Several Months of Sciatica

Pain & Rehab Forum [Moderated]
1

I’m a 32 year old male that has been performing mainly just the big barbell lifts consistently since I was in high school. Since September 2025, I have had consistent pain in my left glute with “tightness” in my left hamstring and calf. I have had a variety of interventions that I will outline below, but none have produced meaningful progress. I meet with a surgeon tomorrow to discuss possible surgery, and I would like to gauge whether I’ve exhausted other options.

Background: I have a 90% desk job, but I am very active in DIY projects and working outdoors on my property (e.g. tree work, chopping wood, landscaping). I am 6’ 2” and weigh ~250 lbs. I’d say I’m on the stronger end of normal.

TL;DR - I have an L5-S1 herniation compressing S1 nerve root on left side. Initial injury in late July, sciatic symptoms appeared in September. I only did about 1-2 months of real PT (with lifting) before backing off due to lack of progress. Diclofenac helps tremendously. Steroid injection hasn’t helped. Surgery is now an option, but I think I’d prefer to return to PT with lifting.

Here’s a timeline of my experience:

  • Summer 2025: Lots of pickup basketball, lifting, and DIY/tree work. Generally exhausting, workout logs include complaints of back soreness/tightness.
  • July 25, 2025: Workout log includes pain very low on the left side of my back. Don’t finish workout, but return to lifting within a week.
  • August 2025: General back soreness and mild pain. Continue lifting.
  • September 2025: Complaints of left glute + lower back pain increasing. Generally didn’t hurt during deadlifts but was irritating before/after. After one lower body workout during which it was irritated, my glute began to really hurt. Primarily hurt while standing up from sitting. Left foot sometimes tingled. Discontinued squats/deadlifts
  • October 2025: Saw a PT for what I thought was piriformis syndrome. No real progress or regression.
  • November 2025: Saw an Orthopedist who immediately performed X-ray and said it was likely L5-S1 herniation. Pain is generally a bit worse and bothers me throughout the day. PT became more back-focused, including high rack pulls. These did not bother me at all. Started oral diclofenac twice a day and saw massive improvement in pain.
  • December 2025: Got an MRI which confirmed L5-S1 herniation and significant S1 nerve root compression. Discontinued much of PT lifting and focused on the very gentle exercises supplied by orthopedist.
  • January 2026: Received steroid injection. Didn’t help at all. In the few days off of diclofenac, pain increased significantly.
  • Feb-Mar 2026: Very reliant on diclofenac. Pain is basically unmanageable off of it.

Right now, I think I would like to continue on diclofenac to manage pain and go back to real PT with lifting. I would likely follow the BM Low Back Pain template. Is this reasonable with my timeline, or am I delaying inevitable surgery now that I am ~6 months from initial injury?

Thanks!

2

Hi there,

Sorry to hear about this experience you’ve been suffering through. Unfortunately given the degree of sensitivity you are reporting, I do not think that using continuous NSAIDs like Diclofenac and self-managing through the back pain template would be the best strategy moving forward. I think you would require more individualized guidance and support through this process, and ideally finding a strategy and dose of training that allows you to not require chronic NSAIDs like this. Several of our pain & rehab clinicians have personal experience with this, having gone through sciatica themselves, and have specific expertise in guiding people through this over time.

If your interest is in finding the strategy that is most likely to help avoid surgery, working with their team is the way I would go, rather than attempting to continue self-managing with diclofenac and a general back pain template that isn’t individualized to your situation, symptoms, and tolerance.

3

Austin,

Thank you for the quick reply! Though disappointing, trying to get off the meds definitely makes sense.

I did say my preference is to avoid surgery (likely microdiscectomy). But, in my context, would your experience indicate that it’s a reasonable course of action at this point?

I will definitely be looking into working with some BBM clinicians following my consultation with the surgeon.

Thank you!