Why is my sciatica not going away?

From medicalnewstoday.com

Sciatica is a type of nerve pain that radiates down the back into the hip and leg, usually because of a herniated disk. It often goes away in a few weeks, but can become chronic.

Compression, inflammation, and irritation of the sciatic nerve can cause sciatica. The sciatic nerve runs from the lower back to the feet.

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

Does sciatica go away?

Sciatica typically goes away within 4-6 weeks, even without medical intervention.

Lifestyle changes, such as eating a healthful diet and maintaining moderate activity levels, can help to stop sciatic recurring.

Why is my sciatica not going away? 

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

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.

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

Another risk factor is spinal stenosis, which 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.

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 with 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 worsens.

Treating the underlying condition may help treat sciatica.

Infection

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

Spinal mass or cancer

Any massTrusted Source in or near the spine may trap spinal nerves, causing sciatic pain.

Some masses are cancerous, others are not, such as an epidural hematoma. An epidural hematoma is an accumulation of blood in the epidural space. The epidural space is an area between the vertebrae and their surrounding membranes.

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.

Spinal stenosis

As a person ages, the normal wear and tear on their spine can cause spinal stenosis. In spinal stenosis, wear and tear, or inflammation cause a narrowing of the spinal canal. This is the small space in the center of the spine that carries the spinal cord and nerve.

A narrowing of this canal can put pressure on the spinal cord and nerves, causing nerve pain throughout the body.

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 causeTrusted Source 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 

                                                                               Oscar Wong/Getty Images

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

• Aerobic exercise promotes fitness and can help a person reach and maintain moderate body weight.
• 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, as if marching, for 30–60 seconds.

Discover more of the best exercises for sciatica here.

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 contact 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 before visiting a doctor.

It is advisable to see a doctor if:

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

Outlook 

Although the outlook for most people with sciatica is good, those with chronic sciatica face a longer and more complicated recovery. The majority of sciatica cases resolve within 4-6 weeksTrusted Source without medical intervention.

A 2020 study found that surgery for herniated disks that cause sciatica offered better results than conservative treatments, such as exercise. However, the trial was small, and the researchers only recruited participants from a single treatment center. Researchers also noted that a person’s outlook is typically better the earlier surgery occurs.

However, some studiesTrusted Source show that occupations involving strenuous back movements, depression, and poor socioeconomic situations can increase the risk of recurrent, or chronic sciatica.

Summary 

Sciatica can be intensely painful, although most people do not have to live with it long term.

It is common for sciatica to last for several weeks. If weeks turn into months, however, this may indicate that it is time to seek a diagnosis and explore other treatment options.

https://www.medicalnewstoday.com/articles/why-is-my-sciatica-not-going-away

Doctor explains why sciatica is so painful at night with top tips on how to improve it

From msn.com

A doctor has explained why the pain from sciatica can be worse at night and how to improve it.

Sciatica is a condition that gives you severe pain in your lower back and legs, and it can stop you from getting a good night's sleep. Dr Tony Nalda, who runs the Scoliosis Reduction Center, has explained why the pain from sciatica can feel worse at night and what you can do to help it.

Sciatica is a medical problem that happens when something else in your body rubs or presses on your sciatic nerve. It can be caused by things like back injuries, spondylolisthesis, spinal stenosis, and slipped discs - which is a common cause, reports Bristol Live.

What are the signs of it?

Dr Nalda said: "The most common symptom of sciatica is shooting pains in your hips and legs. You may also experience weakness or numbness, or find it hard to move your legs. Some people have tingling or stabbing pains in their legs and thighs, or increased discomfort when they sit down."

                                                      There can be many causes of the condition         © Getty Images/iStockphoto

Why does it hurt more at night?

People have fewer things to distract them at night, which makes the pain feel worse because it's all they can think about. Dr Nalda said: "Also, lying down for extended periods increases pressure on the sciatic nerve.' Finally, the lack of movement at night can cause the muscles around the sciatic nerve to stiffen."

What can you do about it?

Dr Nalda has these tips to help reduce your sciatica pain:

• Sleep on your back or side, not your front. Sleeping on your front doesn't support your spine properly, and it can make the nerve irritation worse.
• Use special pillows to help your body and sleep on a mattress that's not too soft.
• Try stretching before bed and when you wake up to make your body more bendy and get your blood moving.
• Use cold things to bring down swelling and warm things like a nice bath to relax your muscles and help with the soreness.
• If the pain is really bad, talk to your pharmacist or doctor about stronger medicine.
• Keep moving gently all day, and try not to stay sitting or lying down for too long.
• If it hurts on one side of your body, don't lie on that side. Try the other side instead.

