Sciatica can be acute or chronic, depending on a number of important patient and condition variables. While some flare-ups can last for days or weeks, sciatica can become a chronic issue if the underlying cause is serious and left untreated. Long-term relief and treatment needs are case-specific.
Sciatica involves pain felt anywhere along the sciatic nerve’s pathway due to irritation or compression. Sciatic nerve pain can range from mild to severe, and treatment is case-specific, driven by the underlying cause, and involves reducing pressure on affected nerves.
The sciatic nerve is extensive, and if exposed to uneven forces, sciatica can develop and require treatment.
The sciatic nerve is the largest nerve in the body that starts in the lower back and extends down the buttocks and into the leg and foot.
In most cases, sciatic nerve pain is felt on one side of the body, most often the left.
Where the nerve originates, approximately half an inch wide, and as it extends down the back of the legs, it widens and at its thickest point, is approximately just under an inch in diameter.
When the sciatic nerve is exposed to uneven forces, it can become compressed and/or impinged, become irritated and/or inflamed, and painful.
Radicular nerve pain is commonly regarded as the most debilitating form of back pain, and remember, as nerves are like limbs of a tree, branching off in different directions, an irritated nerve root can cause pain felt anywhere along the sciatic nerve’s pathway, which is extensive.
Sciatica can range from mild to severe, chronic to acute, with some cases resolving on their own in a matter of weeks. Others, particularly those caused by an underlying spinal condition, require treatment to bring relief.
While each case is different, common sciatica symptoms include:
Sciatic nerve compression/impingement is also known to cause:
While pain is the most common sciatica symptom, neurological symptoms can also present with nerve pain, particularly in severe cases or if left untreated.
When neurological symptoms are present, functional deficits can develop in the affected leg as a result of sciatic nerve compression.
The spine has three main sections: cervical (neck), thoracic (middle/upper back), and lumbar (lower back).
As the sciatic nerve originates in the lower back, it’s conditions that involve the lower back that most commonly cause sciatica.
If a disc is herniated in the lower back, this means the intervertebral disc that sits between adjacent vertebrae (bones of the spine) has its inner nucleus pushing through a tear in its outer annulus, and this encroaches on the space within the spine, through which the spinal nerves branch out and project to different areas of the body.
If the sciatic nerve is being compressed and/or impinged, a nerve root can become inflamed, irritated, and cause radicular pain.
Lumbar stenosis is another spinal condition that can cause sciatica as it involves a loss of space within the spinal canal, causing compression of the sciatic nerves traveling within.
Degenerative disc disease in the lumbar spine can also cause sciatica. Disc degeneration can cause discs to lose height and shape and become desiccated, affecting nearby nerves and compromising the spine’s overall health and function.
Spondylolisthesis involves the slipping forward of one vertebra over the one below it, and when this occurs in the lumbar spine, it can cause sciatica.
Conditions like scoliosis, which involve a loss of the spine’s healthy curves, can also lead to sciatica as a scoliotic spine bends unnaturally to the side and rotates, and when the unnatural curve involves the lumbar spine, sciatic nerve irritation can occur.
Although rare, there are also cases where sciatica symptoms are indicative of a severe sciatic nerve injury caused by medical conditions such as cauda equina syndrome, an infection, and/or the presence of tumors pressing on the spine.
So if a person has sciatica, how long should they expect their pain to last?
In addition to the aforementioned spinal conditions that have the potential to cause sciatica, a basic overuse injury, muscle spasms, and/or inflammation in the lower back, or muscles surrounding the pelvis, can also cause sciatic nerve pain.
When sciatica is caused by an injury and/or related temporary inflammation, acute sciatica is more likely, meaning pain can flare up intermittently or be consistent for up to 6 weeks; if sciatica is related to a recent injury or lower-back issue, it can resolve on its own.
If an underlying spinal condition causes sciatica, sciatica symptoms can last for up to 2 years, or longer, if the underlying cause is undetermined and left untreated.
It’s estimated that 20 to 30 percent of people with sciatica continue to experience symptoms for 1 to 2 years after a diagnosis.
So what are the treatment options for sciatica?
When it comes to sciatica treatment and sciatica relief, it’s important to understand that pain is a symptom, not a condition, so determining the underlying cause of the sciatic nerve pain is the difference between merely addressing a symptom or treating the underlying condition itself.
