Sciatica / Piriformis syndrome – Help!

At the start of November I started getting gradual pain in my back and the back of my thigh, after a couple of days it was pretty bad and I was popping ibuprofen 3x a day to try and manage it, I hoped it would resolve itself as all the online advise is to try and keep moving etc. Well it hasn’t got any better, pain down my thigh is debilitating, especially by the end of the day. I’ve been to see the doctor who told me to self refer to the local physio/soft tissue damage clinic. I’ve got an appointment through for the middle of January. I had hoped to be seen earlier than that but I guess the NHS being in the way it is that’s what I can expect. I really wanted a diagnosis of what caused it, and what I should be doing to get it better. I’ve tried to follow some of the exercises on he NHS website but my mobility is nowhere near that of the model – they should produce the videos with an actual person suffering from sciatica and see if they can bend there leg like that!!!

For the first few weeks I was pretty positive and just kept on keeping on but I’ll be honest this last week I’m feeling pretty low, spiraling down due to lack of being able to do much around the house, not getting out (walking is torture, I have to take a break very 5 mins), can’t get comfortable in any position sitting or standing, can’t play with the kids and even my work is starting to take a hit due to concentration being shot. Dreading Christmas and putting up decs, shopping  etc. Also not sure if this is ever going to ‘get better’ or if this is it now. I don’t feel like ‘me’ anymore. Just a grumpy, tired version. I’m especially frustrated because I don’t know what caused it – I used to do regular core strength workouts etc and felt in good shape before this struck.

Can anyone offer advice on exercises to try, anything I can do to relieve the pain I’ll give a go. Will cycling help?

There’s a load of stuff on YouTube but I’m not sure I’d rely on it.

My first port of call these days is a good local sports physio. If you are near Nottingham/Derby I can recommend a couple. Initial consultation is £55-60 I think, so a pound a day while you are waiting for the NHS.

I had very similar, and definitely concur with the advice to see a good sports physio – see who your local running club uses, is a good start!

Also, just Google “piriformis stretch”, and do that (stretch, not Google it!) ideally twice a day. Will take just a day or so to start making a difference.

I too was going to say tty sports physio while you wait and where are you? Though it’s possible with sciatica someone might want a scan to know what’s causing it, interesting you can’t determine / remember what might have set it off. Dr Jo on youtube will have stretches but don’t overdo anything.

Depending what’s causing it there can be different outcomes, if caused by a ruptured or slipped disc then intervention will be needed, it won’t fix itself,  if it’s been caused by a trapped sciatic nerve it will probably sort itself out in time, I had this a few months ago and can’t describe the all consuming nature of it and the absolute pure agony it caused, I was taking all the painkillers I was allowed but some times I couldn’t move at all without getting shooting agonising pain in my buttock and calf, then in time I could walk twenty yards or so but had to borrow a walking stick from a neighbour, which helped enormously, hot baths also helped and loosened things up, I saw my Dr pretty quickly where it was established it wasn’t a disc problem and he reckoned it would fix itself in six weeks or so, it took more like eight to ten weeks, in that time I made sure I walked every day although I had to walk in short five minute or so bursts and then rest on a bench for five or ten minutes, naproxen helped during the night as it lasts for eight to ten hours.

This time last year I was in your position.  In my case it was a herniated disc, and according to the spinal consultant it was about as bad as they get.  You won’t get to know the cause without an MRI and the NHS won’t do an MRI without trying physio first – I’m fortunate enough to have great health insurance through work so I went private, but that’s not a cheap option without insurance (IIRC about £1k all in for initial consultation with orthopaedic consultant, MRI, MRI follow up consultation, and consultation with spinal surgeon).
Despite the bad initial prognosis, I’ve made a full recovery without surgical intervention.  A good physio is key.  The first one I saw was useless, the second was amazing.  Someone that specialises in sports injuries and back injuries would be ideal.  Also key is taking it slow – some of the piriformis stretches you see on YouTube may be doing more harm than good at this point. My initial focus was just doing very simple exercises focusing on movement of all parts of the body.  Keeping moving is essential, walking sucked but I think it played a major part in my recovery.
It was a slow and painful process for me.  I had a major setback after a couple of months and was about to push the button on surgery, but following my physios advice and consistency in doing the exercises and walking resulted in a slow but consistent improvement after that.  I was very overweight at the time and losing weight was also likely a major factor in my recovery, but this may not apply to you.

