Why is my sciatica not going away?

Sciatica is a form of pain in the nerve that radiates into the hip and leg down the back. In a few weeks, it sometimes goes away, but for certain persons, the disorder is chronic.

The pain may feel like an intense cramp or electrical impulses that are burning.

Chronic sciatica may be sciatica, which lasts longer than 3 months or goes away and comes back.

A long-term disorder that can cause persistent pain is chronic sciatica. It is harder to treat than acute (short-term) sciatica, but relief can be obtained by many treatments.

This paper discusses what sciatica is, what induces it, and how it can be treated.

Why is my sciatica not going away? 

Sciatica Exercise

Sciatica happens when the sciatic nerve is pressed on or trapped by something.

A herniated disk in the lower spine is the most common cause.

Spinal stenosis, a disorder that causes the spinal column to narrow, is another risk factor.

Herniated disk

Doctors do not know why some cases of sciatica become chronic.

Because of a herniated disk, both acute and chronic cases happen. In most situations, within a few weeks, herniated disks improve on their own. It can cause chronic pain when they do not.

Injury

Individuals with herniated disks often remember a particular injury that caused the pain.

An injury does not mean the pain is going to be permanent.

People who have a herniated disk from an injury, however, can again develop the same injury, especially if they continue to repeat the movements that led to it.

Inflammation

Spinal nerves may be trapped by inflammatory conditions , causing sciatic pain.

People with chronic inflammatory conditions can find that their sciatica flares as their condition gets worse, such as rheumatoid arthritis.

Sciatica may be treated by treating the underlying disorder.

Infection

An infection in or around the spine, which is a swollen and infected mass, may cause an abscess. This abscess, causing sciatica and often other symptoms, can trap spinal nerves.

An individual with an abscess may develop a fever, have pain in other areas of the body, or find that after getting another infection, sciatica begins.

Spinal mass or cancer

Spinal nerves can be trapped by some form of mass in or around the spine, causing sciatic pain.

Some are cancerous masses. In other cases, the discomfort may be caused by epidural hematoma, which is a swollen blood patch near the spine.

It is necessary for individuals with sciatica to see a doctor to rule out potentially dangerous conditions, such as cancer , especially if sciatica does not go away.

Wear and tear

As a person ages, the normal wear and tear on their spine can cause the spinal column to narrow, resulting in spinal stenosis.

For some individuals, spinal stenosis causes chronic or worsening pain.

Lifestyle issues

The risk of sciatic discomfort or prolonging the recovery time can be increased by many lifestyle factors.

Individuals with these risk variables can find that sciatica is persistent or recurrent. Sciatica risk factors include:

  • little physical activity and prolonged sitting
  • having overweight or obesity
  • smoking

Since sciatica frequently accompanies an injury, if they continue the action that caused the initial injury, individuals will often find that the symptoms do not improve.

Tuberculosis

A rare form of tuberculosis ( TB), a lung infection, is sacroiliac joint tuberculosis, which physicians call tuberculous sacroiliitis.

It occurs when an abscess that spreads to the sacroiliac joint in the pelvis and lower spine is formed by the infection. Symptoms of TB may also be present in a person, such as breathing problems or coughing.

TB is a very rare cause of sciatica, but testing is necessary if symptoms persist and a person has a history of exposure to TB.

Spinal misalignment

It may place pressure on the gap between the vertebrae when the spine is not correctly aligned, such as when a person has scoliosis or another chronic condition.

This pressure may cause herniated disks. It can also compress and cause nerve pain in the sciatic nerve. An individual can require surgery, physical therapy, or other therapies, depending on the cause.

Will my sciatica come back?

Especially when a person has a chronic medical condition, Sciatica can and does come back.

Symptoms can also be re-developed by people who do not make lifestyle changes to avoid more sciatic pain. Sciatica, however, recovers on its own within a month or two for most individuals.

Exercises for sciatica 

Sciatic discomfort can be relieved by exercise. An individual with sciatica might be supported by the following exercises:

  • Aerobic exercise promotes fitness and can help a person reach and maintain a moderate body weight. Try low impact exercises, such as swimming or walking.
  • Stretch the hip flexors by standing straight in front of a chair. Bend the knee to a 90-degree angle and put the foot on the chair. Lean forward to stretch for 30 seconds.
  • Kneel with the buttocks resting on the heels, then put the chest to the ground with the arms elevated straight above the head and flat on the ground. Hold for 30 seconds.
  • Lie on the back and bring the knees to the chest. Hold for 30 seconds. Some people find additional relief by rocking from side to side in this position.
  • Lie on the back, with the knees bent and the feet flat on the floor. Lift alternating legs up, as if marching, for 30–60 seconds.

Other symptoms of sciatica

The most common symptoms of sciatica include:

  • electrical sensations along the side of one leg
  • pain that radiates from the lower back to the hip and down the leg
  • intense leg cramps
  • pain when walking or moving
  • numbness in the legs, hips, or lower back
  • pain when sneezing or coughing

When to see a doctor

Sciatica, with or without therapy, typically goes away on its own.

The cause of sciatica may be diagnosed by a doctor and medication may be administered to speed healing.

Sciatica, however, is not a medical emergency, and waiting to see if the symptoms improve on their own until seeing a doctor is fine.

Seeing a doctor is recommended if:

  • sciatic pain interferes with daily functioning
  • sciatica lasts longer than 3 months
  • sciatica goes away and then comes back
  • the pain is unbearable or gets steadily worse

Outlook 

While the outlook is good for most individuals with sciatica, a longer and more challenging recovery is faced by those with chronic sciatica.

A 2020 study showed that surgery for sciatica-causing herniated disks provided better results than conservative therapies, such as exercise. The trial was limited, however, and only participants from a single treatment center were recruited by the researchers.

Summary

Sciatica can be very painful, but there is no long-term need for most people to live with it.

It is common for sciatica to last for several weeks. However, if weeks turn into months, this may mean that it is time to pursue a diagnosis and consider other options for treatment.

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