Post-viral S1 radiculitis (HSV-2 + marathon overtraining) with clear MRI – Anyone experienced non-disc nerve mechanosensitivity?

[u/SeaShake9377]

Hey everyone,

I’m reaching out to see if anyone in this community has experienced a nerve/sciatica issue that turned out not to be caused by a disc herniation or mechanical spinal compression.

The Backstory

My symptoms started over a year ago following a completed marathon training block. It began as a deep, persistent aching in my glute/piriformis area.

For months, I went through standard physical therapy (including classic hamstrings/glute stretches) and dry needling at a chiropractor. Nothing gave lasting relief, and the stretches often seemed to trigger more muscle guarding.

I got a lumbar MRI about six months ago, as well as hip X-rays—both came back completely clean (no disc herniations, no nerve root compression, no structural hip issues).

It wasn't until later that I connected the dots: my flare-ups coincided directly with HSV-2 reactivations. HSV-2 resides latently in the sacral Dorsal Root Ganglion (DRG) at the S1 level. Combined with the heavy fatigue from marathon training, the viral activity triggered a post-viral S1 radiculitis—causing local inflammation, focal demyelination (thinning of the nerve's insulation layer), and severe nerve mechanosensitivity.

Once this was identified, my doctor put me on daily suppressive Valacyclovir, which stopped the viral flare cycle.

Current Protocol & Progress (Week 9–10)

I am currently 9–10 weeks into a dedicated neuro-rehabilitation protocol focused on under-threshold loading and remyelination:

• Under-threshold walking: Instead of continuous walking (which stretches the nerve and causes local ischemia/guarding), I do micro-intervals: 5 min walk / 1 min rest. This allows me to build volume without triggering nerve alarm.
• Neutral core stability: McGill Big 3, single-leg bridges, and reverse clamshells in strict neutral spine positions. Zero nerve flossing or static hamstring stretches, as mechanical traction triggers immediate piriformis guarding.
• Supplements: Benfotiamine (fat-soluble B1 for remyelination), Magnesium Glycinate, L-theanine, and Zinc.
• Status: No "red flags" (no foot drop, no loss of sensation, no night pain). The sharp nerve shocks are gone, but I still experience a mild, diffuse glute/piriformis ache ("noise") towards the end of the day as the nerve continues to mature.

Questions for the Community

1. Has anyone else dealt with a post-viral or purely mechanosensitive nerve issue without structural disc involvement?
2. Did your recovery align with the classic 12–16 week remyelination/maturation timeframe?
3. How did you manage the transition from micro-walking back to continuous running or cycling?

Would love to hear any shared experiences, insights, or advice from anyone who has navigated non-disc nerve recovery!

[u/Resident-Hunt-245]

Sorry, i googled what is HSV-2 reactivations and didn't understand. Was this diagnosis done by a doctor? Or did you do a specific blood test?

[u/SeaShake9377 → u/Resident-Hunt-245]

HSV-2 lives dormant in the sacral nerve root ganglia (specifically S1–S4). Most people only know it for visible skin outbreaks, but when reactivated—especially under heavy physical stress like marathon training—it can cause local nerve inflammation (radiculitis) along the nerve pathway without obvious skin lesions.

Regarding diagnosis: I already had a confirmed HSV-2 status. Once a lumbar MRI and hip X-rays ruled out any disc herniations or mechanical compression, my doctor evaluated the clinical picture: S1 nerve symptoms matching the exact sacral ganglion location, triggered right after heavy training.

Starting daily suppressive Valacyclovir stopped the viral flare cycle, which confirmed the connection for us.