Dr Nalda said: "A medical specialist may recommend physiotherapy, painkilling injections, or even surgery. If you act wisely, you can lessen the pain and improve your quality of life."

https://www.msn.com/en-gb/health/other/doctor-explains-why-sciatica-is-so-painful-at-night-with-top-tips-on-how-to-improve-it/ar-BB1kNiDD?ocid=msedgdhp&pc=HCTS&cvid=23d953a48fb74ede8a80763f5dcfd03c&ei=17 

How Should I Lay With Sciatica? A Review By Doctors

From msn.com

Expert opinion from Robert H. Shmerling

M.D. Senior Faculty Editor, Harvard Health Publishing · 30 years of experience · USA

There is no single correct position recommended for people with sciatica. For many, finding a comfortable position is a matter of trial and error. To some extent, the cause of sciatica may affect which positions are most comfortable. For example, side-sleeping may be better for someone with sciatica due to lumbar spinal stenosis while back sleeping may feel better for the person with disc disease. And, of course, no matter what position you start with, people tend to move around during sleep so choosing a single position for sleep is often impossible. 

That said, many experts make the following general recommendations: Place a pillow under the knees and/or lower legs when lying on your back. Put a pillow between the knees if lying on your side. Try curling up in the foetal position. Use pillows to keep the head and upper back tilted forward a bit or sit in a reclining chair that allows a forward bend to the back. Stick with what works. If stomach sleeping is more comfortable, don’t feel compelled to follow advice about other positions, especially if the other positions cause more pain. If finding a comfortable position is challenging, work with a physical therapist who can help you identify and maintain positions that reduce pain when you lie down.

Expert opinion from Ipsa Arora

MD (Internal Medicine) · 5 years of experience · USA

Lie flat on your back, with your heels and buttocks in touch with the bed, and your knees slightly bent towards the ceiling. To provide support, place a cushion between your bed and your knees. Gradually add more cushions until you achieve a comfortable knee posture. It is fairly unusual to experience no alleviation after a few days. Continue to try different sleeping positions until you discover one that helps you to sleep through the night.

Expert opinion from Piyush Puri

MBBS · 1 years of experience · India

Start with a good spinal alignment. When you lie down, ensure your head, shoulder and hips are in straight line. Try using a small pillow below your neck and head but not your shoulder. Try sleeping on the side, especially if you sleep on the side opposite of where it hurts. Putting a pillow between your knees can make side sleeping even more comfortable.

https://www.msn.com/en-ae/health/medical/how-should-i-lay-with-sciatica-a-review-by-doctors/ar-BB1lYxs7

 

'Sciatica was gone': hospital performs robot-assisted spinal surgery in Canadian first

From globalnews.ca

Dave Myen didn’t think much about being the first patient in Canada to receive a robot-assisted direct lateral spine surgery two months ago. He was just looking for anything to relieve the pain.

Now he says he feels thankful the robot enabled minimally invasive surgery and reduced recovery time.

“When I woke up from surgery, the sciatica was gone. It’s just amazing.”

He still has about four months to go until the fusion of his impacted vertebrae is considered complete, but he says everything is progressing well.

Myen suffered from chronic back pain that led to sciatica in his right leg and extreme pain in his lower back, impacting his daily life “to the point that the shooting pain in my right leg caused me to stumble and fall.” 

After numerous visits with his family doctor, chiropractors and massage therapists, he ended up at London Health Sciences Centre in London, Ont., as the first patient in the country to undergo the procedure with the Mazor X Spinal Robot.

While robotics have been used in spinal surgeries in Canada before, LHSC said this was the first time it was used in a direct lateral surgery, which basically combines two surgeries in one.

“Normally when we do back surgeries we put the patient on the operating table when they are facing downwards,” Dr. Victor Yang, neurosurgeon at LHSC, explained.

“In Dave’s scenario, he also needed surgery done from the side of the spine as well…In the old days, we will do this surgery in two stages. And sometimes they (were) even spread over different days. And even if we can do it on the same day, we’ll still have to flip the patient between two positions. And that means that the patient will be under anaesthetic for a longer time.”

                                               Dave Myen, left, and Dr. Victor Yang, right. supplied by LHSC

The robot allowed Yang and the rest of the team to perform two surgeries in one, in a minimally-invasive way. The robot allows the team to “virtually” see where the patient’s bone is and then guide them in the right direction. Because it was minimally invasive, it also sped up recovery time, meaning Myen was discharged from the hospital in just a few days.

