Sciatica after a sudden car brake

Triathlon Forum
1

I’m having a sciatica for more than year

My story starts back in June 2012.
I was driving in the car (like 10mph), when I didn’t notice that the car in front of me stopped (due to red flashlight), and my response was to hit the brake very fast and hard, which probably resulted in some sort of whiplash (“Luckly” I didn’t hit the car).

Initial signs weren’t so bad, or at least I thought so. Then, I gradually started to feel some deep pain in my right upper buttock and referred pain down the leg (numbness/weakness) all the way to the toes. The acute pain was mostly like very strong muscle pain in the upper buttock (about 3 moths), then when it subsided, I was only left with some sort of numbness/weakness that starts in the upper buttock and goes down the leg. It’s more like a dull pain, but it’s really annoying pain, and feels like it’s limiting me. I found that when I run/ride the bicycle it gets worst, so I started to avoid these activities. Also found that putting a belt or very tight pants would make it worse.

Fast forward to now, it’s already been almost a year and half, and I’m still having this pain. During this time, I had 3 MRIs (2 regular and 1 with contrast), all being negative no signs to disc problems or spinal stenosis. Also had 2 EMG tests and nerve conduction tests on my right buttock and leg, all negative, no signs to any nerve damage. Had 20 PT session no major improvement. 1 piriformis cortisone/steroid injection, no improvement whatsoever. Tried 1 chiropractor session, felt worse didn’t continue. Had 1 deep tissue massage, also felt worst. Didn’t try accupunture (I’m kinda skeptical about it). Tried some muscle relexants/Ibeprofen doesn’t really take away the sensation. I started doing swimming, thought it was helping, but not eventually it was just a temp relief, and even sometimes it could make it worst too.

I was seen by many doctors, including neurologist, pain mangment, sports medicine (orthopedist), back/pain doc. Some of them suggested that it might be the SI Joint (SIJD) or the piriformis. So I had an injection to the pirofrmis it didn’t help. Now my sports medicine doc suggests to try another injection (the first one was done by another doc). I asked him if we can have a botox injection (after reading some success stories here about the injection with botox) instead of the cortisone, since it wasn’t really useful last time, and I don’t want to spend more money on it ($250 co pay). the insurance company (aetna) refused claiming it’s not medical nes and not proven or safe. The doc will try to have a peer to peer review to appeal, hopefully he will get the approval.
If not, then I’m thinking about asking for another cortisone shot to the piriformis and also maybe try cortisone shot to the si joint.

This pain really affects on my quality of life, and I feel like I made a small mistake, and now I’m paying for it for the rest of my life. I don’t want to keep living like this with this Sciatica pain, I wish I could find a way to beat it, and I looking for other stories guides treatment methods it doesn’t seem very bright, am I gonna be stuck with this pain forever?

Does anyone can identify with what I’m going through, and can suggest maybe ways how to deal with this pain, or how to proceed in my treatments? It just feels like a lost battle. I would be greatful for any piece of advise.

Thanks for reading and helping.

2

I suffered with Sciatica for quite a while and tried many things (although not quite as much as you), PT, Chiro etc.

I started going to see an Osteopath and within a couple of treatments I was getting relief and ultimately I was pain free within a couple of months. She has also been instrumental in fixing many other little nagging issues I have run into from training.

3

I have had recurring sciatica in the past and here is what worked for me. No promises it will work for you, but you’ve got nothing to lose, especially financially - this costs next to nothing: a pinky ball. I’ve recommended it many times in the past here. It’ll cost you all of $4 at your local sports injury supply shop or maybe even at Walmart. Sit/lie on it. Hit the trigger points (easy to find - they’re the spots that hurt like hell). At first just pressure (as much as you can tolerate), then gyrate like you’re doing an intense pinpoint massage. It will hurt bad and maybe even twitch involuntarily (a sign the area will “release” if you keep at it). Move outward in all directions. Make your way all the way over to the hip. The whole process will take 15 min. or so. Do the other side, even if it isn’t displaying symptoms. Do this daily. It will get worse before it gets better. Do not give up. Eventually you will be able to back off to a maintenance level whatever that is for you. It’s a couple of times a week for me. Most importantly, do not stop doing this. Think of it as regular preventative maintenance, just as you might get for massages or chiro visits. Eventually get a foam roller and work your way down the side of the leg and up into your back. These are really just varieties of self-massage that will benefit every muscle group you can target on your whole body. I think of it this way: use the broadest form of massage (foam roller) that will work for an area. So, for example, the roller will not help much with piriformis (or other deep six troublemakers) because it doesn’t get deep enough. That’s when you’ve gotta move down to the smaller, harder devices. A pinky ball is often enough, but occasionally I’ve gotta go smaller and/or harder like a lacrosse ball or perhaps a golf ball.

