[Muenchener]

Something weird has happened to my left leg after sport climbing on Wednesday. I didn't take any big falls or notice twisting/wrenching anything, but in the evening I started to get pain in my left thigh as if I had pulled a muscle. It got progressively worse over two days, until yesterday after work I just about crawled the kilometre from the U-Bahn to home and collapsed on the bed weeping. The call-out doc said most likely sciatica and gave me a painkiller/cortisone shot which seems to be helping.

But: (a) the pain doesn't match what I've read about as classic sciatica symptoms. It feels very much like muscle strain pain but seems to wander around from muscle to muscle in the thigh, without however, ever being a single line down the leg extending into the calf/foot. I still have normal mobility in the leg except that many movements hurt like f*ck. Otoh (b) if it is sciatica, how long does it last and how do I not live in constant fear of it recurring at the slightest provocation?

I have no previous history of anything like this, but am over fifty so I guess starting to fall apart is not completely unexpected.

(Btw I do not intend to rely on medical advice from t'internet and will be knocking on my GP's door - he is a climber too - first thing Monday morning assuming i can get there. But there is a lot of collective knowledge on here about dealing with this sort of thing from a climbing perspective, which I am hoping to tap.)

[Muenchener]

But: (a) the pain doesn't match what I've read about as classic sciatica symptoms. It feels very much like muscle strain pain but seems to wander around from muscle to muscle in the thigh, without however, ever being a single line down the leg extending into the calf/foot.

Forget that. My wife's friend who is a doctor & is visiting for the weekend had a look & said sciatica without the slightest doubt.

So: advice/experience dealing with / avoiding provoking sciatica as a climber?

[Oldmanmatt]

Yep! Sounds exactly like my experience of it!
Had four Epidurals for a prolapsed disc (4/5 lumbar). Had all kinds of odd symptoms, even lost the use of my left leg for six months.
The Epidurals only ever gave temporary relief. Exercise! Keep the core strength, especially around the lumbar and you can control it.
http://www.amazon.co.uk/s/?ie=UTF8&keywords=%27treat+your+own+back%27&tag=googhydr-21&index=aps&hvadid=4755640111&hvpos=1t1&hvexid=&hvnetw=g&hvrand=540610748474198395&hvpone=&hvptwo=&hvqmt=e&ref=pd_sl_71ez6qrw00_e

This was good.

I had useless advice from GPs and all the best and most effective advice and treatments came from Physios.

[Oldmanmatt]

Oh yes. Not had more than a twinge since 2000, when I seriously rebuilt the strength in my core. As long as I keep it up, it's fine.
I let my core lapse as I was afraid of irritating it. This was a mistake.
I never do full sit ups now, only crunches, as this seems to be the one thing that does irritate.
Maintaining flexibility (another thing I tried to avoid, by mistake) is also crucial.
And I stopped running. That also sets it off. Switch to cycling and swimming.

[fried]

I've been suffering from sciatica related to a bulging disk in my back since a fall in February. I've been pretty lucky in that I have minimal pain compared to a lot of people and can happily sit or sleep, it only kicks in if I stand up for too long. Althogh it seems to be getting a bit worse at the moment....

So I'll tell you what my physio/ internet told me.

1. Your Posture is crap.
2. You need to build up your core muscles.
3. Walking is very good but not around the supermarket, swimming is better.
4. Try to stretch your hamstrings.
5. Look up some stretching exercises.

But be careful because it depends at what stage you are. A friend was told that she shouldn't do any exercise while there was still pain. Mine told me to keep moving unless it hurt.

Seeing a physio would be a good first step. Good luck.

[erm, sam]

I have had several bouts of relatively mild sciatica over the last few years. I thought they were bad at the time but from reading about other peoples sciatica they were not that bad. Felt pretty painful at the time though. Mine has gone away eventually after spending a couple of years thinking a lot about core stability and stuff like that. Eg moving from not being able to do 5 wall squats without pain to being able to do 50 squats with only normal muscle fatigue.

When it was bad I found gentle swimming was about the only thing that would make mine hurt less. Finding a good physio was really the key to sorting it out.

Also sleeping in my front with no pillow at my head and a pillow under my hips would unload the nerves enough to make sleep ok.. But I think things like that are different for everybody..

Hamstring tightness definatly came up, but I'm not sure i've made much headway in that department..

[petejh]

I'd echo all of the above. I had  bad sciatica in each leg at different times, both times down to the bottom of the foot. It started after a fall skiing with a heavy pack but my posture was crap for years before that. MRI's, x-rays and private consultations with lots of expensive specialists confirmed a large disc bulge at L4/5 impinging on the nerve root, with degenerating L3/4 above. Be aware though that many people have disc bulges with zero symptoms, so MRI doesn't 100% confirm the cause.

At worst I couldn't walk more than a hundred metres without having to sit down, unbearable toothache pain in legs. That happened twice and lasted for about six months each time, first about eight years ago and then four years ago. I tried to walk twice a day every day and it slowly improved. As with all injuries, physio, lots of core, stretching - carefully, and  just staying active is definitely the way, without doing any heavy lifting or stuff which over-aggravates it. I used to love fell-running but haven't run since the sciatica started.
That book somebody linked to is good.  I was considering surgery at it's worst - I went for an epidural two years ago and it worked. I'm aware of the effects of epidurals not lasting in many people but it's worked so far for me (perhaps because I never want another!). I think the cortisone reduced the nerve inflammation enough for me to get on top of it with exercise and stretching. These days I seem to keep on top of it by being very active and staying aware of how my core and back are feeling - I still get twinges in my left leg, I don't think it'll ever completely go away.

