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With delicious irony I very reluctantly took some time off the bike in December to work on core strength etc. I didn't think I had any issues other than weakness or imbalance in the low back which just meant a bit of localised pain at the end of rides.
3 weeks in to my 'recovery' I take our wee boy to the climbing wall and come back in full low back spasm. Thankfully/sadly I'm well versed in these now and it eased off in 3-4 days, but left me with some residual sciatica.
I don't KNOW that it's a disc bulge but sitting down definitely aggravates it, and physio demonstrated it was 'neural' with some leg lift exercises. Doctor (needed a sick note) didn't suggest anything specific other than the usual avoiding sitting so I've got a couple of week's grace from work to work from home/bed/the sofa and also take regular breaks to do basic 'neutral back' core work and also cobras and 30 second dead-hangs from a chin up bar.
Walking is fine and I'm keeping sane by scouting out future riding terrain, but I think long and/or hilly walks aggravate it so need to stay short and preferrably no driving, so the local field edges are getting well explored!
So other than waiting (NHS says potentially 3-4 weeks) what else can I do? Any tips?
Keep moving, take plenty of pain killers to mask the pain, ignore the pain, it's not a sign that you're doing more damage.
Getting your back moving is what makes it better. Last time I had it, I found the sooner I got on the bike, the better it felt. YMMV, but for most people this is true.
Very few people actually have bulging discs that are pressing on the nerves, most of the clinical tests are pretty unreliable for this, and the current thinking is that sciatica is mostly down to referred pain from the paraspinal muscles being in spasm rather than nerve root irritation.
Unless you've got signs of a neurological defecit (unable to lift foot, complete loss of sensation in part of the leg on the affected side, loss of sensation and continence for bowels or urine), or a past medical history that suggests it may be something more sinister (eg. current cancer diagnosis) then scanning isn't much use.
The main issue that I see with patients with back pain who aren't helping themselves are:
- Not taking enough painkillers for various reasons.
- Stopping doing things because it hurts to do so and they worry that they're making things worse.
Oof, sorry to hear that. After suffering myself a couple of years ago with sciatica and a muscle spasm (right up there with a kidney stone pain wise) I wouldn't wish it anyone.....well, not many people anyway 😀
When I could finally move about again I spent time with my GP, local muscle/bone specialist and a sports physio (who I still see now every 6-8 weeks) main issue was down to muscle imbalance and weak glutes/lower back etc, typical long term cycling issues apparently. I was given a number of stretching exercises from the physio and had a good chat about building core strength with resistance exercises. I've continued with that weekly for the last couple of years and seen no resurgence in the issues I had, still see the physio, still do the stretching exercises and I'm in the gym three days a week with a full body routine. I don't think I've ever been fitter/stronger, but it's a long road, there's no quick fix.
NICE is slow to react to changes in the medical consensus but its still a very good starting point for advice<br /><br /> https://www.nice.org.uk/guidance/ng59
Forget these creams, they truly do little. neurofen and movement works best.
Apparently I had a bulging disc 10 yrs ago, pain was more than I have ever experienced in my life (and I have broken and dislocated too many bits), so yeah, sympathies.
800mg dosing of ibuprofen, a steroid injection in the disc (both a terrifying and hilarious experience that needs a thread of it's own), and a lot of really intense physio has, so far, touch wood, here but by the grace of god etc etc, sorted me since.
For a few weeks after the acute incident, good prescribed painkillers really made life possible and removed the fear of recurrence, so Kramer's advice is pretty aligned with my experience.
IME, the things that are the biggest help are hamstring stretches, pigeon pose (variations of), rolling the periformis with either a ball or roller and riding. The constant pressure from the saddle whilst pedaling seems to ease it off.
YMMV, IANAD etc
@Kramer's advice is pretty aloigned with what I experienced (and continue to experience) too. I know better than to moan about any soreness or pain when I'm around Mrs a11y (aka Dr a11y) if I've not already maxxed out on pain relief. Dope yourself up and get on with it.
My acute incident was 5+ years ago and still suffering now, but manageable most of the time without getting in the way of life. Ongoing exercises to strengthen my core etc, pretty much what @flicker's written above although sounds like I'm not quite as far along the recovery road.