I can keep my piriformis issues at bay, but it is only through constant attention. Do not forget to stretch regularly as well, like three times a day if you can spare the time. Scratch that. Make the time. It’s just the reality. Be diligent. I bet your problem abates in time and you can get back the situation where the only thing holding you back when training or racing is your fitness. Best of luck to you.

4

Where/who is the Osteopath you went to?
Do you know any good ones in the LA area?

5

Sorry, I’m in Eastern Canada so I’m no help to you.

6

That MOI is common cause of SI joint pathology or hip pathology if traumatic enough. I’m treating a patient right now for both hip and shoulder after she nailed the brake and horn pretty hard. Both extremities stiff and as a result the force gets transferred right to the hip/shoulder joints. You could have some chronic inflammation/irritation to the area. Find a good clinician to assess your pelvis/sacrum/leg length to find any structural/functional discrepancies.

Same thing goes for the wallet scenario. George Costanza wallet will definitely put increased force on your pelvis when sitting and can cause similar issues. Not traditional “sciatica” but similar presentations. Only the cause is coming from a more proximal area.

7

Hi, I found your post on google, I’ve the same problem. I spent 5 months thinking about a bulging disk, but eventually I discover that the pain was caused by the piriformis.
I’m treating it with massages with a tennis ball, stretching and swimming. The main problem is that every day I need to drive a lot to go to work. In this period the pain is gone but sometimes I feel a little tingling to my gluteus.
What about you? Did you find a solution? I hope you are well!

8

Hi robertotmn,

I’m still having the problem.
I tried to get the pinky/lucruz ball and a foam roller and used it for some massage sessions as described in one of the replies above, but I don’t think it really resolved it. I’m now just using the lucruz ball to sit on it when I feel the pain is getting worst (not sure it’s really helping, maybe just psychologically).
Also tried 1 week of taking nasid ibrufen 3 times a day, I thought I felt a little improvement, but then I did some movement that made it worst and I realized it wasn’t really helping.

I also think that the pain can get worst because of sitting for long time like driving or sitting at work. I try to take a break more often at work to stand. I’m still avoiding all activities that make it worse and wearing light pants to avoid putting pressure against it

The insurance company declines the appeal for Botox injection to the piriformis because they say it’s not med proven.
I tried 1 acupunture and massage sessions but I didn’t really feel improvement. My spine/sports medicine doctor still thinks it’s the piriformis according to his clinical diagnosis, and he suggests to have another cortisone/steroid injection although I’m not sure if it will help since I already had one made by another doctor a year ago which didn’t help much. I made a second opinion appointment for tomorrow
for another sports medicine doc. For now I also stopped swimming cause I got to the point where I felt that it dosen’t really resolve the problem. I guess I’ll update more tomorrow after I meet with the other doc.

I guess being in protective mode made my pain less noticeable and I try to keep myself busy with other stuff, so I guess it’s not bad as it used, but It’s probably only because I keep it at bay, and I know that one mistake can unleash it again for few days until it calms down lol. I learned to live with it and master it in a way hehe.

9

I would explore this possibility.
http://www.ncbi.nlm.nih.gov/pubmed/9456549
http://www.jvascsurg.org/article/S0741-5214(98)70330-1/abstract

10

Hi Fry,

I’m not very sure what are the links you provided.
It seem like some medical papers from 1998 about injury caused by the seat belt to the common iliac? Is it the same as the si (sacrum iliac) joint?

I’m aware that I was probably sitting in a bad position when I had to quickly brake, not sure if it was the seat belt. I think it was more the whiplash force or something.

11

These are my treatment, I hope you’ll get well!

This stretching position is helping me a lot http://www.athletico.com/blog2/wp-content/uploads/2012/06/Yoga.pigeon.edited-1024x368.jpg

When I’m at work i try to seat this way http://4.bp.blogspot.com/_P5DPLYwwqOQ/TTN0_XiVdFI/AAAAAAAAALA/GBsuZ0M1LRs/s1600/WhKvM2y_seated-piriformis-stretch%255B1%255D.jpg

Or even with this way, but the ankle under the opposite knee, not over.
http://i1201.photobucket.com/albums/bb343/thepermanentnomad/chair8.jpg?t=1337992117&__SQUARESPACE_CACHEVERSION=1337992977029

And here the tennis ball massage
http://www.youtube.com/watch?v=9dimfNtsN7I

In my case sciatica started when i switched to my new car with automatic gear. I always used the manual one. Now the pedals are bigger and i can seat more relaxed… I don’t know why, but in the first moments i were keeping m right foot straight on the gas and turn it counterclockwise to break.
Probably this wrong position caused my piriformis syndrome. Notice if you do the same!
Best luck :slight_smile:

12

These are my treatment, I hope you’ll get well!