Robotic surgery is not as simple as purchasing a robot and booking surgeries. In this case, the Schulich School of Medicine and Dentistry at Western University funded the original cost of the robot for research purposes before it was fully approved by Health Canada. Yang said they spent over a year studying the robot, learning how to use it and training the team. The Mazor X received Health Canada approval in July 2021 and the technology was transferred to LHSC for clinical use.

“Having a robotic surgery program takes a whole village, it is not a one-person job,” he said. “We have Dr. (Marcelo) Oppermann, who is my clinical fellow, and also all of our operating room nurses, and they were trained over multiple sessions…the neuro-radiologist, as well as a neuro-anaesthetist and the vascular surgeons, they (also) form part of our team to make this new technology available for our patients.”

The clinical neurosciences team has since successfully performed five more minimally invasive surgical spinal procedures with the robot.

                                                  Dr. Yang stands behind the Mazor X robot. supplied by LHSC

Yang believes its use will become more and more commonplace in spinal surgeries, where robotics is not yet as well-established as it is in other surgeries, as it provides “more consistency and, in general, better outcomes and care.”

Myen, meanwhile, is excited about the possibilities the surgery has granted him.

“I am excited to get back to my everyday life and some of the things I enjoy and also have a summer that is not full of pain, but rather freedom to do the things I want.”

https://globalnews.ca/news/10450034/london-health-sciences-centre-robot-spine-surgery-sciatica/

Your office chair could be ruining your gym results — here's why

From www.t3.com

Are you working from a poorly designed office chair?

Since Covid-19, hybrid and remote working has had more than its fair share of benefits, especially when it comes to improving our work/life balance. However, it's also left many people with poor work setups, or even no setup at all. These substandard work environments could be affecting our bodies more than we know, especially for those with fitness goals. 

With this in mind, Matt Ousby, ergonomic chair expert at Slouch, has teamed up with fitness and physiotherapist experts to reveal how a poorly designed office chair could be affecting your progress in the gym. 

Keep reading to find out the short and long term effects of using the wrong kind of office chair, and how it could be affecting your fitness goals as a whole. 

                                                                                (Image credit: Andrey_Popov / Shutterstock)

WHAT ARE THE EFFECTS OF USING THE WRONG OFFICE CHAIR?

Shaun Thompson, a personal trainer and coach, explains that one of the most common short term issues he sees resulting from a poor work setup is ‘shrimp neck’. Sometimes known as tech neck, this issue is caused by constantly looking down at laptops and phones, which can have a detrimental effect on our shoulders and necks. Other issues include tight hamstrings and weak glutes due to long periods of sitting. 

Shaun also explains that long term can include impingement and sciatica, resulting in horrific pain and consistent migraines. He also cautions that “using and overworking the wrong muscles can cause serious issues such as slipped discs or torn muscles.”

 HOW IS YOUR CHAIR AFFECTING YOUR PROGRESS IN THE GYM? 

Shaun explains that pain from poor work setups can affect our ability to move around, even if it’s just a short walk at lunchtime. It can bring on issues such as sciatica, which can be extremely painful and can put your gym goals on hold for a considerable amount of time. 

In turn, poor mobility can affect our bodies in the gym as well. Shaun explains how our "mobility is the foundation you work from which then allows you to build strength and lead a high quality of life." 

https://www.t3.com/news/your-office-chair-could-be-ruining-your-gym-results-heres-why 

Top Mattresses for Sciatica in 2024

From globeecho.com

Chronic back pain issues are common, with sciatica being a prevalent condition caused by irritation of the sciatic nerve. The pain or numbness associated with sciatica often stems from irregularities in the spine. While a bad mattress may not be a direct cause of sciatica, it can exacerbate the condition and hinder potential treatment. Consulting a doctor to determine if a mattress change could help manage the condition is advisable. This guide aims to assist individuals in selecting the best mattresses for sciatica, with a focus on alleviating pain and improving sleep quality.

The Saatva Rx mattress stands out as the best overall choice for sciatica, incorporating a Therapeutic Support Core and Lumbar Zone to enhance support for the lower back and hips. With a medium firmness profile suitable for all sleeping positions and body types, the mattress promotes spinal alignment and pressure relief. Its seven-layer construction includes durable recycled steel coils, body-contouring foam, and micro-coils, ensuring support and durability where needed most. The mattress’s zoned support design caters to individuals with chronic pain, while the hypoallergenic organic cotton cover adds a layer of comfort.

