Why is my sciatica not going away?

Article featured on MedicalNewsToday and medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA — Written by Zawn Villines on October 23, 2020

Sciatica is a type of nerve pain that radiates down the back into the hip and leg. It often goes away in a few weeks, but for some people, the condition is chronic.

The pain can feel like an intense cramp or burning electrical sensations.

Sciatica that lasts more than 3 months or that goes away and comes back may be chronic sciatica.

Chronic sciatica is a long-term condition that can cause ongoing pain. It is more difficult to treat than acute (short-term) sciatica, but several remedies can offer relief.

This article reviews what sciatica is, what causes it, and how to treat it.

Why is my sciatica not going away?

Sciatica happens when something presses on or traps the sciatic nerve.

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

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

Herniated disk

Doctors do not know why some cases of sciatica become chronic. Many acute and chronic cases happen because of a herniated disk. In most cases, herniated disks improve on their own within a few weeks. When they do not, this may cause chronic pain.

Injury

People with herniated disks often remember a specific injury that triggered the pain. An injury does not mean that the pain will be chronic. However, people who have a herniated disk from an injury may develop the same injury again, especially if they continue repeating the movements that led to it.

Inflammation

Inflammatory conditions can trap spinal nerves, causing sciatic pain. People with chronic inflammatory conditions, such as rheumatoid arthritis, may notice that their sciatica flares when their condition gets worse. Treating the underlying condition may help treat the sciatica.

Infection

An infection in or around the spine can cause an abscess, which is a swollen and infected mass. 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.

Spinal mass or cancer

Any type of mass in or near the spine may trap spinal nerves, causing sciatic pain. Some masses are cancerous. In other cases, an epidural hematoma, which is a swollen blood spot near the spine, can cause the pain. It is important that people with sciatica see a doctor to rule out potentially dangerous conditions such as cancer, especially when 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 people, spinal stenosis causes chronic or worsening pain.

Lifestyle issues

Several lifestyle factors may increase the risk of sciatic pain or extend the healing time. People with these risk factors may find that sciatica becomes chronic or recurs. Risk factors for sciatica include:

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

As sciatica often follows an injury, people may also find that the 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 happens when the infection creates an abscess that spreads to the sacroiliac joint in the pelvis and lower spine. A person may also have symptoms of TB, such as breathing problems or coughing. TB is a very rare cause of sciatica, but if symptoms persist, and a person has a history of exposure to TB, testing is important.

Spinal misalignment

When the spine is not properly aligned, such as when a person has scoliosis or another chronic condition, it can put pressure on the space between the vertebrae. This pressure may cause herniated disks. It can also compress the sciatic nerve, causing nerve pain. Depending on the cause, a person may need surgery, physical therapy, or other treatments.

Will my sciatica come back?

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

People who do not make lifestyle changes to prevent more sciatic pain may also redevelop symptoms. However, for most people, sciatica heals on its own within a month or two.

Exercises for sciatica

Exercise can help ease the sciatic pain. The following exercises might help a person with sciatica:

  • 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 usually goes away on its own, with or without treatment.

A doctor can diagnose the cause of sciatica and may prescribe treatment to speed healing.

However, sciatica is not a medical emergency, and it is fine to wait to see whether the symptoms resolve on their own before visiting a doctor.

It is advisable to see a doctor 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

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.