Thanks folks, some useful advice there!
I'm actually in very little pain, but having ended up on the surgeon's table previously am anxious to do the right thing early.
current thinking is that sciatica is mostly down to referred pain from the paraspinal muscles being in spasm rather than nerve root irritation.
VERRRRRRY interesting! I've been working on mindfulness and breathing exercises to reduce tension and stress in the low back (very effective) and noticed that it seemed to hrlp the sciatica too, but though there wasxa different mechanism at play. Will keep at it 👍
The constant pressure from the saddle whilst pedaling seems to ease it off.
I'm being gentle on my piriformis for other reasons (I think it's more likely to be weak/long rather than short or tight, don't want to be mashing it with a lacrosse ball) but am re-assessing my saddle choices, Fizik Antares is flat as a board which seems to work for me, but can't be very supportive. Stupidly sold 2x Specialized Power Arc recently but have bought another to experiment with 🙄
Piriformis release with a tennis ball is my go to if sciatica plays up
I know better than to moan about any soreness or pain when I’m around Mrs a11y (aka Dr a11y) if I’ve not already maxxed out on pain relief.
I’m pretty sure that I read some research that it wasn’t necessarily a good thing to be a close relative of a doctor when it comes to illness, as we tend not to have a lot of sympathy left when we’re off the clock. 🤣
We are almost a year on from the day Mrs IRC went to the doctor with sciatica type back pain. Luckily she got a same day appt. Her GP sent her to hospital. After seeing her scan the neurology surgeon told her she was getting an operation on her spine the next day as her spinal cord was being compressed by a slipped disc.
Full recovery and relief from what had been a gradual onset of symptoms prior to sudden deterioration the day she saw her GP.
She was lucky she didn't just keep popping pills. Lucky she got a same day GP appt. Lucky that the specialist who carried out her op wasn't usually based at the hospital she went to but was there for a week doing a number of planned ops and fitted her in as an emergency.
As Kramer said above though there were other symptoms apart from pain.
NICE is slow to react to changes in the medical consensus but its still a very good starting point for advice
Hmm. Does NOT recommend traction, I could maybe ease off the dead-hangs 🙄
After seeing her scan the neurology surgeon told her she was getting an operation on her spine the next day as her spinal cord was being compressed by a slipped disc.
I got lucky 4 years ago, terrible symptoms, all the drugs the NHS could offer, but eventually got surgery under work health insurance. Thankfully I'm not anywhere near as far along that road this time around
I’m pretty sure that I read some research that it wasn’t necessarily a good thing to be a close relative of a doctor when it comes to illness, as we tend not to have a lot of sympathy left when we’re off the clock. 🤣
That's putting it mildly 🤣
neurofen and movement works best.
Recent experience tells me that ibuprofen + codeine + paracetamol (co-codamol) 8/500 or 30/500 work well. and then movement can just happen.
Does NOT recommend traction
Was a thing ~40 years ago? Not therapeutic.
I had a bulging/ruptured disc 15 years ago. I remember going for an MRI and feeling sick at seeing how much my spinal cord was compressed into a moon crescent shape. Not only was there terrible pain, but I was half paralysed as well. Surgeon was not keen to operate for a number of reasons, but with advice similar to above I now manage the situation very effectively. Getting the right diagnosis is half the battle with these things I think.
Was a thing ~40 years ago? Not therapeutic
I mean, intuitively it seems to make sense, sitting increases compression through the spine (apparently) so decompressing it somehow seems like a worthwhile idea?
But yeah, I hadn't been noticing much difference. Can't say Mackenzie exercises seem very beneficial either, I always worry I'm pinching the disc between vertebrae rather than squeezing it forwards.
If it is bulging discs then the only real recovery at least for me and my two (MRI detected) is daily stretching and I've been told the more I ride the more stretching I'll need to do, As already mentioned above, I find riding my mtb eases any disc pain which is a relief in more ways than one!
Mine are also a bit strange as they are affected by my hydration status. The more dehydrated I am the more they prolapse out, which is why my best time of day is first thing in the morning as they are apparently rehydrating overnight.