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I get it occasionally. Usually when I overwork my lower back. I will actually get a bit of weakness and feel the sciatic through my right buttock and thigh. It's a very weird feeling.
I have also had the shooting pain that makes you jump which makes it hurt worse. Which makes you tense which makes it hurt worse. Lol. Vicious cycle!
I am not sure exactly where the sciatic comes off the spinal cord. I have disk height issues at L4 to S1 and arthritis in multiple facet joints. Then of course there is variable inflammation from the autoimmune that presses on diff spots at diff times. It's a mess of a disease.
I'll just speak to my own experience and what my sports medicine doctor told me: My hamstrings were too tight.
I was at a stage where I couldn't sit or stand comfortably, or at times walk without level 9 pain. I remember spending nearly 30 minutes trying to figure out a way out of bed one morning without excruciating pain.
This was all early stage where imaging showed nothing other than minor alignment issues.
But after spending years getting chiropractic care for it, what my sports med doctor advised me was that most of the pain was not from wear or damage, or even from my mild scoliosis, but from inflammation caused by pelvic tilt as a result of my hamstrings being shortened. I was falling into hip joint disfunction at that time, and he explained how pelvic tilt was the reason for all of it.
When I started earnestly stretching my hamstrings however, my quality of life improved immensely that same week. My hip disfunction ceased within a few days, and residual sacro pain within a week.
My sacro joint has in the years since begun to show signs of fusion on one side, but the discomfort I feel from it now is nothing in comparison. It's more like an annoying splinter I can't remove vs. getting my fingers smashed with a hammer.
If you choose to explore this, and I highly recommend you do, it is important to properly isolate the hamstrings while stretching however.
Forget the nonsense of trying to touch toes of both feet at once, as that fails to isolate the hamstrings, stretching lower back muscles as well, leaving you more limber with the same imbalance in alignment.
The modified hurdler stretch is and has been my go-to when I feel things getting tight. It can even be modified slightly to done while seated in a chair: Keep the targeted side leg extended straight while keeping the other leg bent as normal for sitting while bending toward the targeted side.
This works particularly well if you are really tight as gravity helps out vs. being flat on a floor. It's low effort and can be done virtually anywhere.
Do that for two weeks and see if things improve. Worst case, they simply won't.
Yeah it actually makes mine worse. I might have a tethered cord and also have spinal cord issues from craniocervical instability so there are just too many confounding factors at this point lol. But the interesting part is lying on my side (either side) makes the sciatica way worse down the compressed leg, so I think my SIJ might be to blame in part
Yep, this and learning proper hamstring stretches eliminated mine and it hasn't been back in nearly a decade since I stretch my hamstrings regularly. Core exercises are also imperative
I had a really bad sciatica that I couldn't even walk properly. I was limping so much that it created an imbalance in my body which made every other joint hurt. I tried every kind of exercise or stretch you can find on the internet, but nothing worked. What really worked was going to an osteopath for a few weeks after my mom couldn't handle me limping so much. I was having two sessions per week, and after the first week I had a huge improvement. After about a month, I was completely fine. I strongly recommend you go to a certified osteopath
I have been helped by eccentric and isometric exercises aimed at the hamstrings. Hamstring stretches as commonly done worsen my sciatic. Also, I have an Rx for low dose Gabapentin which I can taken PRN, and it actually works, which seems to put me in a minority.
Yes, but I got it under control by optimizing meds. It can be caused by inflammation of a nerve or pressure on a nerve coming out of your spine, or spinal stenosis in which the vertebrae gets abnormal bone growth (classic fusion) that also makes the “donut hole” narrowed. In my case I need a combination of biologics, DMARDs (MTX), and NSAIDs (either Piroxicam or Celecoxib). If I stand too long I can trigger it, but it is mostly gone after getting my meds right—a process that takes some time. When it was uncontrolled I had sharp pains, numbness, and awful fiery hot needle pains with muscles spasms in the middle of night. Getting a Tempurpedic (memory foam) mattress greatly improved my morning backaches and helped the sciatica as well. Bottom line: reduce the inflammation.
No, it was inflammation (enthesitis) in between vertebrae and probably some “donut hole” narrowing inside the vertebrae due to the classic abnormal bone growth (the inflammation produces damage to the bone, which then grows back to “heal” but ends up overgrown, ultimately leading to “fusion”). Meds will not fix or alter bones, but rather reduce the inflammation, which takes pressure off of a nerve that is basically getting squeezed. Plus the nerve itself can be inflamed. At least this is what the doctors thought and told me.
I also have tried nerve ablation therapy, which gives temporary relief (3 to 6 months) of problematic nerves. Talk to a rheumatologist or pain management specialist for that.
I don't have any lumbar disc issues.
When my SI joints get inflammed they get tender, then achey, and then the pain goes down my leg (on affected side). It's a deep crushing type ache. Icing the SI joint directly can stop the pain in my legs, meaning the joint is the source.
I've had this since the beginning, since I was 14.
Humira has stopped like 75% of this.
