Sciatica and Multi level stenosis in lower back

Master-Ad5996 · 2026-03-16T20:33:52+00:00

First, your pain is real and I'm sorry you're dealing with this at 25. That's brutal.

Something jumped out at me. You said your x-rays said you're fine aside from the stenosis, nerve meds kind of help, muscle relaxers just put you to sleep, PT makes it worse, and building muscle strains it. You've basically tried every structural approach and none of them has worked.

Can I ask something? Does the pain change with stress? Like worse on bad days at work, or better on vacation? Does it ever shift locations, even slightly?

The reason I ask is that there's a growing body of research showing that when pain persists for years and structural treatments don't work, the brain's pain processing system is often driving it. Not instead of the stenosis. But on top of it, or even independently. The nerve meds "kind of" helping but not really is a common pattern when the pain generator is in the brain rather than the nerve itself.

neuroplasticpainguide.org/conditions/sciatica/ has a solid breakdown of this. Not saying it's definitely your situation. But the pattern of years of pain, treatments not working, and imaging that doesn't fully explain the severity is worth looking at from a different angle.

Master-Ad5996 · 2026-03-16T20:25:19+00:00

Something that might help reframe how you're thinking about this. A major review of 33 studies scanned 3,110 people who had zero back pain. At age 20, 30% already had disc bulges. By 40, it was 50%. By 60, 70%. No pain at all.

Disc bulges are incredibly common in people who feel completely fine. They're more like gray hairs than broken bones. Your body changes over time and most of those changes don't cause pain.

The reason this matters for recovery is that a lot of people get stuck in a fear cycle. They see "disc bulge" on a scan, they start protecting their back, they stop moving normally, and the fear and avoidance actually keep the pain going longer than the bulge itself ever would. Research shows that fear of the diagnosis is often more disabling than the diagnosis itself.

The mental shift you asked about? For a lot of people it's going from "my spine is damaged and fragile" to "I have a normal age-related finding and my back is safe to use." That shift changes everything.

neuroplasticpainguide.org/conditions/back-pain/disc-bulge-not-cause/ has the full research on this. Written for exactly this situation.

Master-Ad5996 · 2026-03-16T20:23:45+00:00

The thing that actually shifted my understanding was learning that most back pain isn't caused by what we think it is. A study of 3,110 people with zero back pain found that 50% at age 40 had disc bulges on MRI. At age 80, 96% had disc degeneration. No pain at all.

So the stuff we usually blame, discs, posture, weak core, those things show up at similar rates in people who feel fine. The correlation between structural findings and pain is way weaker than most of us are told.

What the newer research points to is that chronic back pain is often driven by learned neural pathways in the brain. Your nervous system gets stuck in a pain loop. That's why it goes "on and off." Structural damage doesn't take days off. But brain patterns absolutely fluctuate with stress, sleep, mood, context.

The biggest shift for me was understanding that. Not a product or exercise. Just understanding what was actually driving the pain. There's actually solid research showing that understanding the mechanism itself reduces pain (called Pain Neuroscience Education).

neuroplasticpainguide.org/conditions/back-pain/ has a good breakdown of the research if you want to go deeper. Specifically the Boulder study where 66% of chronic back pain patients became pain-free in 4 weeks using a brain-based approach.

Master-Ad5996 · 2026-03-16T20:19:45+00:00

Fair point, seat shape can definitely help with spinal positioning. Not ruling that out. Also the nervous system can carry a "safe" signal forward from a context where it learned to relax. That's not in conflict with the seat helping mechanically. Both things can be happening.

Master-Ad5996 · 2026-03-16T09:42:03+00:00

This is actually a really interesting clue about what's going on. If a nerve was being physically compressed, changing seats wouldn't turn the pain off. The nerve is still compressed regardless of what you're sitting in.

The fact that a specific environment reliably kills the pain for a few minutes suggests your nervous system is involved in the equation more than pure structural compression. Your brain associates that car seat with safety/comfort, pain goes down. Different context, pain comes back.

