Sciatica is a condition caused when the body’s longest and widest nerve is pressed or trapped.
That nerve is the sciatic nerve, which extends from the top of the leg and down to the foot. When someone suffers from sciatica, they may experience sharp pain, numbness, tingling, or weakness in the lower back, leg, or foot.
It’s important to distinguish whether you are experiencing sciatic pain or general lower back pain.
Most cases of sciatica resolve in less than 4-6 weeks, but there are exceptions.
If you’re experiencing prolonged lower back and leg pain due to sciatica, this article will explore common causes and give you some prevention tips.
In this article, I’ll explain why sciatica might not go away, how long it can last, whether the pain will come back, and what to do when the pain won’t go away.
I’ll also discuss when you should see a doctor, and some prevention tips you can try to reduce future incidences of sciatica.
Why Is My Sciatica Not Going Away?
Prolonged sciatic pain is not only uncomfortable, it can interfere with daily life.
There are many reasons why your sciatica may not be going away, including:
If injury was the cause of your sciatica, returning symptoms could mean you have re-aggravated the original injury.
This is especially common when you repeat the actions or movements that led to the injury.
About 90% of sciatica cases are caused by disc herniation.
Between each of the vertebrae in your spine are donut-like structures, called discs, that keep the bones from painfully bumping into each other.
When one of the discs is torn or bulges out from its normal position, usually from pressure on the lower back, the jelly-like disc can push into the spine and pinch a nearby nerve—that’s disc herniation.
In most cases, herniated discs improve on their own.
When they do not, it can lead to chronic sciatica pain.
Bone spurs are areas of extra bone growth.
They can form on the spine as a result of osteoarthritis, trauma, or other degenerative conditions and cause ongoing sciatica pain.
Underlying Health Conditions
Some underlying health conditions can impact your body’s ability to heal—especially in older adults.
When these conditions exist, sciatica can last longer than typically expected. T
hese conditions include:
- Heart disease
- High blood pressure
An infection in or around the spine can cause a swollen, infected mass called an abscess.
This abscess can trap spinal nerves, causing sciatica and, sometimes, other symptoms.
A person with an abscess may develop a fever, have pain in other areas of the body, or find that sciatica begins after they have another infection.
Some lifestyle factors can increase the risk of prolonged sciatic pain and healing time.
These risk factors include:
- Being overweight
- Poor diet
- Lack of exercise
- Prolonged sitting or standing
Improper alignment of the spine, such as when a person has scoliosis or another chronic condition, can put pressure on the space between the vertebrae and cause chronic pain.
Depending on the cause, a patient may need surgery, physical therapy, or other treatments.
Spinal Mass or Tumor
Sometimes a mass can develop in or near the spine and may trap spinal nerves, causing sciatic pain.
In rare cases, this mass can be cancerous. One rare example of this is called a malignant peripheral nerve sheath tumor.
Wear and Tear
Wear and tear on your spine (a common part of aging) can lead to a condition called spinal stenosis, which is narrowing of the spaces within the spine.
This narrowing can compress your sciatic nerve and lead to chronic or worsening nerve pain.
How Long Does Sciatica Last?
While most cases of sciatica resolve on their own in 4-6 weeks with no long-term complications, conditions like those listed above can result in prolonged pain.
If left untreated, or if the underlying cause is severe, sciatica may become chronic and persistent, lasting for two months or more. An estimated 20-30% of people may continue to suffer from sciatica for 1-2 years.
Will Sciatica Come Back?
Sciatica can come back, particularly when its underlying cause remains untreated.
It is also important to make necessary lifestyle changes that can affect the healing process.
These can include, but are not limited to: changes in diet and physical activity.
What To Do If It Won’t Go Away
If your sciatica persists, try these home treatments to see if they provide pain relief.
- Cold therapy: Apply an ice pack or cold compress to the area for 10-20 minutes, several times a day.
- Heat therapy: Apply a heating pad or hot water bottle to the area for 15-20 minutes, several times a day.
- Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) may be prescribed to manage pain, swelling, and inflammation.
- Physical therapy, gentle stretching, and exercise: Working with a physical therapist can help you strengthen and stretch muscles. Yoga can also help improve muscle strength and flexibility.
Before introducing any of these treatments, consult a healthcare professional to be sure your pain is indeed being caused by sciatica, and that these at-home treatments will be safe for you.
Exercises for sciatica
There are several exercises and stretches that can provide short-term sciatic pain relief:
- Low impact exercises such as swimming, walking, or yoga
- Hip flexor stretches
- Glute stretches
- Hamstring stretches
- Hip stretches
When to See A Doctor
If home remedies are not helping, and your pain is prolonged or worsening, you should see a doctor.
Specifically, consult a doctor if:
- Sciatica lasts longer than three months
- Sciatic pain is severe and interferes with daily activity
- Sciatica goes away and comes back
After performing an examination, discussing your medical history, and determining the original cause of your sciatica, your doctor will provide you with several treatment options.
Medications such as muscle relaxers or stronger painkillers are often prescribed. In other cases, the doctor may recommend epidural steroid medications. These are injected into the area around your spinal cord to reduce inflammation.
Surgery for Sciatica
In instances of worsening pain, pain that hasn’t improved with other treatments, and severe weakness in muscles that results in loss of bladder or bowel control, surgery may be the best option.
One type of surgery that could be recommended is a microdiscectomy, a minimally invasive surgery that often offers quick relief of symptoms.
The procedure removes the disc material that is putting pressure on your sciatic nerve. A laminectomy may also be considered. In this surgery, some bone is removed to ease pressure on the spinal cord.
While sciatica can’t always be prevented, making lifestyle changes can help reduce the risk of recurrent symptoms. Recommended changes include:
- Maintaining a healthy weight by eating a balanced diet and exercising regularly
- Minimizing sitting, and maintaining good posture while sitting, driving, and exercising
- Avoiding bending your back when lifting heavy objects
- Not smoking
- Stretching regularly
- Using good body mechanics
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