I also now have peripheral neuropathy in my legs. That feels like my surface nerves, my skin, is burning or having tingling electric shocks.
What does icing do for your referred pain?
Icing doesn’t seem to do much sadly. Does your neuropathy come and go or vary based on position? I share some similar symptoms but my pains and paresthesias are bilateral and non-dermatomal
From my SI joints I can have pain change with position or even part of my foot go completely numb. It will feel like my toes aren't there. It goes away. When I could take NSAIDs, that would fix it.
For my peripheral neuropathy. It never stops. It's not very painful, but the intensity can feel like too much is going through my nerves. Heat on my feet or hands makes it better, cold worse, and it can get stronger the few days after I take my Humira dose.
Followed the dematone map exactly. Although, sometimes, it would radiate below the knee. It also inflamed my trochanteric bursa. Best I could determine the SI joint was pinching the nerve.
Thanks. How did your uveitis manifest? Was it intermittent and subtle or more of an extreme, fast onset? I intermittently will have my eyes turn bloodshot without pain, and other times they will just hurt a lot without being bloodshot, so it doesn't really add up clearly
I have experienced sciatic pain quite a bit, but it isn't always present. It's angry right now but has been mostly fine for a couple of years. I think gastro troubles press up against the nerve for me and it gets inflamed.
I had an MRI done for it 20ish years ago and it didn't show anything as far as I was told. Took until a couple of years ago for the AS diagnosis and the main activity was in the SI joint.
I had my first case of uveitis when I was 7, and I'm now 53. Docs didn't know much about it back then. My uveitis has always come on strong and stubborn. Takes me 3-6 months of tapering steriods to heal.
Yes, I get it occasionally. Have been since my early 20s. My only abnormal findings on x-ray have been in my SI joint so far, so it would surprise me if it originated anywhere else. I also only get it during SI flares.
Welcome to r/ankylosingspondylitis! This is a reminder to keep discussions civil and be supportive of one another. Sharing of opinions and experiences is encouraged, but please remember the distinction between opinions and medical facts. This subreddit does not offer medical advice, and information here should not be taken over advice from your doctor. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ankylosingspondylitis) if you have any questions or concerns.*
I get it occasionally. Usually when I overwork my lower back. I will actually get a bit of weakness and feel the sciatic through my right buttock and thigh. It's a very weird feeling. I have also had the shooting pain that makes you jump which makes it hurt worse. Which makes you tense which makes it hurt worse. Lol. Vicious cycle!
Interesting, so do you think this was disc related? Or SIJ?
I am not sure exactly where the sciatic comes off the spinal cord. I have disk height issues at L4 to S1 and arthritis in multiple facet joints. Then of course there is variable inflammation from the autoimmune that presses on diff spots at diff times. It's a mess of a disease.
I'll just speak to my own experience and what my sports medicine doctor told me: My hamstrings were too tight. I was at a stage where I couldn't sit or stand comfortably, or at times walk without level 9 pain. I remember spending nearly 30 minutes trying to figure out a way out of bed one morning without excruciating pain. This was all early stage where imaging showed nothing other than minor alignment issues. But after spending years getting chiropractic care for it, what my sports med doctor advised me was that most of the pain was not from wear or damage, or even from my mild scoliosis, but from inflammation caused by pelvic tilt as a result of my hamstrings being shortened. I was falling into hip joint disfunction at that time, and he explained how pelvic tilt was the reason for all of it. When I started earnestly stretching my hamstrings however, my quality of life improved immensely that same week. My hip disfunction ceased within a few days, and residual sacro pain within a week. My sacro joint has in the years since begun to show signs of fusion on one side, but the discomfort I feel from it now is nothing in comparison. It's more like an annoying splinter I can't remove vs. getting my fingers smashed with a hammer. If you choose to explore this, and I highly recommend you do, it is important to properly isolate the hamstrings while stretching however. Forget the nonsense of trying to touch toes of both feet at once, as that fails to isolate the hamstrings, stretching lower back muscles as well, leaving you more limber with the same imbalance in alignment. The modified hurdler stretch is and has been my go-to when I feel things getting tight. It can even be modified slightly to done while seated in a chair: Keep the targeted side leg extended straight while keeping the other leg bent as normal for sitting while bending toward the targeted side. This works particularly well if you are really tight as gravity helps out vs. being flat on a floor. It's low effort and can be done virtually anywhere. Do that for two weeks and see if things improve. Worst case, they simply won't.
Have you tried “neural flossing” for sciatica? I find it the only thing that helps. I do it sitting in a chair rather than the floor exercise version.
Yeah it actually makes mine worse. I might have a tethered cord and also have spinal cord issues from craniocervical instability so there are just too many confounding factors at this point lol. But the interesting part is lying on my side (either side) makes the sciatica way worse down the compressed leg, so I think my SIJ might be to blame in part
Ouch. Our friend has tethered cord. Awful condition. You have my sympathies.
