest?

Any other suggestions or tips you can share? Thanks.

[Greg C]

I've been dealing with this shit on and off for about 15 years...

To some extent, I will train through it. It really depends on how bad it is and how much flexibility I lose as a result of aggravating it.

As long as I keep strict effing form it responds positively. There is a balance here that you will have to learn (duh squared) and is individual (imo). Some light weight work is good (RDL seems to help loosen that shit up) as well as stretching regularly through the day.

I've found that DL and Clean variations are my biggest danger areas (with some other random crap of course). As a result, I've not progresses as much as I would like on DL, but then again, I've been able to train pretty continuously for a while too.

Best suggestion? Be smart and listen to your body and don't get too greedy about progress.

[ColoWayno]

There are some things you can try that might give you some long term relief.
Look up 8 Steps to a Pain Free Back.

Or go here:

http://egwellness.com/

MikeO (I think) is trying this stuff too... so maybe it's time to ask him for a report.

[Sami]

I've had disc and sciatica issues for about 7 years now, long before ever starting training. I got it initially from lifting a 20kg suitcase and had sciatica down my left leg for about 5 years. It went away on it's own before I started training, I couldn't believe it. 5 years of that shit was driving me nuts. I only got pain when I was transitioning from standing to sitting or sitting to standing; and it would hurt, and I would limp/cringe for about 30-40 seconds, then it would settle and I'd be ok. But that happened EVERY time I got up or down. I couldn't do any straight-legged stretch down to touch my toes etc.

But anyway, it went away on it's own before I started training. I then discovered SS and started training WITH A BELT and got from a 70kg squat to 105kg squat in a couple of months. I got to a 120kg deadlift too. I then took a long break due to exams and further exams. Came back to training but for some reason thought it'd be a good idea to train without a belt for a little while. I don't know why I did that, but anyway, I got up to 105-110kg squat... and the fucking sciatica came back, but this time down my right leg. Fuck, fuckity, fuck-fuck-fuck.

Anyway, the sciatica came back in Nov of 2009 and it's been with me since. I get a lot of odd tingling on the lateral side of my right calf, sometimes warm, sometimes cold. The degree of pain is highly variable and very inconsistent. Sometimes training is okay, sometimes training hard leaves me limping for weeks. But, sadly, I've discovered that time off from training lessens the pain.

But the pain is not severe enough to cause me to want to stop training. It does get worse, but it doesn't prevent me from actually training. I can still get full ROM in everything, nothing really hurts during lifting, it just is extremely aggravated and annoying when I'm not training. I'll take some strong NSAIDs if it gets bad. Olympic lifts are the worst, and I've had to stop doing them. And I really liked doing them. And form plays a HUGE role. If I get sloppy, the pain gets worse.

I don't think I have a full on herniation, just a bulge. I have no other neuromuscular issues (bladder control etc) or muscle weakness (I don't think). I've only had it x-rayed and they said I've got an anterior step of L5 over S1, mild facetal degeneration and early disc degeneration. I haven't had it MRI'd yet, I need to soon.

[Jeff Horner]

I find that lifting really helps, and when I run it worsens a bit.

I was diagnosed with a degenerative L5-S1 disc and mild facet joint issue on the right side (I forget what they called it) about 7-8 years ago. I basically have half a calf muscle in my right leg because of it.

Here's the solution, and I've been working on this for about a year now:

1. Gain strength.
2. Retrain your neuromusculature around your back.

I've read so much stuff and junk on the internet about this issue and the common theme I've found is awareness of your transverse abdominus and multifidus muscles. As you age you lose muscle mass, obvious to those who came to lifting later in life. I think we also lose the ability to maintain adequate tension for proper posture. In fact it may be that the loss of tension over time is the primary cause, while muscle atrophy is the effect.

So, tense your transverse abdominus and multifidus muscles while you do "everything" "all the time". You think it's easy? Try it for an hour. I bet you can't.

---
Log

[grizzlybuck]

I've got some of the same experiences as others, I wasn't training at the time, but I had L3-L4, L4-L5 herniated disc, with radiating pain all the way down the front of my right leg. Being an idiot, I tried to work through the pain (pretty physical job) as if I sat down for 5 minutes or so, the pain would go away, on my feet for 10-15 it's back. I ended up missing 6 months of work.

Now more on to answering your question, early last year I had radiating pain down my left leg (meaning that I had irritated the nerve coming out of the left nerve root of one of the above vertabre) I was training at the time, though in a disorganized manner (intense, but with a mix of machines and DB work, and leg press being the primary lower body exercise) Like others, I found if I used STRICT form and made sure to keep my back in its natural state, that exercise did not hurt it. It eventually went away (couple bouts of steroidal anti-inflams, and some chiro visits) and has been pretty good since. Been on SS since late May.

Good luck, listen to your body, it wouldn't hurt to get some strong anti-inflams in you Toredal (sp) and prednesone might really help get you through the worst of it, if you haven't pushed too hard.

[cervicornis]

Thanks for all the feedback and advice. It's somewhat comforting to know that others deal with this shit and it doesn't prevent you guys from training.

I plan to rest until this acute pain diminishes, and then I will start back with light squats and deads (strict form). I should know my body better than any doctor, and if I'm smart about my training, I hope I can work around this. I might eliminate cleans, at least for a while, as they seem to irritate things.

ColoWayno - I looked at that website and I'll be honest, it reads like a bad infomercial. Can you share any of the tips/techniques in this "Gokhale Method"?
No disrespect intended and I'm willing to try anything at this point, but I am inherently skeptical of this sort of thing.

[ColoWayno]

ColoWayno - I looked at that website and I'll be honest, it reads like a bad infomercial. Can you share any of the tips/techniques in this "Gokhale Method"?
No disrespect intended and I'm willing to try anything at this point, but I am inherently skeptical of this sort of thing.

I ran across her book the same way I ran across SS. I looked for the best books out and read customer reviews.
(From amazon)
143 Reviews
5 star: (134)
4 star: (3)
3 star: (1)
2 star: (3)
1 star: (2)
That's a start. Then I skimmed it in the bookstore and said what the heck.

It's been discussed quite a bit on this site so just google site:startingstrength.com "8 steps" "pain free"
if you are interested. I know at least one guy tried the "stretch-laying" and it worked well enough for him to invest in the book.

Good luck.

[cervicornis]

Thanks, Colo. I will check it out.