I finally know what causes the pain in my lower back during bike rides over 20 miles. At around that time, the skin goes numb in the lumbar region, also my toes go numb. About 5 miles later, the pain starts. The only way is stops, is by getting off the bike.
So, what I think is happening is that the L5 nerves are being compressed when my spine is in this position on bike (the areas where I experience numbness is the L5 nerve root and nerve end in the toes / feet). I don’t get this pain at any other time in my life, so perhaps this is made worse by my Hyperlordosis, as that area is already compacted due to the steep curvature. (See MRI below – mine in on the left, slightly more ‘normal’ example on right)
I googled nerve compression and the my two main issues came up…
Symptoms of nerve compression in the L5 nerve roots
• Chronic lower back pain at the site of the compression.
• Numbness and tingling in the feet and toes.
I guess I’ve never put the back and feet numbness together and made the connection until now. Maybe because I don’t get any of the typical Sciatica symptoms, like pain shooting down my leg etc. This diagnosis also explains that while the pain is mostly on the right side of my back, it can move to the left at time (nerves are on both sides), and that it’s not always consistent in its behaviour (sometimes it’s manageable, sometimes excruciating).
Anyway, it’s feels like after 12 years of struggling with this, I finally know what it is, which is great. But what I still don’t know is, whether there is any non-surgical treatments that might actually help. I am working on my core / glute strength and stretching my hip flexors (specifically the Psoas) to try and reduce the Lordosis, but with a clearer idea of the problem, there may be some more options out there, before I have to give up cycling long distances for good.