Why doesn't my sciatica go away and come back?

Sciatica occurs when something presses or pinches the sciatic nerve.

The most common cause is a herniated disc in the lower spine.

Another risk factor is spinal stenosis, a condition that causes the spine to narrow.

disc prolapse

Doctors don’t know why some cases of sciatica become chronic.

Many acute and chronic cases occur due to a herniated disc. In most cases, herniated discs will improve on their own within a few weeks. If not, it can lead to chronic pain.

injury

People with a herniated disc often remember a specific injury that caused the pain.

Injury does not mean the pain is chronic.

However, people who have a herniated disc from an injury can develop the same injury again, especially if they keep repeating the movements that led to it.

inflammation

Inflammatory conditions can pinch spinal nerves and cause sciatic pain.

People with chronic inflammatory conditions like rheumatoid arthritis may notice that their sciatica flares up as their condition worsens.

Treating the underlying condition can help treat sciatica.

infection

Infection in or around the spine can cause an abscess, which is a swollen and infected mass. This abscess can pinch spinal nerves and cause 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 starts after another infection.

Spinal mass or cancer

Any type of mass in or near the spine can pinch spinal nerves and cause sciatic pain.

Some masses are cancerous. In other cases, an epidural hematoma, a swollen patch of blood near the spine, can cause the pain.

It’s important for people with sciatica to see a doctor to rule out potentially dangerous conditions like cancer, especially if sciatica doesn’t go away.

wear and tear

As a person gets older, normal wear and tear on the spine can cause the spine to narrow, resulting in spinal canal stenosis.

In some people, spinal stenosis causes chronic or worsening pain.

Lifestyle problems

Several lifestyle factors can increase the risk of sciatic pain or increase healing time.

People with these risk factors may find that sciatica becomes chronic or comes back. Risk factors for sciatica are:

  • little physical activity and long periods of sitting
  • Are overweight or obese
  • smoking

Also, because sciatica often follows an injury, patients may find that symptoms do not improve if they continue the activity that caused the original injury.

tuberculosis

Sacroiliac joint tuberculosis, which doctors call tuberculous sacroiliitis, is a rare form of tuberculosis (TB), a lung infection.

It occurs when the infection creates an abscess that spreads to the sacroiliac joint in the pelvis and lower spine. A person can also have symptoms of TB, such as difficulty breathing or a cough.

TB is a very rare cause of sciatica, but if symptoms persist and a person has had a history of TB, testing is important.

Spinal malalignment

If the spine is not properly aligned, such as with scoliosis or another chronic condition, it can put pressure on the space between the vertebrae.

This pressure can lead to herniated discs. It can also compress the sciatic nerve and cause nerve pain. Depending on the cause, a person may need surgery, physical therapy, or other treatments.