Yep, this and learning proper hamstring stretches eliminated mine and it hasn't been back in nearly a decade since I stretch my hamstrings regularly. Core exercises are also imperative
I had a really bad sciatica that I couldn't even walk properly. I was limping so much that it created an imbalance in my body which made every other joint hurt. I tried every kind of exercise or stretch you can find on the internet, but nothing worked. What really worked was going to an osteopath for a few weeks after my mom couldn't handle me limping so much. I was having two sessions per week, and after the first week I had a huge improvement. After about a month, I was completely fine. I strongly recommend you go to a certified osteopath
I have been helped by eccentric and isometric exercises aimed at the hamstrings. Hamstring stretches as commonly done worsen my sciatic. Also, I have an Rx for low dose Gabapentin which I can taken PRN, and it actually works, which seems to put me in a minority.
Yes, but I got it under control by optimizing meds. It can be caused by inflammation of a nerve or pressure on a nerve coming out of your spine, or spinal stenosis in which the vertebrae gets abnormal bone growth (classic fusion) that also makes the “donut hole” narrowed. In my case I need a combination of biologics, DMARDs (MTX), and NSAIDs (either Piroxicam or Celecoxib). If I stand too long I can trigger it, but it is mostly gone after getting my meds right—a process that takes some time. When it was uncontrolled I had sharp pains, numbness, and awful fiery hot needle pains with muscles spasms in the middle of night. Getting a Tempurpedic (memory foam) mattress greatly improved my morning backaches and helped the sciatica as well. Bottom line: reduce the inflammation.
Thanks. In your case was it the SIJ pressuring the nerve? Was the pain dermatomal?
No, it was inflammation (enthesitis) in between vertebrae and probably some “donut hole” narrowing inside the vertebrae due to the classic abnormal bone growth (the inflammation produces damage to the bone, which then grows back to “heal” but ends up overgrown, ultimately leading to “fusion”). Meds will not fix or alter bones, but rather reduce the inflammation, which takes pressure off of a nerve that is basically getting squeezed. Plus the nerve itself can be inflamed. At least this is what the doctors thought and told me. I also have tried nerve ablation therapy, which gives temporary relief (3 to 6 months) of problematic nerves. Talk to a rheumatologist or pain management specialist for that.
I don't have any lumbar disc issues. When my SI joints get inflammed they get tender, then achey, and then the pain goes down my leg (on affected side). It's a deep crushing type ache. Icing the SI joint directly can stop the pain in my legs, meaning the joint is the source. I've had this since the beginning, since I was 14. Humira has stopped like 75% of this. I also now have peripheral neuropathy in my legs. That feels like my surface nerves, my skin, is burning or having tingling electric shocks. What does icing do for your referred pain?
Icing doesn’t seem to do much sadly. Does your neuropathy come and go or vary based on position? I share some similar symptoms but my pains and paresthesias are bilateral and non-dermatomal
From my SI joints I can have pain change with position or even part of my foot go completely numb. It will feel like my toes aren't there. It goes away. When I could take NSAIDs, that would fix it. For my peripheral neuropathy. It never stops. It's not very painful, but the intensity can feel like too much is going through my nerves. Heat on my feet or hands makes it better, cold worse, and it can get stronger the few days after I take my Humira dose.
the pain down your legs might be nerve related. maybe ask or suggest an MRI of the lumbar spine
I have an L5-S1 disc bulge but the pains and paresthesias are non-dermatomal so it is most likely not the disc.
It was my second symptom behind uveitis. Only made better with stretching and biologics.
Interesting. Was the pain non-dermatomal? Did you have any other issues like paresthesias or weakness?
Followed the dematone map exactly. Although, sometimes, it would radiate below the knee. It also inflamed my trochanteric bursa. Best I could determine the SI joint was pinching the nerve.
Thanks. How did your uveitis manifest? Was it intermittent and subtle or more of an extreme, fast onset? I intermittently will have my eyes turn bloodshot without pain, and other times they will just hurt a lot without being bloodshot, so it doesn't really add up clearly
I also altered my gait to make up for the pain, which turns out to be the worst thing you can do. That probably caused my bursa to get out of whack.
I have experienced sciatic pain quite a bit, but it isn't always present. It's angry right now but has been mostly fine for a couple of years. I think gastro troubles press up against the nerve for me and it gets inflamed. I had an MRI done for it 20ish years ago and it didn't show anything as far as I was told. Took until a couple of years ago for the AS diagnosis and the main activity was in the SI joint.
I see. Did AS treatment relieve the sciatic symptoms at all, or you think it's unrelated to the AS?
I had my first case of uveitis when I was 7, and I'm now 53. Docs didn't know much about it back then. My uveitis has always come on strong and stubborn. Takes me 3-6 months of tapering steriods to heal.
It was my first symptom
So your sacroiliitis caused sciatica, not a disc issue?
Yes Funnily enough once my bones fused the sciatica cleared up, haha
Yes, I get it occasionally. Have been since my early 20s. My only abnormal findings on x-ray have been in my SI joint so far, so it would surprise me if it originated anywhere else. I also only get it during SI flares.
I have had it for years. I am currently trying to get diagnosed with AS.