All of that is to say, I feel for you – it is completely debilitating and like you I felt hopeless at first and like I’d never be healthy again.  Don’t give up though, have faith in the process and know that small improvements will eventually add up.  In January I could barely stand, I couldn’t get dressed by myself, and I was screaming in pain every day.  Within a couple of months I could walk for an hour, albeit with a significant amount of pain.  By around April I could start doing short sessions of easy spinning on the turbo, and a couple of months later I started jogging.  Everything was done very incrementally, you really must listen to your body and not push too much.  Less than a year on and I’m pain free, doing century rides, and jogging up to 10 miles – hopefully that gives you some hope.

Also, painkillers are useless.  Ask your GP about amitriptyline.  It takes a while of taking it to be effective, but it made a huge difference for me.

Sorry you’re feeling a bit rubbish OP. It’s horrible, isn’t it. Chin up etc – this isn’t ‘you’ from now on. You can get better.

I think you’ve got to work out what’s causing the pain, and then what works for you to fix it. I can only speak for disc problems, as that’s what I’ve had a couple of times. It can take a long time, but they do get better. I went from unable to stand and not being able to feel my left foot to happily spending a weekend in the Tweed Valley or a week riding and climbing in Wales with no issues. It just takes time.

What didn’t help: some people find stretching helps, but it did nothing for me. Ditto cycling – it made my back worse for a while. Anything that sent shock up my spine was bad news, and I had to be really careful how I sat. No slouching on the sofa for you! Long car journeys were horrific.

What did help: pilates style stuff. Walking. Swimming. Bouldering, weirdly (and being careful!). And time – there’s no quick fix and trying to push through the pain absolutely didn’t work.

Obviously, if you don’t have a slipped disc this is all bobbins and all the stuff that didn’t work for me did work for friends – you just need to figure out what helps you.

Ignore comments telling you that a slipped disc won’t fix itself. You may need surgery, but it definitely can improve on its own. You just can’t rush it sadly. As above, don’t push it – take it gradually. I made my first disc issue way worse by not realising what it was and continuing with my manual job until I literally couldn’t stand. Take it easy if you need to.

Good luck!

I had a nervy, electronic sort of pain around the piriformis area for a while. May have been referred pain from a bulging disc or something to do with historical calf injuries but none of the people I saw really had a clue what was going on even after an MRI. What eventually worked for me was a beginners Pilates workout from ‘move with Nicole’ on YouTube. I think the whole workouts were helpful but particularly when you lie on your side and work your upper leg by moving it up and down and around. See 13:00 onwards below. Can’t guarantee it’ll work for you of course, but don’t give up hope, it took me months of trial error to find something that worked but got there eventually.

Having had sciatica from a herniated disc for the past year I do feel for you. I fully agree with qtip, it seems like it will never get better but with good physio it can resolve without surgery but it will take time. I had a period in April where I couldn’t stand for more than 10 minutes but I am now almost back to normal, although very very cautious about lifting things and some activities I have to pace with periods of rest such as working at a workbench . I do have residual numbness in my foot from the nerve impingement but even that is likely to go given time.
I know it’s not possible for everyone but I was advised to get an MRI privately whilst having physio sessions, principally because two different people gave alternative diagnoses- at first I was given exercises for sacroiliac joint issues which exacerbated the pain, but the second opinion was herniated disc and I am so glad that I did get the scan as otherwise I might still be in pain as it confirmed the L5/S1 disc protrusion.

I had sciatica when i had a desk job, my posture was terrible. Physio showed me the stretches which i still do, i ve had no reoccurence. Stretches, losing weight, and i stopped running and just walk now. It really was the most painful thing i ve had.

Poke around the muscles around your buttocks/thighs to see if you can find any areas that are more sore than they should be, and if so then start trying to release them with pressure/vigorous massage, followed by a days rest. Runners get this a lot. I had it years ago, found the sore point and got my osteopath to massage it into submission. These days I’ve got my jigsaw massage gun to do that.

Thanks all, I’ll watch the pilates video and give it a go. Will try and keep moving as well, hopefully there is light at the end of it.

Yep I’d like to find out what caused it as not only will that help my recovery but also help to know how to avoid a recurrence. Can’t afford private so hoping NHS may diagnose in January, In the meantime I’ll try and find a good sports physio. Will they know how to diagnose e.g. sciatica vs piriformis? Also not sure how to tell a good physio from a bad one apart from no progress after spending £££ on sessions.

I do have a desk job, I think stretches may help me but I’ve seen some people say stretches are a waste of time. My right leg has always been less flexible than my left though and that is where the pain is. I can’t cross my right leg over very easily to try the piriformis stretch for example, it just doesn’t bend that much!

Thanks again to everyone that replied.

I had back pain which I initially thought was tight quads. I did Runner’s Lunge stretches, to the point where I had pains in my abdomen, but no relief.

