Lose Weight, Gain Hurt?

December 26, 2008 10:42 PM

I used to get sciatica as a result of a lower back problem. It mostly went away, perversely as I put on some weight. Now, I am losing the weight to deal with the lower back pain itself, and the sciatica is coming back as the weight comes off. Coincidence, or to be expected? It seems kind of backwards to me.
posted by blue_wardrobe to Health & Fitness (7 answers total)

i wonder if it's not the weight but the amount of stress you're putting on your back. maybe while you were gaining weight you were also not being as active, and now that you're exercising to lose weight you're using it more?

idk, but update if you fix it because my bf has sciatica, i want to be able to help him.
posted by big open mouth at 10:54 PM on December 26, 2008

Best answer: Catabolic state is a typical exacerbator of mononeuropathies, so that's one thing. In other words if a single nerve is damaged/healing, losing weight generally tends to make it dysfunctional while you're taking the weight off. Seems to have something to do with weight loss, nutritional factors and the body's endocrine state.

A fat belly exaggerates the lumbar spinal curve; perversely, the extra-curved lumbar spine may actually stress the intervertebral discs in such a way as to squeeze them forward, instead of back where they compress the nerves. That's another way that losing weight can exacerbate sciatica.

So yeah, not unheard of. But as with any unexpected symptom definitely consult a doctor.
posted by ikkyu2 at 11:54 PM on December 26, 2008 [1 favorite]

By the way there are stretches that help sciatica. Maybe your doc can point you to some resources?
posted by St. Alia of the Bunnies at 4:56 AM on December 27, 2008

Response by poster: @ikkyu2: thanks for some plausible explanations. I am under the care of a doctor, but for me, understanding mechanisms helps me a lot.

@bom: sorry - but I'm not actually being that active yet. The main reason to lose the weight is to alleviate the pain enough to be able to be a bit more active. I have found the back pain to be somewhat of a feedback loop: pain => inactivity => weight gain => pain, so I am making a more than conscious effort to break the loop.
posted by blue_wardrobe at 5:31 AM on December 27, 2008

Do you have access to a pool? Just floating without gravity pulling on you can be a pain-free or reduced-pain way to spend an hour when you have back issues. Consult your doctor first, of course.

Good luck - I've had similar issues and losing the weight was a huge help.
posted by SuperSquirrel at 7:04 AM on December 27, 2008

I'm in my own feedback loop of pain (two lumbar discectomies about 10 years back). I'm also overweight, but I've found that attempts to exercise my way out of it have caused more pain. I think, and this is my totally unscientific idea, that overdoing any attempt to get back into shape is sure to make the lower back gods angry.

By just losing weight, if your back is upset, follow through on the various methods of stabilising it. I've been using the McKenzie methods, and there's the book Treat Your Own Back, which has some pretty good stretching activities. If you're finding pain just by losing weight, maybe you need to get your back into alignment to deal with the new weight/posture issues.

Then again, IANAD/IANYD/IHSBIAVPBH (I have severe back issues an very poor back habits)
posted by Ghidorah at 7:36 AM on December 27, 2008

I had intense sciatic pain through the weight gain and loss of both my pregnancies. I cannot recommend a physical therapist's assessment enough. The PT was able to quickly determine that it was pressure from muscle inflammation due to my back/hips/buttocks adjusting quickly to weight changes and not a herniated disc. Knowing that, they suggested I make two simple changes in my posture and within two days the pain was gone. I've been doing follow-up stretches and exercises (none of which anyone would describe as "active") and have had only the occasional twinge once a week or so. A huge improvement and one made with very small changes. Good luck!
posted by cocoagirl at 7:00 AM on December 28, 2008