How I Got to the Bottom of My Sciatica Pain in My Back and Leg

The pain started in waves in my lower back and travelled down my left thigh as I worked bent over my laptop on my couch—the pandemic years had crystallized bad habits. The uncomfortable tightness turned searing over the coming days, building quickly, like I’d crossed an invisible damage threshold. The sciatic nerve is the largest in the human body, two inches thick at its widest. It stretches from the lower back, down past Achilles’ weak spot to the bottom of the heel, creating problems for around 40 percent of us—and not just, as I’d always thought, for old people.

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A year and a half in, my symptoms have varied as widely as the cures I’ve tried. I’ve experienced lower back soreness, tingling and numbness from my butt to my heel, all sorts of painful muscle tension and a sharp electric shock in the back of my leg. I’ve been X-rayed, then MRI-ed, which revealed that my three lower discs (the toothpaste-textured jelly between my vertebrae) bulge out, creating pressure on the nerve. I’ve seen physiotherapists, acupuncturists and a neurosurgeon, who counselled patience, which is not my strong suit.

I’ve used a standing desk, floated in a sensory deprivation chamber and had six massages, including one from a woman who stood on my back. I’ve applied hot magic bags, freezing ice packs and the pummelling force of an M3 Pro massager. I’ve ingested ibuprofen, Robaxacet, naproxen and amitriptyline—an antidepressant doctors prescribe for many ailments, including nerve issues—to keep pain from waking me up as I sleep with a pillow stuffed between my knees.

And, my god, I have walked, like I was trying to give my pain the slip at every corner. I imagine my pain like a baby, howling its needs at the crack of dawn. Walking was the only way I could start my summer days. I learned to document my nearby park’s native plants and spot the cormorants who visit its water basin.

I gave up the gym, biking and yoga and, around the one-year anniversary of my sciatic woes, took up swimming a couple of blocks from my Montreal apartment. Though the bored-out-of-their-skull lifeguards seemed barely old enough to vote, they bopped their heads to hits from the 2000s—MGMT, Lady Gaga’s “Poker Face,” a Ja Rule and Ashanti duet. Maybe their boss was a millennial who’d given up new music in 2008 or maybe I’d become the target audience here. Maybe this was nostalgia-fuelled motivation for the newly broken. Among the many cruelties of the pandemic, a minor one was dealt when, as I doomscrolled from my couch with a curved lower spine, a meme informed me that 35 is middle-aged.

My third physiotherapist, who could have been my son if I’d made different contraceptive choices in high school, asked if I’d had any falls. I answered no, but later spliced a mental supercut of all the times my boots lost contact with icy sidewalks slicked by Quebec winters. I added genetic predisposition on my mother’s side and incalculable hours spent working in a half-recline worthy of a seder table. My current physiotherapist and plain old therapist have emphasized that trying to pinpoint a specific cause, or blaming myself for the onset, is not helpful. Neither suggested that the pain was all in my head.

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But Tanner Murtagh, a registered social worker at the Pain Psychotherapy Canada clinic in Calgary, clarifies that, actually, pain is all in your head, because it is processed in the brain—though that doesn’t mean the pain isn’t very real. He explains that consistent experience of pain can often become neuro-plastic, or what used to be called psychosomatic. “It’s occurring due to the brain and nervous system being stuck in danger mode,” he says. “This can come about after long bouts of pain. The brain has learned to fear it, interpreting non-painful stimulus as painful. It can also be tied to childhood trauma.”

Examining fearful relationships to pain isn’t just valuable in psychotherapy. Kalem Kachur, the founder of Physiothérapie Solution Active in Montreal, focuses on back and sciatica issues, using the McKenzie method of treatment—a system that zeroes in on the problem, identifying what tissue needs to be stretched or strengthened, and addresses relationships to pain, too. “We end up having so much fear of moving, fear of the pain, that it can very often lead us to have pain for longer,” he says. “We don’t become desensitized but are actually hyper-sensitized to it.” After identifying with that fear, I made an appointment at Kachur’s clinic, where Duc Nguyen became my fourth (and hopefully last) physiotherapist.

Rather than starting me with a long sequence of stretches and strengthening exercises, Nguyen began with just one pose. He had me lie on my stomach and push myself up, fully extending my arms into a yoga-style cobra, which made my pain furious. The pose is the opposite of the forward flexion we do so often, and can help restore equilibrium to the joints. Repeating it up to 40 times during the session alleviated pressure on the nerve, leaving me more pain-free than I’d been in a year. I was also told to use a cylindrical lumbar pillow to correct my posture, since slouching overstretches and irritates the back’s tissue, and better posture allows things to heal. “It’s like leaving a scab alone and not picking at it,” Kachur says.

One of the best strengthening exercises I now do is sitting up straight with my core and back engaged, shoulders down and chest out. Friends and family have poked fun at what has become my default posture—it’s never too late to find your trademark look. Kachur highlights the need for regular movement during work hours, to step away from desks, sitting and standing alike. “If you’re really bad at that, drink lots of water,” he advises. “You’ll get up.”

After initial success for a few weeks, my progress plateaued, potentially because of my pain’s inflammatory nature, which takes longer to heal. Nguyen had me change the angle of my cobra pose, then do spinal twists, attempting to home in on the right remedy. He had me put my left foot up on a chair, bend toward the floor to open my hip, and intensify the pose by pulling on the bottom of my foot.

This simple manoeuvre bumped the pain down a few notches, reigniting the embers of my faith that I can get better, slowly and steadily. Murtagh encourages keeping an eye on the big picture. “Anyone who comes to our clinic says, ‘I want my pain gone.’ We want to aim for it. But that can create a lot of pressure,” he explains. “Collecting all the small wins, like, ‘I’m actually a bit less fearful when the pain comes on now,’ that’s a huge piece.” I learned that it’s key to listen to my pain rather than fear it, trusting it will improve as it’s increasingly understood.

Recently, I went back to my childhood pool with my mom, who goes there to exercise and help heal various injuries. I watched her swim back and forth, at her own pace, a few lanes over, before I pushed off into the crawl. As I moved through the water, I hoped that the pain would loosen its grip. Then I remembered I needed to loosen mine, too.

Next: My Severe Back Pain Turned Out to Be Due to a Hip Misalignment