I went to the local Physio who told me I had Piriformis Syndrome. She showed me a sitting cross-leg stretch, which I did repeatedly and tried to keep going. The pain fluctuated, but was definitely worse in the morning. but eventually I got to the point you seem to be. Stepping up a kerb was difficult and a trip to the pharmacy was a major expedition.

I contacted the GP who arranged for me to see the NHS Physio same day (!), but one look at me and he said go home, take Co-Codamol for 3 days then come back. I went back and he identified that the problem was not a disc issue, but a pinch between L3 and L4. He gave me some stretches to do and these have made a massive difference.

The main pain now is in my hip. I think I have strained my hip flexors doing the Runner’s Lunge stretches initially. I cant lift my left leg to get into the car. I have to manually lift it with my hand. Hopefully with light exercise it will recover.

I aim to try to keep up the stretching as at 49, things are likely to get worse rather than better if unaddressed.

Good luck OP. See a decent physio, get some stronger painkillers, rest, and find the therapeutic exercise that works for you.

For about 3 years I had excruciating leg and knee pain, really horrible sensation that used to wake me in the night as if my knee was being sawed through. Walking as very painful at times

Went to a physio who said I had torn cartilage type injury, I was doubtful as I had no recollection of any likely event that would cause an injury. He said I needed an operation

Anyway, eventually I read about piriformis syndrome and did a release exercise for it on the chance it might help. Instant relief and utter joy.

I got the exercise off youtube, but basically you lay on your back. Bring legs up so feet still touch the floor but knees are roughly 90′. Put one leg across the other to make a pretzl, basically crossing your leg. Then with a fist or ideally a tennis ball, put it under the top of your buttock of crossed leg and gently allow your body weight to press down on the ball. You may need to move it around/adjust to hit the right spot but when you do youll know. Somewhere between hip and lower back.

I got a full sensation of relief and pins and needles disappating, right down to my feet. Utter joy

Hold for 30-40 seconds then do the other leg

I know what causes it now – basically sitting, especially in a sofa. It got especially bad again during lockdown as i was loafing about a lot. I dont know if it is sciatica- it seems to be similar and share many symptoms/causes

FWIW, painkillers never helped, at least anything I could buy. I ghostly thought I was crippled  by it, but the release exercise fixed it completely

Painkillers are useless for sciatic pain. I got prescribed anti-depressent FFS total waste of time.

Sofa and arm-chairs probably won’t help, but I found it wasn’t so bad sitting on a dining chair in the evening. I have a desk job as well and it was difficult to concentrate sitting all day. I used a piles cushion helped to relieve the pressure on the sciatic nerve at the base of my spine.

+1 for sports physio. I have an awesome one near me and some simple stretches had me moving pain free in a month.

I’m just getting over what sounds like exactly the same thing.

The same thing happened to me and it’s taken from December 2023 to get to a position when it on the mend.

first thing, go to doctors, tell them about it and that you have tried physio already, even if you haven’t so you get referred to msk asap and possibly get scans.

I had to wait a while, but after mri scan showing back was fine and then felling hopeless, like the constant pain was the new normal, I went to see a chartered physiotherapist

turned out they agreed with the msk physio that it seemed to be hamstring related in my hip and gave me some exercises to help strengthen it but without stretching it.

i d tried to do lots of yoga and Pilates, that made it worse.

nerve pain has stopped, I am off the nerve meds and walking pain free again, back on the mtb and road bike.

not back to full fitness yet, but I wasted 5 months with the wrong advice.

good luck, get the referral asap and find a chartered physiotherapist.

Thanks to everyone who has replied again. A few stories of mis-diagnoses has me a bit worried. @robfury – so it was the hamstring/hip exercises that finally helped? Wondering about this as my hip seems tight and the pain feels like an overstretched hamstring.

@kormoran – don’t suppose you have a link to the you tube video? I’ll have a search for it anyway.

Different video to the one I watched but same technique

Doctors originally thought it was back related, mri scanned and it wasn’t.

one physio was thinking it was it band related due to pain down to knee etc.

stretching hamstring made it worse for me.

I was give some strengthening exercises to do that helped, without stretching the hamstring.

that seemed to stop it restricting a nerve and then no more nerve pain.

So many possibilities really, but I would get the gp to refer you to msk and ask for a scan.

lay it on thick, as untill they rule out a couple of things it’s very hard to know what to do.

it’s tough mentally, but it can get better.

find a good chartered physiotherapist, most of them have lots of nhs experience and not just sports related physio knowledge to pull from.

I rode 60miles on Saturday, I am a bit achy but no nerve pain, so a few days off the bike now