Monday, 26 July 2021

Why Is My Sciatica Not Going Away?

From healthline.com

Sciatica is a condition caused by an irritation, inflammation, pinching, or compression of your sciatic nerve. It can lead to moderate-to-severe pain and weakness in your lower back, buttocks, and legs.

Sciatica typically heals in 4 to 6 weeks, but for some people, it can last longer. In this article, we look at potential reasons why your sciatica pain is sticking around.

Here are some of the reasons why your sciatica may be getting worse.

Injury and reinjury

If an injury was responsible for your sciatica, and if your symptoms get better and then worse, you may have re-aggravated the injury that originally caused your sciatica.

Sudden injuries and repetitive overuse injuries can lead to sciatic symptoms. Herniated discs are the most common cause of sciatica.

Age and underlying health conditions

In general, younger people heal more quickly than older people. But there are many underlying health conditions that can also slow your body’s ability to heal. Some conditions include:

  • high blood pressure
  • diabetes
  • obesity
  • heart disease
  • alcoholism
  • malnutrition
  • smoking

Infections

An epidural abscess is a collection of pus that develops between the bones of your spine and membrane of the spinal cord. It may lead to swelling that puts pressure on your nerves and leads to sciatica.

Wear and tear

Wear and tear on your spine can lead to a condition called spinal stenosis, which is narrowing of the spaces within the spine. This narrowing can compress your nerve and lead to sciatica.

Lifestyle issues

Sciatica often responds to gentle exercise. It’s thought that mobilizing the sciatic nerve may help improve symptoms by decreasing nerve sensitivity. Gentle stretching and exercising may be recommended as a part of treatment.

Alternatively, a sedentary lifestyle and spending a lot of time sitting can potentially aggravate symptoms of sciatica.

Spinal mass or tumour

In rare cases, a cancerous mass can put pressure on your sciatic nerve. One very rare type of tumour that can develop is called a malignant peripheral nerve sheath tumour.

Sciatica often responds to home treatment, but you should see a medical professional first to make sure you’re dealing with sciatica. If you haven’t already tried treating your symptoms at home, you may find the following methods helpful:

  • Cold. Try applying an ice pack or cold compress to the painful area for about 20 minutes several times a day.
  • Hot. You can apply hot packs or heating pads to the sore area for 15 to 20 minutes several times per day after the first couple of days 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.
  • Physical therapy, stretching, and exercise: A physical therapist can help you strengthen weak muscles and stretch tight muscles that may be contributing to your pain. The United Kingdom’s National Health Service recommends resuming normal activities and gentle exercise as soon as possible. Always perform these activities under the guidance of a professional.

Seeing a doctor

If you’ve already tried home remedies but your pain is getting worse, it’s a good idea to visit a medical professional.

Your doctor may prescribe muscle relaxers, stronger pain killers, or other medications. In some cases, they may recommend epidural steroid medications. These medications are injected into the area around your spinal cord to reduce inflammation.

In certain cases, surgery may be the best option. This includes instances of worsening pain, pain that hasn’t improved with other treatments, and severe weakness in muscles that results in loss of bladder or bowel control.

One option is a microdiscectomy, a minimally invasive surgery that often offers quick relief of symptoms. The procedure removes the disc material that’s putting pressure on your sciatic nerve.

A laminectomy may also be considered, which is a surgery that involves removing bone to ease pressure on the spinal cord.

Sciatica typically lasts about 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 linked to chronic sciatica include improper lifting techniques and not engaging in regular moderate-intensity physical activity when possible.

Risk factors for recurrent herniated discs include:

  • diabetes
  • smoking
  • disc protrusion

Sciatica may recur, especially if the underlying cause isn’t treated. For example, if you use improper lifting techniques and developed sciatica after herniating a disc, continuing to use that same lifting technique puts you at risk of injuring your back again.

A 2016 study found that in a group of 341 people seeking non-surgical care for a lower back herniated disc, 23 percent of people with leg pain experienced pain again within a year, and 51 percent experienced pain again within 3 years.

The researchers also found 28 percent of people with lower back pain experienced pain within a year, and 70 percent experienced pain within 3 years.

A 2015 review of studies found that nearly half of 609 people seeking treatment for leg and back pain experienced symptoms for more than 3 months. Just under 75 percent of the participants in the study had sciatica.

Making lifestyle changes like the following may help you prevent recurring sciatica symptoms:

  • Eat a balanced diet and exercise regularly.
  • Minimize sitting, and sit with good posture.
  • Avoid bending your back when lifting heavy objects.
  • Choose exercises that are unlikely to cause lower back injuries.
  • Avoid smoking.
  • Minimize your chances of falling by wearing sturdy shoes and keeping the floors of your house free from clutter.

Most of the time, mild sciatica will go away within 4 to 6 weeks. But you should talk with your doctor at the onset of symptoms to make sure you’re dealing with sciatica. You return to see a medical professional if:

  • your pain is getting progressively worse
  • your symptoms start after a sudden injury
  • you have severe pain, muscle weakness, or numbness
  • you lose control of your bladder or bowels
  • symptoms last longer than 6 weeks
  • pain interferes with your daily life
  • you haven’t responded to treatment after your initial visit to see a health professional

After your initial visit to see a health professional, you should discuss a plan for when to return if symptoms haven’t gone away.

Most of the time, sciatic pain goes away within a couple months. It’s best to see a medical professional at the first sign of symptoms to develop a treatment plan.

Some people have pain that may last longer than average. To prevent recurrent sciatica, try not to bend your back while lifting. It’s also a good idea to consider exercising regularly and eating a balanced diet.

If you have severe pain, your pain is getting progressively worse, or if you notice anything else concerning, it’s a good idea to speak with a health professional.

https://www.healthline.com/health/back-pain/why-is-my-sciatica-not-going-away


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