Sciatica and cycling

Regular bike riders, motorcyclists and professional cycling athletes may be familiar with the phenomenon of bicycling sciatica. Sciatic pain that specifically affects cyclists can be linked to both physical and psychological sources, and will often include a bit of both for a challenging symptomatic profile. Why is it that sciatica and cycling often come together, and how can you find relief?
The facts of sciatica and cycling
Cycling involves long periods of sitting, and one of the most common symptomatic expressions of affected patients is seated sciatica. Being sat on a hard bicycle seat applies pressure around the buttocks, the coccyx and the sciatic nerve, particularly when patients have abnormal positioning of the nerve within their piriformis muscle. Staying seated for long periods can leave anyone feeling sore and stiff, but when you combine it with the continuous activity of the legs and the torso position involved in cycling, the pain can become severe.
Meanwhile, the psychological aspects of sciatica frequently find their way into the mind as you ride. Long bike rides give you time to think, and this can bring about defensive responses to any sensitive psycho-emotional issues that threaten to come into the mind. Furthermore, competitive cyclists place tremendous pressure on their performance, and perfectionist traits are often linked to causes of mind-body back pain.
Solving bicycling sciatica
It’s never a good long-term solution to cease a beloved activity. It is better to work on gaining an accurate diagnosis and specifying the cause of the pain in order to address it. It is standard practice to assume a structural source, but unresponsive chronic sciatica is frequently misdiagnosed. The best approach is to play an active role in your care, exploring potential treatments.
Sciatica has a fearsome reputation, but it is certainly not impossible to treat. The fundamental approach is to get the accurate diagnosis that leads to the appropriate therapy agenda. Beware of explanations for cycling sciatica that don’t seem to add up to you. You must consider all possibilities, both mental and physical, and ensure that suggested structural issues are evaluated. This way, you can ascertain whether your cycling is truly exacerbating them.
The bottom line
In many cases, the treatment for cycling sciatica is relatively straightforward. It may be as simple as some journaling and emotional work, or perhaps changing your bike seat or modifying your riding technique. Drastic ongoing therapies, or surgical interventions, may not be necessary. Seek accurate, logical diagnosis information from one or more medical professionals to tackle your bicycling sciatica.
While I’ve been to my general Doc for saddle sores, it appears to possibly be a combination of piriformis pain and sciatica that has stopped much of my mtn biking the past year. The doc said I had some abrasion going on and over time it sometimes will become a small lump and a pimple like look to it. When that happens I’m sidelined from the mtn bike for 1-4 weeks. But with enough miles or effort (more effort yields more pain) it can and will come back. Sometimes it’s just a general redness and stinging sensation at the leg to butt “meeting” area if I try to stand for the majority of my ride. Sitting can be uncomfortable and that stinging pain is always present sitting unless I stay off the bike for a month but can and will return. I have tried pyriformis and sciatica PT on my own with some success but never permanent. Bike and saddle adjustments, different padded liners, saddles (have 6 now!), ice, heat, bagbalm, chamois creams, oxy 10, polysporin, etc. I always get out of wet clothes immediately after a ride to try to avoid issues. At this point I’m usually OK standing but that can give me a lower back ache if I try to never sit during the day. I just don’t know who to see about this, a dermatologist, general doc or an orthopedic specializing in bike injuries. I was mtn biking 50-60 miles a week but can only go maybe 15-20 now before I have issues. I even did a few 10 mile rides standing for the entire ride just to be able to get out and ride. Just turned 73 and still in very good shape except for this debilitating issue!
Sounds like a very frustrating problem. The problem started with the saddle sore so that may be is the priority to deal with, as the sciatica type symptoms may possibly being brought on by the compensations (standing for longer, riding out of the saddle for too long. It is also important to know the nerves that feed the skin also feed the muscles under that skin so it is possible for muscle tissue near the skin to feel irritated if the situation persists for too long. Hope you resolve it soon.
I have had sciatica for a few months now. I have it in the lower back left side and a burning sharp pain dull pain on the topside of my left thigh just above the knee as though someone has kneed me there.
I’ve been prescribe codeine and amytriptyline.
I do everything I can for my self including walking, swimming and some pilates stretches I learnt.
