Sciatica flare up 3/4 through AT thru-hike. Need advice!

[Fallesafe]

Hey, nice to meet you all! I'm new to this forum and in a bit of a jam right now. I'm about 3/4 of the way through a flip flop thru-hike of the AT. I flipped up to Maine from Peekskill, NY about two weeks ago. And I just hit Katahdin and the 100 MW harder than I should have with heavy ibuprofen use. Right now I'm in Monson with sciatic inflammation. And I think how I handle this could potentially be the difference between finishing my hike or having it end before I get out of Maine.

In 2008, I had an L5-S1 fusion in my lower back. So I'm familiar with this pain. It tends to flares up occasionally when I hit intense uphill climbs harder than I ought to. I actually had to get off trail for a few days in Tennessee for a similar flare up. But I did it to myself a bit worse this time.

Today was a zero day for me. And I have another one scheduled tomorrow. I've spent this whole day resting, stretching, and decompressing my spine on an inversion table. I'm thinking of doing some heavy icing too. Has anybody else experienced a similar problem? If so, what's the best way to get an acute sciatic flare-up to calm down? I'm willing to do whatever I can to get through this. I've got about 650 miles left to go. And I don't care if it takes me until the middle of November to finish this thing.😂Thanks for any advice you can give!

[RangerZ]

My professional engineering advice: See a doctor - don’t take medical ( or professional engineering ) advice from the internet.

[JNI64]

My plumbing professional advice is also see a doctor.
You don't want to mess around and do some kind of permanent damage now do you? I have had lower back problems for years degenerative disc's. I get alot of pain including nerve pain. One thing I've found very recently is putting 2 tennis balls in a sock and tie the sock in a knot so they can't move. Lay on the tennis balls situated at the bottom of your spine, your vertabre should fit in between the balls and stretch it out .now move the tennis balls up 1 vertabre at a time and relax. It should provide a stretch in between vertabre and relieve muscle spasms.

[Slo-go'en]

Considering your heading into some seriously difficult terrain with very steep ups and downs with poor footing, I would recommend you pack up and go home. Not what you want to hear. If you have another flair up and can't move for a few days, you could run out of food a long way from any town. Cell service is really spotty in Maine and if you don't have a SPOT device, your stuck until someone who has one happens to come along.

[TwoSpirits]

I'm not a doctor, and I don't play one on Whiteblaze, and I'm probably not nearly as experienced as others here, but I would urge you to heed their advice. Heartbreaking indeed, but far better than the possible -- perhaps even probable -- alternatives...and running out of food deep in the Maine woods might be the least of them. If you try to "push through the pain" you may alter your normal gait and throw your balance off...and in that terrain, you could find yourself down with a truly catastrophic injury.

The pain is there for a reason; there isn't much more your body can do to get your attention. I'm sorry your hike would end this way, but better to come back and ENJOY, not just endure, the most beautiful part of the trail.

[Traveler]

Agreed with TwoSpirits. The pain is there for a reason which could be to stop a while to recuperate, or there could be a mechanical issue in your body that will become worse and prevent you from walking completely wherever you are. You are headed for what I believe is the most difficult terrain on the AT that will be steep, slippery, and relentless. If you make it out of the Mahoosuc range into NH with a known issue like this, if a "haul out" rescue is needed you may be responsible to pay for that cost. So from a purely financial reason, you should seriously consider seeing a qualified doctor before you set yourself up for a nasty series of problems.

If the doctor says good to go, then there you go!

[garlic08]

Ditto all the above. You have a unique set of circumstances. I sought medical advice on a minor, developing sciatica problem from a chiropractor. His very sensible advice was to walk--a lot. That worked for me. You've already been walking a lot, and have some scars, so it may not be not good advice for you.

[Fallesafe]

Thanks for the advice all. Much appreciated!👍

[Daybreak]

I had on and off sciatica for a a few years before my first AT thru hike. I had done all the things the doctors said and surgery was all that was left. Sitting too long, any sport or any serious jarring would set it off. I was down to walking. Walking helped immensely and kept it at bay. I could hike and backpack in the Whites without issues. My plan was to go as far as I could. I started slow mostly with the gear I had and a heavy pack. I never had serious back problems.

I used two poles for the first time. I put 100% of my pack weight on my hips keeping my straps well above my shoulders. The straps simply kept my internal frame pack snug. I shifted my heavy gear to the top of the pack toward my body to help me walk more naturally upright. I wore my pack in town if I need to carry food, packages... I also had a book, some birding stuff (spring), extra food that allowed me to take more slow days. IMO, these helped tremendously.

Within a few days after finishing my sciatica reappeared at night in bed. If I rolled to my other side it would swap to my other leg. My walking was limited as my knees needed a break. I had fusion surgery for minor spondylolisthesis that solved most problems. Too much sitting with little walking will still set off minor issues now 20 years later.

[4eyedbuzzard]

Time heals a lot of wounds . . . I've had herniated disks at L3-L4, L4-L5, L5-S1 in the past (all from around 2003 thru 2008). Every once in a while I tweak one of the old injuries, usually from lifting and twisting. It typically takes me about two weeks to fully recover. The first two to three days are pretty bad. Lots of pain meds and ibuprofen, keeping my back out of flexion and in extension as much as possible, McKenzie exercises, etc. Then I just have to take it slow for the rest of the week or so. Usually walking on level surfaces isn't a problem. But there's no way I could carry a pack and hike trail terrain, especially in NH or ME. Take a week's break from the trail and come back if you're healthy, but take it easy and avoid bending and extreme stretching of limbs and impacts. If you're lucky, you'll make it through the Whites before the snow flies. Best of luck!

[Mr. Bellamy]

I had constant sciatica a few years back and finally a doctor prescribed two weeks low-dose Prednisone with one Cortisone shot. That did the trick, it went away and never returned. Inquire about this.