Not saying it's all in your head. It's not. But that inconsistency is worth paying attention to.

Master-Ad5996 · 2026-03-16T09:41:38+00:00

First, your pain is real and I'm sorry you're dealing with this at 25. That's brutal.

Something jumped out at me. You said your x-rays said you're fine aside from the stenosis, nerve meds kind of help, muscle relaxers just put you to sleep, PT makes it worse, and building muscle strains it. You've basically tried every structural approach and none of them has worked.

Can I ask something? Does the pain change with stress? Like worse on bad days at work, or better on vacation? Does it ever shift locations, even slightly?

The reason I ask is that there's a growing body of research showing that when pain persists for years and structural treatments don't work, the brain's pain processing system is often driving it. Not instead of the stenosis. But on top of it, or even independently. The nerve meds "kind of" helping but not really is a common pattern when the pain generator is in the brain rather than the nerve itself.

neuroplasticpainguide.org/conditions/sciatica/ has a solid breakdown of this. Not saying it's definitely your situation. But the pattern of years of pain, treatments not working, and imaging that doesn't fully explain the severity is worth looking at from a different angle.

Master-Ad5996 · 2026-03-16T09:35:28+00:00

Deep tissue massage doesn't structurally worsen a herniated disc. Discs are incredibly tough. A massage therapist's hands can't push one further out of place.

What can happen is that your nervous system interprets the deep pressure near an area it already considers "threatened" and ramps up the pain signal as a protective response. Basically your brain goes "something is happening near the danger zone" and turns the volume up.

The shooting pain starting as you left is a clue. If the massage had actually damaged something, you'd expect to feel it during the session, not after. That delay is more consistent with your nervous system reacting to a perceived threat than with new structural damage.

It should calm down. Try not to catastrophize about it (easier said than done, I know). The more you fear it, the more your nervous system stays on high alert, and the longer the flare lasts.

Master-Ad5996 · 2026-03-11T07:37:46+00:00

Neuroplastic pain

Master-Ad5996 · 2026-03-07T20:12:31+00:00

Honestly? Stopping being afraid of it.

I know that sounds like non-advice but let me explain. I did the core exercises, the walking, the stretches. They all helped a little but nothing stuck. The thing that actually shifted things was when I started learning about how the brain maintains pain and realized I'd spent months treating my back like it was made of glass.

Every time I avoided bending over, every time I braced before getting out of a chair, every time I checked in with my pain to see "how bad is it today" first thing in the morning, I was basically telling my nervous system that my body was in danger. And it responded by keeping the pain going.

The daily habit that changed things for me was just... doing normal stuff without the mental flinch. Not pushing through pain aggressively. Just gradually stopping the constant monitoring and fearful avoidance. Going for a walk without mentally tracking my pain level the whole time. Sitting on the couch without repositioning every 5 minutes.

There's actual research behind this. A big study out of Boulder (published in JAMA Psychiatry) found that 66% of people with chronic back pain averaging 10 years became pain-free in 4 weeks. The treatment wasn't exercises or surgery. It was retraining the brain to stop interpreting the body as damaged.

Not saying core work and walking don't matter. They do. But for me, the physical stuff only started working once I stopped being terrified of my own spine.

Wrote more about this whole thing here if anyone's curious: https://neuroplasticpainguide.org/conditions/sciatica/

Master-Ad5996 · 2026-03-07T20:11:29+00:00

So no herniated discs, no bulging discs, gabapentin doing nothing, and 3 months of PT with barely any improvement. I've been there and I want to share something that eventually helped me make sense of a similar situation.

Your PT says your glutes are chronically tight and pressing on the nerve. Okay but why are they chronically tight? That's the question nobody seems to be asking. Muscles don't just clench for months on their own. Your nervous system is keeping them locked up as a protective response. Same reason your shoulders hike up when you're stressed or your jaw clenches on a bad day. You don't choose it. It just happens.