This stretching position is helping me a lot http://www.athletico.com/....edited-1024x368.jpg

When I’m at work i try to seat this way http://4.bp.blogspot.com/...retch%255B1%255D.jpg

Or even with this way, but the ankle under the opposite knee, not over.
http://i1201.photobucket.com/albums/bb343/thepermanentnomad/chair8.jpg?t=1337992117&__SQUARESPACE_CACHEVERSION=1337992977029

And here the tennis ball massage
http://www.youtube.com/watch?v=9dimfNtsN7I

In my case sciatica started when i switched to my new car with automatic gear. I always used the manual one. Now the pedals are bigger and i can seat more relaxed… I don’t know why, but in the first moments i were keeping m right foot straight on the gas and turn it counterclockwise to break.
Probably this wrong position caused my piriformis syndrome. Notice if you do the same!
Best luck :slight_smile:

Hi robertotmn,

Thanks for sharing your treatment info.
I’m familiar with everything you mentioned and tried it too, but it didn’t really help much.

I’m not sure I understand what you mean about turning the leg counter clockwise to brake, isn’t that in every automatic car?
I mean the pedal brake is on the left, and the gas pedal is on the right, so I would think you move your leg to the left(counter clockwise) to hit the brake, isn’t it how it’s supposed to be? (at least that’s how I do it)

13

hi kralor,

some good advice and links above.

you could also try bowen therapy:
http://bowendirectory.com/#California

some therapists in the LA area if you check the list.

i’d add that as with any therapy, sometimes it takes a couple of sessions to get some benefit or relief, so best not to be in a hurry to dismiss something that doesn’t “cure” your pain straight away. try to have a more patient approach than what i picked up from your posts so far, with regard to treatment you have recieved so far.

some of the best advice posted though was, you just gotta help yourself more.

stretching, foam rolling, use of different size balls for trigger point therapy, maybe look at the use of a sacro wedgy ( www.sacrowedgy.com ), or sacro aligner, ( www.spynamics.com ).

basically, invest in time and effort to help yourself return to athletic activities you enjoy again, rather than the situation you find yourself in now, walking on egg shells, limiting everything to avoid suffering pain.

good luck!

14

These are my treatment, I hope you’ll get well!

This stretching position is helping me a lot http://www.athletico.com/....edited-1024x368.jpg

When I’m at work i try to seat this way http://4.bp.blogspot.com/...retch%255B1%255D.jpg

Or even with this way, but the ankle under the opposite knee, not over.
http://i1201.photobucket.com/albums/bb343/thepermanentnomad/chair8.jpg?t=1337992117&__SQUARESPACE_CACHEVERSION=1337992977029

And here the tennis ball massage
http://www.youtube.com/watch?v=9dimfNtsN7I

In my case sciatica started when i switched to my new car with automatic gear. I always used the manual one. Now the pedals are bigger and i can seat more relaxed… I don’t know why, but in the first moments i were keeping m right foot straight on the gas and turn it counterclockwise to break.
Probably this wrong position caused my piriformis syndrome. Notice if you do the same!
Best luck :slight_smile:

Hi robertotmn,

Thanks for sharing your treatment info.
I’m familiar with everything you mentioned and tried it too, but it didn’t really help much.

I’m not sure I understand what you mean about turning the leg counter clockwise to brake, isn’t that in every automatic car?
I mean the pedal brake is on the left, and the gas pedal is on the right, so I would think you move your leg to the left(counter clockwise) to hit the brake, isn’t it how it’s supposed to be? (at least that’s how I do it)

You are right, re-reading my comment is difficult to understand, i try to explain well.
My problem started when I were pushing the brake with my right foot internally rotated, my right toe was pointing to left and the angle was high, like this.
http://i156.photobucket.com/albums/t16/sammiebucket_2007/P9180316-1.jpg

The proper way to push the brake is with the foot straight, pointing the front of the car!

I hope this is clear… if it’s not, I’ll do a little video

15

I’m suggesting you go see a vascular Dr. , maybe there’s a problem with the Iliac Artery or Femoral artery. Your seatbelt sits across your lap right where the two come together.

I had all your same symptoms and like you learned how to live with it for years. I had also been diagnosed with Sciatica during that time and told that I would just have to live . I had MRIs , X-rays , injections, nothing helped. In the end I couldn’t sit for more than 5 min without being in pain, cycling was painful and in the last year running too.

It may or may not be something that was caused by the accident. Your Iliac artery supplies the blood flow to your pelvis and your legs. If there is a problem with blood flow you will experience all the symptoms you listed above. Given that they haven’t been able to find a problem with your other tests I would get your vascular system checked out next. Visit a vascular Dr and have him do an ultrasound and an ABI test. You need to have both tests to determine whether or not there is a problem. When I first went in my ultrasound looked great…it was the ABI test that showed there was a problem.

Hope this helps, I know how frustrating this can be!