[wolf]

Time to call it a day,it is not going to get any better it will get worse if you continue.so do it next year i should know i pushed it and had to have surgery after hike

[firesign]

Hey, nice to meet you all! I'm new to this forum and in a bit of a jam right now. I'm about 3/4 of the way through a flip flop thru-hike of the AT. I flipped up to Maine from Peekskill, NY about two weeks ago. And I just hit Katahdin and the 100 MW harder than I should have with heavy ibuprofen use. Right now I'm in Monson with sciatic inflammation. And I think how I handle this could potentially be the difference between finishing my hike or having it end before I get out of Maine.

In 2008, I had an L5-S1 fusion in my lower back. So I'm familiar with this pain. It tends to flares up occasionally when I hit intense uphill climbs harder than I ought to. I actually had to get off trail for a few days in Tennessee for a similar flare up. But I did it to myself a bit worse this time.

Today was a zero day for me. And I have another one scheduled tomorrow. I've spent this whole day resting, stretching, and decompressing my spine on an inversion table. I'm thinking of doing some heavy icing too. Has anybody else experienced a similar problem? If so, what's the best way to get an acute sciatic flare-up to calm down? I'm willing to do whatever I can to get through this. I've got about 650 miles left to go. And I don't care if it takes me until the middle of November to finish this thing.😂Thanks for any advice you can give!

A lot of lower back problems are a result of tight hamstrings especially from hiking. The tight hamstrings pull the pelvic girdle out of position and potentially create a lot of problems inc sciatica at the L4/L5.
Try these stretches:

Hamstring towel stretch.
Supine Piriformis stretch

Best of luck

[RockDoc]

These problems can be chronic and hard to treat. My wife has been struggling with it for two years, despite many ortho and PT visits. There's no easy fix.

[RiverbirchHiker]

Thanks for the advice all. Much appreciated!👍

I'd love to hear an update--let us know how things turned out. I'm hoping for the best for ya.

You got into a tough spot--I understand how you wanted to finish regardless of the upcoming southern Maine terrain. Being 3/4 of the way thru is a hard part too. Almost at the end.

[Fallesafe]

I'd love to hear an update--let us know how things turned out. I'm hoping for the best for ya.

You got into a tough spot--I understand how you wanted to finish regardless of the upcoming southern Maine terrain. Being 3/4 of the way thru is a hard part too. Almost at the end.

Thanks man! I'm ten miles away from New Hampshire right now. Southern Maine was tough. But I'm taking it really slow (9-10 miles per day with all the zeros I need). I do about 45 mins of warm up + stretching twice per day. And I'm always carrying an extra day of food. That way, if I have a problem, I can take two zeros wherever I am (one day fasting and one day eating). I'm also going to take advantage of as much slackpacking as I can through the Whites. It's too early to make any definite predictions. But if I can make it through the next 120 miles, I've got this.👍

[4eyedbuzzard]

It looks like after some showers on Monday you are headed toward a nice stretch of good weather from Tuesday morning through Saturday with some sun and highs in the 40s and low temps around 30s at elevation. Definitely going to be windy up on the ridges as usual. But keep checking the weather whenever you can as it's notoriously subject to change (and usually not for the better). Stay warm and dry and have a great hike!

[GlitterHiker]

Just reading this a bit late, but maybe it will help you in the future, or someone else. I was having sciatica pain and as @firesign mentions above, my doctor and PT thought is was from too much weightlifting (deadlifts) and hiking and not nearly enough stretching, particularly of the hamstrings. Doctor recommended Do Yoga With Me website. I've found this class to be extremely helpful for the pain:
https://www.doyogawithme.com/content...ciatica-relief

It's a free class. They are updating their website the weekend of Sept 26/27 so there may be glitches accessing the free classes for a few days. Hope this helps!

[jfan]

I had constant sciatica a few years back and finally a doctor prescribed two weeks low-dose Prednisone with one Cortisone shot. That did the trick, it went away and never returned. Inquire about this.

Exactly the case with me. It's been 2 years now since the injection. Prior to that, I couldn't sit or stand in one place for any length of time, and I would wake up 5-6x per night and have to change positions. None of the Youtube sciatica fixes worked.

I hope I didn't jinx myself.

[Fallesafe]

Hi, OP here. Since someone bumped this thread recently, I wanted to thank everyone again for their advice and give an update in case somebody else is dealing with this issue in the future. When I made this post on 9/3, I had ~668 miles left with all of southern Maine and NH ahead of me to get back to NY. My back was in terrible shape. I had sciatica going all the way down to the underside of my foot on the right leg. And it really looked like I wasn't going to finish. I finally DID complete my thru-hike on 12/3 (92 days later @ ~7 miles per day). But it was really tough going. The biggest thing that inflamed my nerves was the awful terrain in Maine and NH. It didnt get much better until I was in Vermont. And I had to consciously just slow way down and accept that I'd be doing terrible mileage the whole way home. There were a few things that helped me a lot.

1) Every morning, I religiously did about 50 minutes of warm up and stretching. Then I hit the main main muscle groups again briefly before bed.
2) Sciatic nerve flossing. Do this very sparingly (like literally 10 reps per day). Its very easy to overdo. But all the other exercises I tried actually made things worse. https://www.youtube.com/watch?v=85OEGNd9DIE
3) Letting weight loss really take place as my hike went on, and not gorging myself every time I went into town.
4) A zero day at every resupply point.
5) Too much ibuprofin (but I really tried limiting myself to 6 per day)
6) And I'm embarrassed to even write this one. But Marijuana. I was in states where it was legal and had nothing to lose. And I was very surprised how well it dulled my pain!

Good luck to any other hikers with bum backs!