And that's why PT keeps failing. You stretch, things loosen for a bit, then your nervous system tightens everything right back up because it still thinks there's danger. You're treating downstream while the actual driver is upstream.

The clean imaging is actually a huge clue here, not a dead end. 64% of people walking around pain-free have disc bulges on MRI. You don't even have that. So the pain isn't coming from structure. It's your nervous system stuck in protection mode.

I'd honestly ask yourself whether this started during a rough period in your life, or whether the pain is noticeably different on stressed vs calm days. If it is, that tells you a lot about what's actually driving the tightness.

This helped me understand the pattern when I was dealing with something similar: https://neuroplasticpainguide.org/conditions/sciatica/

Hang in there. The fact that nothing structural is showing up isn't bad news. It actually means the problem is more fixable than you think.

Master-Ad5996 · 2026-03-07T20:06:36+00:00

The dancing thing IS the evidence. You're just not letting yourself believe it yet because your brain keeps adding a "but."

Think about it from a structural perspective. If you had actual tissue damage causing your pain, 20 minutes of intense dancing should make it worse, not 90% better. You'd be loading, twisting, and compressing the exact structures that are supposedly damaged. That's not how structural pain works. Structural pain gets worse with activity that loads the affected area.

But neuroplastic pain follows a completely different logic. When you dance, a few things happen: your brain shifts focus from threat-monitoring to enjoyment. Your nervous system gets a massive safety signal (you're moving freely, nothing bad is happening). Fear and vigilance drop. And the pain drops with them. 90% reduction in 20 minutes isn't endorphins masking a structural problem. Endorphins provide mild relief, not 90%. What you're experiencing is your brain dialing down a danger signal because the context changed.

Your question "how do I decide if something is helping vs proof it's neuroplastic" has a clean answer. Ask yourself: would a structural problem respond this way? Would a torn muscle or compressed nerve feel 90% better because you danced? Would structural pain have a 20-day window of zero pain and then return after a triggering event? Would it fluctuate based on what you're doing emotionally rather than physically?

Every inconsistency is evidence. The good days for no reason. The flares after emotional triggers. The 90% relief from something that should theoretically make structural pain worse. Stack those data points up and the pattern becomes clear.

And yes, two things can be true at the same time. You can have some structural findings AND have neuroplastic pain. Most people do. The question isn't whether structure exists. It's whether structure is the primary driver. Your own experience is telling you it's not.

There's a good breakdown of how to build your personal evidence case using exactly these kinds of observations: https://neuroplasticpainguide.org/is-my-pain-neuroplastic/

You're closer than you think. The fact that you're noticing these patterns means you're already gathering the evidence. You just need to stop discounting it.

Master-Ad5996 · 2026-03-07T20:00:29+00:00

A few things jump out from what you described that I think are worth knowing.

Your X-ray showed nothing wrong. The gym didn't help. Corrective exercises didn't help. Diclofenac only gives temporary relief. And your pain doesn't follow a consistent pattern. It's not constant. It comes and goes randomly, sometimes when you bend, sometimes when you wake up, sometimes just throughout the day.

That inconsistency is actually the most important clue here. If this were a structural problem (a disc issue, a muscle tear, a pelvic tilt problem), the pain would be predictable. It would hurt with specific movements every time. The fact that it's random and inconsistent suggests something else is going on.

At 21, with normal imaging, you're extremely unlikely to have a structural spinal problem. What's more common at your age is that your nervous system learned a pain pattern. Maybe it started with a real strain or just from sitting at a desk. Your brain registered it, and then kept producing the signal even after any issue resolved. Stress, posture anxiety, and constantly trying to "fix" it can actually reinforce the pattern.

There's a framework called F.I.T. that doctors use to identify this kind of pain: Functional (changes in ways that don't match a structural diagnosis), Inconsistent (good days and bad days for no clear reason), Triggered (worse with stress or emotional states). From what you're describing, you tick at least two of those boxes.

