Sciatica is a widespread issue in society and cyclists are not immune from it. Here John Kempler shares his sciatica story.
Hold onto your seat (unless it hurts your back), because we’re talking about everyone’s favourite topic: back pain!
Okay, maybe it’s not everyone’s favourite topic, but it’s an important one nonetheless. According to the Australian Commission on Safety and Quality in Healthcare, lower back pain is a leading cause of disability worldwide and costs the Australian health system a staggering $5 billion annually. Ouch!
But let’s talk about something a little more specific: sciatica. This is when pressure is placed on nerves in the lower back, causing pain in the buttocks and legs. It’s caused by a variety of factors such as slipped discs, pinched nerves, or arthritis. The sciatic nerve runs from the lower back through the hips and buttocks and down each leg.
When it’s pinched, inflammation, pain, and numbness can occur, ranging from mild to sharp, burning pain. It can at times feel like a jolt or electric shock and can be worse when coughing, sneezing, or sitting for long periods.
In 2017, an article was published titled ‘Despite escalating prescriptions, nerve pain drugs offer no relief for sciatica’. This was written by Christine Lin, Senior Research Fellow, George Institute for Global Health and Andrew McLachlan, Professor of Pharmacy (Aged Care), University of Sydney and, at the time, they reported that “around 5 to 10% of people with low back pain have sciatica, equating to around 200,000 to 400,000 Australians.
Cyclists from the age of forty may be more susceptible to the onset of sciatica. If a rider gets fatigued or lazy, they will tend to flex the lower back which stresses the lumbar spine joints and can exacerbate sciatica. This is especially the case if the saddle and and handlebars are positioned incorrectly.
Now, I know what you’re thinking: “Great, another ailment to worry about!” But don’t panic just yet. While it’s notoriously difficult to treat sciatica with over-the-counter medication and complementary therapies, there is hope.
Let me tell you a little story. I’m a fit 69-year-old and a low-level but enthusiastic club cyclist. I ride every day in real life or using Zwift, the ubiquitous indoor bike training game, and rack up around 200 km per week and take on a 70 km ride with my bike club most Sundays. Usually the oldest member of the bunch, it’s enjoyable yet challenging to keep up with the young guns!
I occasionally participate in sportives like L’Etape du Tour, Bowral Classics and even Maratona in the Dolomites, Northern Italy. For those technically inclined, my FTP ranges between 200-220 watts depending on my health. However, I do sit at a desk for long periods, and I’m sure my posture isn’t always the best.
A few months ago, I developed severe pain down my left leg. Some years ago, I had a right hip joint replacement and so thought it was the onset of arthritis in my ‘good hip. I contacted my orthopaedic specialist who, despite being a very busy hip and knee surgeon, is always willing to answer my bothersome emails. Based on a recent x-ray, he advised there was plenty of room in my left hip joint and so recommended I contact a physiotherapist.
I decided to battle the cross-city traffic to visit with a reputable and highly-regarded sports physio. I had consulted Adam some years earlier for a pinched nerve in my neck when, in addition to massage, exercise and some stern lecturing, he had used a traction machine to very good effect. After a few visits and improvement, I decided to search for a practitioner with such a machine, but nearer my home.
I rang several physios in my vicinity and could not find one with a traction machine. In fact, I was told by one they were “old school” and a chiropractor might have what I needed. Now, I know what you’re thinking again: “Chiropractors? Aren’t they those quacks that crack your bones and talk about energy fields?”
Though unsuccessful in finding a practice with the machine I was looking for, I did book a visit with a chiropractor who had a distraction table. He advised these expensive benches are used to “decompress lumbar discs that have bulges, protrusions and herniation”. It was my first ever visit to a chiropractor as I had always considered their work to be on the fringe of legitimate health care. I was very wrong!
At the first visit, Glen confirmed his professionalism when he referred me for an “EOS” and an MRI. The EOS is a low-dose, weight-bearing X-ray technology. It can simultaneously take full-body, frontal and lateral (side view) images of the skeletal system of a patient in a standing or sitting position, using much less radiation than traditional X-rays or CT scans. MRI stands for Magnetic Resonance Imaging and is a non-invasive imaging technology that produces three dimensional detailed anatomical images. Undergoing an MRI procedure is a slightly uncomfortable experience during which you have to stay very still while you lie in a chamber with lots of electronic noises pinging around you.
The MRI report revealed that, according to Glen, I had a “bunch of issues” with fancy names such as spinal stenosis (narrowing of canal that contains the spinal cord and nerves) and spondylolisthesis (one vertebra slipping over another). Ironically.
“…If stretching and traction machines help, maybe I should just hang upside down like a bat…”
After a few more visits, there was further improvement but then I seemed to plateau. It was at that point I thought I would conduct an experiment.
I thought, “If stretching and traction machines help, maybe I should just hang upside down like a bat!” It’s a perfectly logical thought, right? The weight of my lower body would stretch my spine.
So I hoisted myself up on my grandchildren’s swing set in our garden using elastic bandages. It wasn’t very comfortable or practical as I could only hold my weight for thirty seconds or so. That’s when a friend told me about inversion tables.
I ordered one and, after self-assembly (aided by my handier son-in-law), I gave the table a try. And you know what? It worked! After three weeks of using it, I no longer have sciatica pain when walking. There are some minor residual pains when I move or twist in a certain way and these are being addressed with further treatment and exercises provided by a physiotherapist.
Now, I’m not suggesting that everyone should hang upside down like a bat or invest in an inversion table. There are risks for people with high blood pressure, and self-assembly might seem daunting for some. But if my success could be replicated, it could be a game-changer for the estimated 400,000 Australians who suffer from sciatica. And at less than $200 for the table, perhaps Medicare could help as it’s a bargain compared to the $5 billion annual cost of back pain to our healthcare system!
So there you have it, folks: a tale of back-related pain, bicycles, and bat-like behaviour. But in all seriousness, self-help together with advice from allied health professionals might help many people with sciatica avoid pain killers and surgery.