Here at the Scoliosis Reduction Center, I specialize in nonsurgical treatment for a variety of spinal conditions, so when it comes to providing sciatica relief, I first conduct a comprehensive physical exam, and when combined with X-ray imaging, I can determine the underlying cause of sciatica.
Once the underlying cause is determined, I can craft a customized treatment plan that addresses important patient/condition variables and pain management.
Often, the first response a person has to back pain is to stop moving, and while some overuse injuries and conditions will require rest and activity modification, as the very design of the spine is based on movement, this can have a negative effect on the spine and its surroundings.
While all physical activity should first be cleared with a patient’s care provider, with many spinal conditions and lower back pain, continuing low-impact gentle exercise, such as walking and stretching, can actually help with pain by keeping the spine and its surrounding muscles as strong, loose, and flexible as possible.
In addition, if becoming less active is the response to back pain, over time, this can lead to muscle weakness, and as the core muscles provide crucial support and stabilization for the spine, this can lead to additional problems.
There are also prescription pain medications that can be used for pain management of sciatica, but this will only provide short-term pain relief; proactive treatment driven by its underlying cause is the best way to achieve long-term sustainable pain relief, although there are never treatment guarantees.
Alternating Hot/Cold Therapy
Alternating hot/cold therapy can be a simple and non-invasive way to get relief from sciatic nerve pain.
Numbing painful areas with cold and applying heat to sore muscles and joints can help reduce inflammation, which is a source of sciatic nerve pain.
Sciatic nerve pain can also be caused by what’s known as piriformis syndrome. The piriformis muscle originates in the buttocks at the edge of the spine and extends to the top of the thigh.
Piriformis muscle spasms can trap the sciatic nerve that’s located in the same area, and this can be another cause of sciatica.
Sciatica stretches and condition-specific exercises that are integrated into a proactive treatment plan can be helpful in keeping important muscles, such as the piriformis, as strong and loose as possible.
Part of my treatment process for sciatica involves identifying parts of the spine that aren’t moving as they should, and this is most commonly found in the lower back and hips; this is understandable as it’s the lumbar spine (lower back) and pelvis that has to support the bulk of the body’s weight.
In addition, stretches that can externally rotate the hip can be very helpful with pain relief by loosening the hip and pelvis, and also creating more room for the sciatic nerve.
Effective stretches for sciatica can help with maintaining a healthy weight, staying active, encouraging good posture, and preventing and relieving sciatic nerve pain.
Although there are never treatment guarantees, condition-specific chiropractic care can help work towards reducing sciatic nerve pain by addressing its underlying cause and making functional improvements.
In addition to prescribing condition-specific therapeutic exercises and stretches, chiropractic care for sciatica can involve the application of controlled pressure to affected joints of the spine, impacting their surroundings, including nearby nerves.
If a patient’s spine is misaligned, this can be the cause of sciatica, so if a condition like scoliosis is the underlying cause, I address this by working towards a structural change within the spine itself: adjusting the most-tilted vertebrae of the scoliotic curve back into a healthier alignment with the rest of the spine.
When the spine has as much of its natural curves restored as possible, and the spine is realigned, the spine can function optimally, leaving enough space for the sciatic nerve to also function as it should, and not experience compression due to uneven forces.
When disc issues are to blame for sciatic nerve pain, I can use gentle chiropractic adjustments to relieve pressure on the area, improve the function of the disc, and facilitate its ideal central placement between adjacent vertebrae so nerve pressure is relieved.
So how long does sciatica last? The answer is case-specific and based largely on severity and underlying cause.
If a person’s sciatica is the result of a recent overuse injury and/or some lower-back inflammation, sciatic nerve pain is likely to resolve on its own within 8 weeks or less; however, if a person’s sciatica is related to the presence of an underlying spinal condition, symptoms can last until the underlying cause is addressed with treatment.
Here at the Scoliosis Reduction Center, if a patient is suffering from sciatic nerve pain, a comprehensive physical examination, combined with X-ray images to see what’s happening in and around the spine, can help me determine the underlying cause of the sciatic nerve pain.
Once the underlying cause has been identified, I can craft a fully-customized treatment plan that addresses all-important patient/condition variables for the best potential results.
By combining lifestyle guidance, when needed, a variety of therapies, and condition-specific chiropractic care, I can help patients work towards increasing core strength so the spine is optimally supported, and increasing space within the spinal canal so the sciatic nerve has enough space to function optimally.