It’s always worse when I’m walking. I have to crouch or sit down for a while to relieve the pain and continually do that until the end of my walk.
I really don’t know what else I can do. The doctor diagnosed sciatica and I’m still waiting for physio.
I’ve tried hot and cold treatment too which sometimes makes it worse.
Is it worth me going to see a chiropractor and osteopath and would they just relieve the paid or can they cure this awful condition.
Hello Gary,
When you say the pain is on the top side of your thigh. If you mean the front of your leg as opposed to back of the leg this is not sciatica. Pain at the front of the leg as you describe it is most likely to be femoral nerve pain. It is similar to sciatica but not the same. A physio, osteopath or chiropractor should be able to accurately diagnose your symptoms.
Best wishes.
So is it necessary to see a doctor? It could be sciatica not sure. And thank you for your advice.
It is always a good idea to see a healthcare professional to get a definitive diagnosis for the symptoms you experience.
I think I hurt myself by lifting a 24 pack of bottled water over my right shoulder the 28 th of June , started feeling the pain in buttocks, right hip and down the back of right leg to my calve area. I ride a tandem bike . How do I ease the pain the pain is not as bad as it was. I ice it and add heat. Is it okay to ride a bike ?
Hello Loren, Use your symptoms as your guide. If you can ride your bike without too much discomfort then you should be fine to carry on. Sometimes we have to modify the load (intensity and distance) in the short term, but that is better than stopping completely. Best wishes.
I’ve had sciatic pain 24 hours per day for the past 7 weeks and it has to be the most horrible pain a person can have. It is so bad I went to the hospital emergency room 5 times during the middle of the night hoping I could get some sort of shot to reduce the pain. I’ve been given about 10 prescriptions and nothing reduces the pain. The pills only help to make me drowsy so I can get about 2 hours of sleep every night.
Until my pain started, I was riding my bicycle exactly 100 miles every week. I am 71-years old. I believe the sciatic pain started because the last time I rode a bicycle I rode a different bicycle and the seat was a little too high. I was pulling a small metal trailer with a dog in in and I pulled the trailer in one direction 9 miles. Then, the trailer got a flat tire and I pulled the trailer back to my house.
I believe that because the bicycle seat was about 3/4 of an inch too high the downward force put too much pressure on my spine. Maybe, in the future having a seat too high is something to take very serious. I’ve been out of work for more than 7 weeks and it doesn’t feel like I am recovering and the pain is not subsiding even though I am exercising every day and going to physical therapy.
I tried to ride my bicycle only about 2,000 feet and the pain immediately gets super severe and sciatica also weakens the muscles in the leg so bad my leg constantly buckles and it is so weak it is difficult and dangerous to ride a bike.
Hi Jack,
Sciatic pain is certainly up there as one of the worst you can experience. You sound super fit so hopefully if you keep up with the physical therapy you will start to make a recovery soon. Certainly getting you bike set up right is key to preventing low back problems so hopefully you sharing you experience will be useful to other cyclists. Thank you
How about short 40 minutes on a bike ride be ok for my sciatic that I’ve had the last few days! Could I have caused it myself by sitting to long during lockdown although I walk dogs regularly and have long healthy walks !
Hi Amanda,
You sound active and as much as possible it would be good remain active to help your recovery. For some people riding a bike can trigger their sciatica symptoms and others not. The key thing is to assess yourself. For people that feel fine when on the bike then they can carry on. If the bike triggers symptoms then it is sensible to back off the bike riding for a short period until symptoms reduce and do something else to remain active that does not exacerbate symptoms. Hope you recover soon.
I have been struggling with sciatic pain for several weeks. I seem to have more pain on the outside tendon of my right leg.. Is this consistent with sciatic pain? I am scheduled for an MRI of my right knee to rule out any other type of injury or problem
Dear Nicholas,
It is not possible to offer a view based on the information provided. Tendon pain on the outside of the right knee alone does not sound like typical sciatica symptoms. A fairly common condition for pain on the lateral side of the knee around the tendons and joint line for runners and cyclists is ‘runners knee’. Hope you get to the bottom of your symptoms soon. Best wishes.