[Johnny Brown]

What they said. Related to spasms in my lower back as a rule. Yoga, obvs.

[Andy Harris]

 checking outperformed syndrome which is very similar to sciatica but often misdiagnosed as sciatica.sciatica is pressure on the sciatic nerve from disc problems.  syndrome is the sciatic nerve being pinched by tension in piriformis muscle.both are very similar but have radically different treatment plans so essential to get right diagnosis. Apparently anyone in their 49ers who has an MRI scan on back will have disc damage whether it presents with symptoms or n so can often have an operation and it has no benefit.worth checking it out.I had it for a couple of months and it hurt so much couldn't climb.physio and exercises saw it right and thankfully haven't had it since.diazepam and transfer in cupboard just in case

[Muenchener]

Thanks everybody for the tips.

checking outperformed syndrome which is very similar to sciatica but often misdiagnosed as sciatica.sciatica is pressure on the sciatic nerve from disc problems.  syndrome is the sciatic nerve being pinched by tension in piriformis muscle.

Assuming "outperformed" is your spell checker's attempt at "piriformis", yes. My internet self-diagnosis has convinced me that I have a lot of the symptoms described in this article e.g.

the lumbar spine was not tender and had full range of motion. ... Passive internal rotation of the right thigh caused pain (Friberg's sign), as did ... voluntary adduction, flexion, and internal rotation of the hip (Lasègue's sign).

... as did attempts at piriformis stretches    I shall be waiting a while before I try those again.

[Andy Harris]

Must use my spell checker hope my mum didn't read the post. I did those stretches to and they were excruciating but then suddenly it all got better. I blame it on heel hooks myself, work of the devil and divine penance for making hard stuff easy ;-)

[Nibile]

Thanks for bringing this issue back. I've suffered from piriformis' syndrome two years ago, and this reminded me to do the prescribed stretch! My left calf muscle is still prone to cramps and also I've had problems with my back, so I'd better stick at it!
Useful video here:

[biscuit]

I had what i thought was excrutiating sciatica about 8 yrs ago  but since then, similar to Sam, i have learnt i know nothing. I went to GP, physio ( NHS not private ) and eventually in desperation i had accupuncture from a Chinese Dr.

I am one of the most unlikely people you will ever meet who would do something like that. I had no faith in it but the Dr was a friend of a family friend who practically pushed me through the door and i was willing to try anything at that point ( and it was free ).

i walked in with a posture Quasimodo would have been proud of and came out about 3" taller. The relief was instantaneous and long lasting. A course of 5 treatments over a month or so and a big bunch of flowers for the doc and i've never looked back.

However i did leave the job that was probably causing it shortly after. Driving 1 1/2 hrs to work, driving at work for up to 6 hrs, sitting at a desk doing paperwork/computer stuff and then driving home again = un happy back/arse/muscles.

Piriformus stretch for me is still something i have to do regularly.

I feel your pain. Get well soon and don't give in to the body falling apart.

[Muenchener]

don't give in to the body falling apart.

Thanks. I have no intention of giving in. Two years into Climbing Career 2.0 I am back at the (modest) level I was at in my late 20s/early 30s, and see no reason why I should be content to stop there. I've already learned that I need to be very careful with my finger pulleys though, and now apparently with other body parts too.

But, bloody hell. Piriformis Stretch Miracle!

I pretty much convinced myself by internet self-diagnosis that my symptoms are more consistent with piriformis syndrome than lumbar sciatica. (A damaged buttock muscle is so much less scary than a damaged spine) My first attempt at piriformis stretching was so agonising I gave up (whereas I felt basically nothing from the lower back extensions that are recommended for sciatica). Persisted by doing the piriformis stretches in a hot bath, which was still v. painful but bearable if I went into & out of the stretch slowly & carefully. Plastered my buttock with hot compresses & hot water bottles for the night, did piriformis stretches - slowly, carefully, painfully - again in the morning and voila!

I can walk almost normally, and sitting down is merely uncomfortable not excruciating. Am not out of the woods yet, and will still go to my GP tomorrow for an orthopaedic/physio referral, but considering that two days ago I could barely walk and was expecting for be basically crippled for weeks, this is quite a turnaround.

[biscuit]

Good news. I am guessing mine was piriformis syndrome too from reading the other posts.

 If i am driving a long way i still have to get relief by putting my left foot up on the dashboard - normally motorways only and not recommended.

Good luck with the recovery it sounds like things are looking promising.

[Oldmanmatt]

Good news. I am guessing mine was piriformis syndrome too from reading the other posts.

 If i am driving a long way i still have to get relief by putting my left foot up on the dashboard - normally motorways only and not recommended.

Good luck with the recovery it sounds like things are looking promising.

This is why I drive an automatic.......

[erm, sam]

Hands up to piriformis syndrome.  Lacrosse balls are my new favorite massaging mechanism and are very suitable for a good bit of buttock release. Grind the ball between buttock and wall/floor untill you can't take any more..

[Muenchener]

Bullet dodged, possibly.

GP sees no sign of sciatic impingement, either lumbar or piriformis - suspects a jammed/twisted sacro-iliac. Ibuprofen, muscle relaxants, stretching: ultrasound/MRI if not significantly better in a few days.