Why is My Sciatica Not Going Away?

According to Harvard Medical School, sciatica may affect around 40% of the population at some point in their lives.

Sciatica has an annual incidence rate of 1 to 5%, and the risk of developing the condition increases with age.

Most people (three out of four) will start recovering from sciatica in a few weeks, while others may require additional treatments. However, surgery is not typically a useful option — it may even worsen sciatic pain.

In this article, we’ll discuss sciatica, the underlying causes of sciatica, what you can do to treat and prevent it, and why chronic cases sometimes happen.

What is Sciatica?

Sciatica refers to pain related to the sciatic nerve, which is the largest nerve in the human body. The sciatic nerve starts in the lower back and branches down each leg. When this nerve is pinched, compressed, or irritated, sciatica occurs.

In most cases, sciatica only affects one side of the body, but it is possible — although quite rare — for it to affect both legs simultaneously. This condition is known as bilateral sciatica.

Sciatica may be caused by:

• Herniated discs
• Bone spurs
• Spinal stenosis (narrowing of the spine)

Disc herniation is the most common cause of sciatica, but it can be caused by anything that presses or squeezes against the sciatic nerve.

How Long Does Sciatica Last?

Most cases of sciatica will resolve in four to six weeks without any treatment. However, if you experience worsening pain or your condition doesn’t improve with over-the-counter treatments or home remedies, speak to a doctor.

While mild cases of sciatica don’t require much treatment — if any at all — there are instances where you’d require therapy, medication, or need to make lifestyle adjustments to recover from sciatica or to manage chronic pain.

Acute Sciatica vs. Chronic Sciatica

Acute sciatica is often more painful than chronic sciatica, but symptoms disappear within a few weeks. This type of sciatica can be managed at home and often requires no treatment.

By comparison, chronic sciatica may be less painful, but it's a lifelong condition that cannot be self-managed and may require surgery, physical therapy, and additional treatments.

What Are the Symptoms of Sciatica?

The exact symptoms of sciatica will depend on which parts of the sciatic nerve are affected. Some general symptoms you may experience if you have sciatic pain include:

• Mild to severe pain or numbness in the lower back, hip, buttock, or leg
• Pain that worsens when you sit or try to stand up
• A burning, tingling pain that feels like an electric shock
• Difficulty moving your legs or feet
• Incontinence (loss of bowel or bladder control)

Why is My Sciatica Not Going Away? Common Reasons

There are many causes of sciatica, and knowing all the risk factors can help you prevent flare-ups or avoid the condition altogether.

Some of the causes listed below can also affect the healing process and make it more difficult for you to recover from sciatica.

Lifestyle factors

Some risk factors linked to lifestyle can be prevented while others cannot. Certain risk factors are also reversible, and many may be eliminated by implementing lifestyle changes.

Lifestyle factors that increase the risk of sciatic pain include:

• Sitting or standing for extended periods
• Not getting enough exercise
• Being overweight or obese
• Smoking
• Drinking
• Malnutrition (not eating a balanced diet)
• Age
• An occupation that puts strain on your body; for example, a job that requires heavy lifting

Herniated discs

Disc herniation is the most common reason why people get sciatic pain.

When one of the discs that comprise your spinal column is dislodged and presses against one or more of your spinal nerves, this can cause sciatic pain.

If your herniated disc does not heal well and continues to press against the sciatic nerve, your condition may become chronic.

Infection

An infection in the spine may cause an abscess that can trap spinal nerves and cause sciatica.

If sciatica flare-ups occur alongside symptoms such as fever, there's a chance that an infection is the cause.

Wear and tear

As we age, our spinal spaces begin to narrow (spinal stenosis). This narrowing can put pressure on the sciatic nerve, resulting in back pain and sciatica.

Spinal misalignment

A chronic condition, such as scoliosis, that results in a misaligned spine can put pressure on the spine which increases the risk of disc herniation — the main cause of sciatica.

Spinal mass

Both cancerous and benign masses in the spine can trap spinal nerves and cause sciatica.

If your sciatica does not heal within a few weeks, visit your doctor to rule out any other serious conditions.

Injury

Injuries that occur due to sudden accidents or repetitive overuse can cause sciatica.

