Question from Engelbert B.: I am 62 years old and have been a "kilometre eater" for 35 years. Thanks to gymnastic exercises, I have been able to avoid back problems, but this year my sciatic nerve is giving me a hard time: It burns and pulls on my right leg from my buttocks to the tip of my toes. The pain tends to occur when I'm at rest, I don't feel anything when I'm cycling. Chiropractic treatments have not brought any improvement. What therapy can help me?
Dr Christian Merkl: I suspect that anatomical changes in your spine are causing the pain. In addition to a herniated disc, degenerative growths and ossifications on the vertebrae could be irritating the spinal nerves emanating from the spinal cord: burning and pulling up to the tip of the toes indicate irritation of the nerve roots. Their exit point from the spinal column may be narrowed, which is referred to as foraminal stenosis. A narrowing of the spinal canal (spinal canal stenosis) can also cause your pain.
In both cases, the condition worsens when the spine adopts an upright posture: Then the vertebral joints slip into a different position with less space for the spinal nerves than in a bent posture with a hunched back like on a racing bike. It is therefore more favourable in this case, so you have no problems when riding. An MRI scan can visualise both causes. The therapy depends on the findings, which you should have fully clarified. If there are indeed degenerative changes with constrictions, these could be surgically removed.