The Purple Restore mattress features a unique GelFlex grid made of hyper-elastic polymer material, providing a responsive and pressure-relieving sensation. Available in two firmness options, the mattress caters to different sleep preferences, with the soft model ideal for side sleepers. With exceptional temperature regulation and support, the Purple Restore offers a distinct feel that may not be universally comfortable. Its 100-night trial period allows users to fully assess its suitability for sciatica relief.

For those seeking a luxurious yet supportive option, the Nolah Evolution Comfort Plus mattress offers a pillow-top design with zoned support coils, ideal for heavier body types. The mattress combines plushness and support to maintain spinal alignment and alleviate lower back pressure. While designed for heavier individuals, the Nolah Evolution Comfort Plus also suits average-sized users with a medium-firm feel. An alternative is the Nectar mattress, featuring a thick layer of memory foam for body-conforming pressure relief. With a medium-firm profile suitable for various sleep positions, the Nectar mattress offers an affordable memory foam option for those with a limited budget.

The Plank Firm Natural mattress boasts a flippable design with two firmness options to cater to back and stomach sleepers. Made of latex foam for a buoyant, responsive feel, the mattress provides comfort and support for those seeking a firmer surface. However, it may not be suitable for side sleepers due to its firm construction. The Leesa Legend mattress offers a medium-soft firmness profile ideal for side sleepers, featuring a zoned support design for enhanced spinal alignment. With a soft hybrid feel and excellent motion isolation, the Leesa Legend prioritizes pressure relief and comfort for individuals with sciatica.

When shopping for a mattress to alleviate sciatica pain, factors such as firmness level, zoned support, and trial period should be considered. Finding a balance between support and pressure relief based on sleeping preferences and body type is crucial. A medium-firm mattress is generally recommended for individuals with sciatica, ensuring spinal alignment and comfort. Although a new mattress may not cure sciatica, it can contribute to pain alleviation and improved sleep quality. Returning a mattress within the trial period is a simple process, allowing users to find the most suitable option for their condition. 

https://globeecho.com/top-mattresses-for-sciatica-in-2024/

Doctor explains why sciatica is bad at night and how to improve it

From bristolpost.co.uk

A variety of things can cause sciatica and it is a painful condition

Does sciatica give you severe pain in your lower back and legs? Besides hindering your days, it can disturb your nights and prevent you from getting a good night’s rest.

Dr Tony Nalda, who leads the Scoliosis Reduction Center, explains why sciatica pain is worse at night and what you can do about it.

What is sciatica?

Sciatica is a medical condition that occurs when something else in your body rubs or presses on your sciatic nerve. Possible causes include back injuries, spondylolisthesis, spinal stenosis, and slipped discs - a common reason.

What are the symptoms?

Dr Nalda said: "The most common symptom of sciatica is shooting pains in your hips and legs. You may also experience weakness or numbness, or find it hard to move your legs. Some people have tingling or stabbing pains in their legs and thighs, or increased discomfort when they sit down."

                                                           Sciatica can disrupt sleep (Image: Getty Images)

Why is it worse at night?

People have fewer distractions overnight, which makes the discomfort seem more pronounced as it’s all the mind has to focus on. Dr Nalda said: "Also, lying down for extended periods increases pressure on the sciatic nerve.’ Finally, the lack of movement at night can cause the muscles around the sciatic nerve to stiffen."

What are the options?

Dr Nalda has these tips to help reduce your sciatica pain:

• Sleep on your back or side, not your front. Front sleeping doesn’t properly support the spine, and it increases nerve irritation.

• Use supportive body pillows and a medium to firm mattress.

• Do stretching exercises before you go to bed and after you get up to increase flexibility and blood circulation.

• Alternate between cold packs to reduce swelling and heat sources (like warm baths) to soothe muscle tension and ease discomfort.

• Ask your pharmacist or doctor about stronger painkillers if normal over-the-counter medication isn’t working.

• Do gentle exercises throughout the day to keep your body moving, and don’t sit or lie down for long periods if you can help it.

• If you’re experiencing pain on one side, laying on that side can make your hip feel more uncomfortable, so try lying on the other side.

Dr Nalda said: "A medical specialist may recommend physiotherapy, painkilling injections, or even surgery. If you act wisely, you can lessen the pain and improve your quality of life."

https://www.bristolpost.co.uk/news/health/doctor-explains-sciatica-bad-night-9191111