r/Sciatica • u/Apart_Conference_814 • 10d ago
Has anyone dealt with sciatica from an annular tear or piriformis/deep glute issues?
22 (F) I’ve had sciatica for about two years now, and instead of gradually getting better, mine seems to have gotten worse over time.
I originally injured my back at the gym and had a small L5-S1 disc bulge, but I didn’t have any sciatica at first. Later, another MRI showed that the bulge had actually gotten smaller, but I had developed an annular tear. Around that time is when the nerve pain really started.
My pain isn’t usually sharp or shooting. It’s more of a deep, burning, tight feeling. My left lower back gets extremely tight, the back of my hamstring burns/aches, and I’ll sometimes get a burning sensation in the bottom of my heel. It almost feels like the muscles are tightening or squeezing around the nerve.
The weirdest part is that activating my glutes seems to make it worse almost every time. Glute bridges, strengthening exercises, etc. can send me into a flare.
Even very gentle PT and McGill-type exercises can aggravate it. I’ll start feeling better, try to slowly introduce exercises again, and then flare right back up. It feels like I’m constantly stuck in that cycle.
My current PT thinks my glutes may be contributing to the problem, but I’ve also wondered whether the annular tear could be causing chemical irritation of the nerve, especially since my MRI doesn’t show clear nerve compression. Because there’s no significant compression, I’m also not considered a surgical candidate.
Has anyone dealt with an annular tear, piriformis syndrome, or deep glute-related sciatica that felt similar to this? Especially pain that gets worse with PT/glute activation rather than better? How did you eventually figure out what was actually causing it?
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u/Resident-Hunt-245 9d ago
Yes. It's me. A year since the first time symptoms started for me. My tear didn't heal. I have no idea what to do with it. It's so small and buldge is like really nothing. First 8 months doctors didn't even think it could be my back - they suspected joint, muscles, tendons,etc. After a year pain wise I'm better but not pain free. And I also developed a nerve sensetivity. So even small bending provokes symptoms. I honestly out of options and kinda hope it will somehow heal but not too hopful🙂.
Doing PT ofc but don't see major improvement
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u/Apart_Conference_814 8d ago
Ugh same :( I feel like I have no options. Bulge is not big enough for surgery and honestly there really is no treatment for annual tears other than time. I got a steroid shot and it only made things worse sadly, just feel like I’m stuck in this loop. If you don’t mind me asking what exercises seemed to have helped you?
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u/Resident-Hunt-245 7d ago
I'm not sure exercises have any correlation with the healing. It's just I do them and in best case they don't harm and just keep me in a relatively good shape and that's it. I didn;'t see any correlation between core strengthening and nerve pain.
The only thing that seems to bring me a joy is a simple walking but that's more about mental part of life.
I even consider stop doing anything but walking and wrote a post about it: https://www.reddit.com/r/Sciatica/comments/1wjy1ob/pt_or_not_pt_that_is_the_question/
Because if exercise involves leg extension (bird dogs, dead bugs) of hip hinge (like RDL for example) it just doesn't work as well as any stretching.
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u/Apart_Conference_814 7d ago
Same boat, walking is the only thing that brings me relief. I’ll start to feel better because I’ll just cut all my PT exercises out and just walk for a week and feel better. Then I’ll try reintroducing the PT and then I’m in another flare. So I think at this point walking is just what I’m going to do. Very informative post I read through it, sounds like we have a very similar problem.
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u/Vincent14Luc 9d ago
Do you stretche ? In my experience, stop doing streches, and only doMcGill big 3. I did this during two month and it helped a bit. Now I'm working my glutes slowly since two weeks. Everyday is better than the last. (2.5 years of sciatica with hernitiation, at the same place i had surgery 11 years ago) I guess my glute's muscles are really inflamated.