Sciatica is a condition caused by irritation, inflammation, entrapment, or compression of your sciatic nerve. It can cause moderate to severe pain and weakness in your lower back, buttocks, and legs.
Sciatica usually heals in 4 to 6 weeks, but it can take longer in some people. In this article, we examine possible reasons why your sciatica pain may persist.
Here are some of the reasons your sciatica can get worse.
Injury and re-injury
If an injury caused your sciatica and your symptoms get better and then worse, you may have made the injury that originally caused your sciatica worsen.
Sudden injuries and repeated overload injuries can lead to sciatic symptoms. Herniated discs are the leading cause of sciatica.
Age and general health conditions health
In general, younger people heal faster than older people. But there are many underlying health conditions that can also slow your body’s ability to heal. Some conditions include:
An epidural abscess is a collection of pus that develops between the bones of the spine and the membrane of the spinal cord. There may be swelling, which puts pressure on your nerves and leads to sciatica.
Wear and tear on your spine can lead to what is known as spinal stenosis, which is a narrowing of the spaces within the spine. This narrowing can compress your nerve and lead to sciatica.
Sciatica often responds to gentle movement. It is believed that mobilizing the sciatic nerve can help improve symptoms by reducing nerve sensitivity. Light stretches and exercises may be recommended as part of the treatment.
Alternatively, a sedentary lifestyle and spending time sitting down can potentially make symptoms of sciatica worse.
Spinal mass or tumor
In rare cases, a cancerous mass can put pressure on your sciatic nerve. A very rare type of tumor that can develop is called a malignant peripheral nerve sheath tumor.
Sciatica often responds to home treatment, but you should see a doctor first to make sure you are dealing with sciatica. If you haven’t already tried treating your symptoms at home, the following methods may help:
- Cold. Try applying an ice pack or cold compress to the painful area for about 20 minutes several times a day.
- Hot. After the first few days, you can apply hot packs or heating pads to the painful area for 15 to 20 minutes several times a day to stimulate blood flow to the injured area.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). NSAIDs like aspirin or ibuprofen can help you manage pain, swelling, and inflammation.
- Physiotherapy, stretching and movement: A physical therapist can help strengthen weak muscles and stretch tight muscles that may be contributing to your pain. The UK’s National Health Service recommends resuming normal activities and gentle exercise as soon as possible. Always carry out these activities under the guidance of a specialist.
Go to the doctor
If you’ve tried home remedies before but your pain is getting worse, it is a good idea to see a doctor.
Your doctor may prescribe muscle relaxants, stronger pain relievers, or other medications. In some cases, they may recommend epidural steroid drugs. These drugs are injected into the area around your spinal cord to reduce inflammation.
In certain cases, surgery may be the best option. These include cases of worsening pain, pain that has not improved with other treatments, and severe muscle weakness that leads to loss of bladder or bowel control.
One option is microdiscectomy, a minimally invasive surgery that often provides rapid symptom relief. The procedure removes the disc material that is putting pressure on your sciatic nerve.
A laminectomy, which is an operation that removes bones to relieve pressure on the spinal cord, may also be considered.
Sciatica usually lasts around 4 to 6 weeks. But about 30 percent of people still have noticeable symptoms after a year.
It’s not always clear why some people develop chronic sciatica and others don’t. Some risk factors associated with chronic sciatica include improper lifting techniques and, if possible, not doing regular moderate-intensity physical activity.
Risk factors for recurrent herniated discs are:
- Disc protrusion
Sciatica can recur, especially if the underlying cause is left untreated. For example, if you use improper lifting techniques and develop sciatica after a herniated disc, you are at risk of injuring yourself again if you continue to use the same lifting technique.
A 2016 study found that in a group of 341 people seeking nonsurgical treatment for a herniated disc in their lower back, 23 percent of those with leg pain experienced pain again within a year and 51 percent had pain again within 3 years had.
The researchers also found that 28 percent of people with low back pain experienced pain within a year and 70 percent experienced pain within 3 years.
A 2015 study review found that nearly half of 609 people who sought treatment for leg and back pain had symptoms for more than 3 months. Almost 75 percent of the study participants had sciatica.
Lifestyle changes such as the following can help you prevent recurring symptoms of sciatica:
- Eat a balanced diet and exercise regularly.
- Minimize sitting down and sit with good posture.
- Avoid arching your back when lifting heavy objects.
- Choose exercises that are unlikely to cause lower back injuries.
- Avoid smoking.
- Minimize your risk of falls by wearing sturdy shoes and keeping the floor of your home free of clutter.
Most of the time, mild sciatica will go away within 4 to 6 weeks. However, you should speak to your doctor at the onset of symptoms to make sure you are dealing with sciatica. You return to a doctor if:
- your pain keeps getting worse
- Your symptoms begin after a sudden injury
- You have severe pain, muscle weakness or numbness
- You lose control of your bladder or bowel
- Symptoms last longer than 6 weeks
- Pain interferes with your daily life
- You have not addressed the treatment after your first visit to a doctor
After your first visit to a doctor, you should discuss a plan to return if symptoms have not resolved.
Most of the time, sciatic pain goes away within a few months. It is best to see a doctor at the first sign of symptoms to develop a treatment plan.
Some people experience pain that can last longer than average. To avoid recurring sciatica, try not to arch your back while lifting. It’s also a good idea to exercise regularly and eat well.
If you are in severe pain, your pain is getting worse, or you notice anything else, it is a good idea to speak to a doctor.