If your injury never fully heals, or you reinjure yourself, you may experience sciatic flare-ups and worsening pain.

Inflammation

Inflammation can cause swelling that traps spinal nerves, resulting in sciatica pain.

In order to remedy sciatica caused by inflammatory conditions, you'll need to address the underlying condition (for example, rheumatoid arthritis).

Underlying health conditions

There are several underlying health conditions that can contribute to, worsen, or prevent your sciatica from going away.

Here are some conditions that can increase the healing time for sciatica:

• Diabetes
• Heart disease
• High blood pressure
• Obesity
• Alcoholism

Can My Sciatica Come Back?

If the cause of your sciatica remains untreated, you may experience recurrent sciatica. Constant changes in the spine as we age can also cause sciatica to return or flare up.

Sciatica may also come back if you don’t make certain lifestyle changes to prevent recurrence, such as increasing exercise and making the necessary dietary changes.

If a chronic condition — such as spinal stenosis — is the cause of your sciatica, improper management of this condition can cause your pain to return. Similarly, if you’ve developed sciatica due to an injury, a reinjury can trigger your sciatica again.

What Can I Do to Ease Sciatic Pain?

Prevention is better than cure, but if you’re already struggling with sciatica pain, there are a few things you can do to relieve the pain.

Sciatica exercises

There are several gentle exercises you can do to relieve pain associated with sciatica. Remember to start slowly and listen to your body: if you develop more pain while performing a stretch, speak to your doctor or physical therapist.

Some exercises that help sciatic pain include:

• Knee-to-chest stretches
• Standing hamstring stretches
• Pelvic tilt exercises
• Glute bridges
• Deep gluteal stretches

Physical therapy

A physical therapist can work with you to teach you the proper stretching techniques and exercises that will ease your sciatic pain.

Your physical therapist will typically recommend a gentle exercise program that focuses on stretching and strengthening your muscles, especially those in your back, legs, and abdomen.

Other treatments

You may want to supplement your sciatica exercises and physical therapy with a few other treatments for optimal results. For example, including over-the-counter pain relief medication in your treatment plan can decrease pain or discomfort from physical therapy.

Some additional treatments include:

• Prescription and OTC medications
• Spinal injections
• Ice or hot packs
• Alternative therapies, such as yoga, acupuncture, and biofeedback therapy

How Can I Prevent Sciatica?

There are several steps you can take to guard against sciatica. Some of these methods will be more appropriate than others, depending on the risk factors that apply to you.

Some simple ways to prevent sciatica include:

• Practicing proper lifting techniques and avoiding lifting heavy objects by yourself.
• Using a seat cushion if you sit while working.
• Investing in proper shoes and avoiding clutter to minimize the risk of accidents.
• Getting up from your desk at 30-minute intervals to stretch.
• Maintaining a good posture at all times, including when you sit, sleep, stand, and walk.
• Eating a healthy, balanced diet.
• Performing gentle stretches and avoiding exercises that may injure your back.
• Maintaining a healthy weight.

When Should I See a Doctor?

Sciatica can heal with or without treatment. However, if your sciatica doesn’t heal within three months, it interferes with your daily tasks, or you experience worsening symptoms, seek medical advice.

Below are a few other symptoms to watch out for:

• Severe back, leg, abdomen, or side pain while resting, lying down, or bending at the hip
• Swelling in the back, thigh, or legs
• A pulsing sensation in the leg
• Loss of sensation or weakness in the groin, leg, or genitals
• Night sweats or fever
• A cold sensation in the feet or toes
• Loss of bladder or bowel control
• Weight loss or appetite loss
• Changes in the hair, skin, hands, or feet
• Severe pain at night
• Persistent pain

If you experience one or more of the symptoms listed above in addition to sciatic pain, contact a doctor.

Where Can I Learn More About Sciatica?

Do simple tasks like walking or bending cause you pain? Is your current sciatica treatment not working? LifeMD is here to help, with personalized appointments that happen over your smartphone, computer, or tablet.

Whether you’re dealing with acute or chronic sciatica, licensed medical providers can get you on the right treatment plan. Schedule an appointment today.