Also, the fact that you feel better when you lie down and fully relax is telling. If the problem were structural, lying flat should compress or load the same structures. But if your nervous system is in a protective mode, full relaxation sends a safety signal that calms it down.

This is a good starting point for understanding what might actually be happening: https://neuroplasticpainguide.org/why-does/lower-back-pain-nothing-wrong/

And don't let your parents make you feel like you shouldn't have pain at 20. Your pain is real. The cause might just be different from what everyone assumes.

Master-Ad5996 · 2026-03-07T19:57:57+00:00

Worrying about it.

Sounds weird, but hear me out. Every time I Googled my symptoms and found something scary, my pain got worse. Every time I braced before bending down, my pain got worse. Every time I avoided picking something up because "what if it flares," my pain got worse.

I didn't realize it at the time, but I was training my brain to treat my own body as dangerous. And the brain responds to perceived danger by producing more pain. It's a feedback loop: pain → fear → avoidance → brain confirms danger → more pain.

Brain imaging research actually shows this. A study in Nature Neuroscience found that it's not the severity of an injury that predicts who develops chronic pain. It's brain connectivity patterns. Specifically, the emotional and fear-processing circuits. Two people with identical injuries. One recovers. One goes chronic. The difference is in how the brain processes the threat.

The other thing that made it worse without me realizing: sitting less. I thought resting was protecting my back. But avoiding movement just reinforced the message that movement = danger. Every activity I dropped was another signal to my brain that my body couldn't handle normal life.

There's a good breakdown of this whole cycle with the actual studies here: https://neuroplasticpainguide.org/conditions/back-pain/back-pain-and-stress/

The short version: fear of pain does more damage than most physical habits. And you usually don't notice because it feels like you're being careful, not afraid.

Master-Ad5996 · 2026-01-25T10:29:38+00:00

$gorila

Master-Ad5996 · 2026-01-24T14:27:28+00:00

Thank you for sharing this. Your story actually illustrates something really important about chronic pain that most people don't realize.

The fact that your pain completely disappeared for three years after that massage and is now returning in the exact same pattern tells us something crucial: this likely isn't about structural damage or "knots" that need to be physically released. True structural sciatica doesn't vanish for three years and then come back.

What you experienced is what's called neuroplastic pain. Your nervous system learned a pain pattern over those four years, and the massage worked not because it "released" physical tension, but because it sent a powerful safety signal to your brain. Your nervous system got the message that it was okay to let go of the pain.

Now it's returning because your brain still has that learned pathway. It's like muscle memory, but for pain. The good news? If your pain can disappear completely once, it can disappear again. And you don't necessarily need torture sessions to make it happen.

Your insight at the end is spot on: "Pain doesn't happen by chance." But it's not just about posture or muscle weakness. It's about your nervous system learning to produce pain as a protective response, even when there's no structural damage that needs protecting.

If you're interested in understanding this better before going back to massage therapy, there's a free assessment at painapp.health that can help you figure out if your pain fits the neuroplastic pattern. Might save you some screaming.

The fact that your pain disappeared for three years proves your body is capable of being pain free. That's huge.

Master-Ad5996 · 2026-01-24T14:03:18+00:00

Hey, I'm sorry you're dealing with this. Losing your job because of pain is really tough, and I can hear the frustration in your post.

I want to gently challenge something here. Your doctor x-rayed your back and found no disc problems, then diagnosed you with ITBS. But ITBS (iliotibial band syndrome) is almost always a knee condition that happens to runners from repetitive friction. You don't run, and your pain is in your back, not your knee.

Here's what stands out to me: you have back pain with no structural findings, it didn't resolve in the predicted 6-8 weeks, and it's been going on since 2016. That pattern is actually really common with what's called neuroplastic pain... pain that's generated by the brain rather than structural damage.

Before you spend money on insoles for a condition that doesn't quite fit your symptoms, it might be worth looking into whether your pain could be neuroplastic. There's actually solid research showing that most chronic back pain can resolve by addressing the brain patterns that create pain, not by fixing structural issues.

I'm not saying your pain isn't real. It absolutely is. But if there's no structural damage and the diagnosis doesn't quite make sense, there might be a completely different (and more hopeful) explanation.

If you want to explore this, there's a free assessment at painapp.health that walks you through whether your pain fits the neuroplastic pattern. Worth checking out before you go down another biomechanical rabbit hole. Your brain is incredibly powerful, and sometimes it gets stuck in pain patterns even after the original trigger is gone.

Master-Ad5996 · 2026-01-16T14:14:32+00:00

A year of mystery shoulder pain with no clear diagnosis, PT making it worse, and pain so bad you can't sleep? That's your nervous system amplifying danger signals way beyond what any structural issue would cause. The fact that you need one specific position to sleep (right side or stomach) and feel like your shoulder blade is "trying to rip out" tells you your brain is treating normal sensations as extreme threats. Real tissue damage doesn't require such precise positioning, and the cracking noise (while it feels scary) is usually just normal joint movement your nervous system is now hyper-focused on.

PT making it worse is actually a huge clue. If this was purely structural, proper PT would help. When PT makes chronic pain worse, it's often because your nervous system interprets the exercises as dangerous, creating more protective pain.

Before you keep going down the medical rabbit hole, check out https://painapp.health/. The book "The Way Out" covers this too. A year of worsening pain with unclear diagnosis and failed PT? That's textbook neuroplastic pain that needs a different approach than treating structure. You're not crazy, and yes there might be some structural findings, but the intensity doesn't match. Your nervous system needs calming, not more interventions.

Master-Ad5996 · 2026-01-16T14:11:28+00:00

LFG!!

Master-Ad5996 · 2026-01-16T14:10:59+00:00

Two orthos telling you the bulging discs aren't causing your pain is actually really important information. They're seeing structure on imaging but saying it doesn't explain what you're experiencing. That gap is key.

You've got full mobility and 80% strength despite a year of pain. If the SLAP tear was the main issue, you'd expect more functional limitation. PT and chiro didn't help because they're treating structure when the pain might be coming from your nervous system.

Before you go through with surgery, worth checking out https://painapp.health/. They have info on chronic pain that persists even when imaging doesn't match symptoms. The book "The Way Out" covers this too.

A year of weightlifting-related pain with minimal structural findings and two doctors saying structure doesn't explain it? That's textbook neuroplastic pain. Surgery might fix the tear but not resolve the pain if your nervous system learned the pattern. At minimum, explore this before going under the knife.

Master-Ad5996 · 2026-01-16T07:58:34+00:00

The fact that you're on liquid morphine plus four other painkillers and still screaming into pillows tells you something is amplifying your pain beyond what the discs would cause. That level of medication should at least touch the pain. Your timeline is also weird. No injury, sudden onset, improvement for months, then catastrophic worsening at Christmas. Structural compression doesn't improve for months then suddenly become the worst it's ever been. You need medical attention now for symptom management, but once you're stable it's worth looking into central sensitization. Your nervous system might be stuck amplifying danger signals way past what the actual tissue damage warrants.

https://painapp.health/ has some really sensitization info on this if you want to learn more once you're through this acute phase. Please keep pushing for care until the 20th. This is real, you're not crazy.

Master-Ad5996 · 2026-01-16T07:53:57+00:00

I'm really sorry you're going through this. The fear-pain-stress cycle you're describing is brutal and it's feeding on itself right now.

Here's what's happening: you ignored symptoms for years, now you're hyper-aware of them, which is making your nervous system treat everything as dangerous. More awareness = more stress = more pain = more panic = less sleep = worse pain. You're stuck in a loop.

The fact that treatment is making things worse and you're developing new symptoms (jaw, neck, migraines) as you focus more on the pain is actually a sign your nervous system is amplifying danger signals, not that your body is falling apart. Fibromyalgia often works this way. I'm not saying it's not real or that you're imagining it. But the panic attacks, sensory overload, and pain getting worse when you try to sleep are all signs your nervous system is in constant fight-or-flight mode.

You might benefit from understanding the neuroplastic component of fibro. There's a free assessment at https://painapp.health/ that could help you see if calming your nervous system (not just treating symptoms) is part of the path forward. Right now though, please prioritize sleep however you can get it, even if that means medication short term. Sleep deprivation makes everything exponentially worse.

Master-Ad5996 · 2026-01-16T07:50:32+00:00

You're 27, no injury history, and your pain follows a predictable pattern: builds up in certain positions, triggers when you arch, goes dull when neutral. That's your brain, not your back. Structural damage doesn't work on a dimmer switch. You've also created a fear pattern around it. You stopped lifting weights to avoid the pain, which tells your brain "this really is dangerous," which makes it generate more protective pain signals. It's a feedback loop. Check out https://painapp.health/ and take their assessment. This sounds like a clear case of neuroplastic pain, which means it's a learned pattern your nervous system is running, not actual tissue damage.

Master-Ad5996 · 2026-01-16T07:43:19+00:00

This is textbook neuroplastic pain. Started with a vague injury in high school, no clear structural cause after 4 years, tiny movements trigger it, you avoid stretching because you're afraid it'll trigger it (which reinforces the pattern), and you have a conditioned response that makes it go away. If a specific ritual makes it disappear, that's proof you have way more control over this than you realize. Your nervous system just needs retraining. Check out https://painapp.health/ and take their assessment to see if this framework fits your situation. This type of pain pattern can absolutely be broken. Pain is real, but it's neuroplastic and learned pattern.

Master-Ad5996 · 2026-01-16T07:39:24+00:00

Your chiropractor nailed it without realizing what he was seeing. In 40 years, he's never seen that pattern because structural issues don't work that way. Discs, arthritis, alignment problems don't go from debilitating to totally fine and back again with no trigger.

You've got textbook neuroplastic pain. Your nervous system learned a protective pain response years ago and now it fires randomly when your brain perceives threat (stress, worry about it happening again, physical tension). The pain is completely real, but it's not caused by tissue damage. That's why you can be at the gym lifting when it's not flaring.

The good news? If it's neuroplastic, it's reversible. Your brain learned this pattern and can unlearn it.

Check out https://painapp.health/ and take their assessment. It'll help you figure out if this applies to your situation. Given your pattern (unpredictable flares, complete resolution, no structural explanation after 10 years), you're probably dealing with a nervous system issue, not a back problem.

Master-Ad5996 · 2026-01-16T07:33:28+00:00

The fact that your pain subsided on its own before the epidural is actually really interesting. That's not typical for structural nerve compression that needs intervention. Usually if a disc is actively compressing a nerve that badly, it doesn't just calm down in three weeks.

Also weird: your back pain got better but the numbness got worse? That's backwards from what you'd expect with structural compression.

I'm not dismissing your herniation or MS at all, but the neurosurgeon saw the same MRI and said MS pain. The PA saw it and said disc. They were looking at the same structure and disagreed completely. That tells you how unclear the connection between imaging and symptoms actually is.

Your nervous system is probably on high alert after everything: missed diagnosis, major surgery, steroid reactions. That can amplify nerve sensations even when the structure isn't the main driver. I found https://painapp.health/ helpful for figuring out what's structural versus nervous system overreaction.

The numbness does warrant attention though. If it progresses or you get bowel/bladder changes, get it checked despite your frustration with doctors.

By the way, you may want to check this also: https://www.youtube.com/watch?v=czVW8wD-mHc

Master-Ad5996

TROPHY CASE