Chronic Sciatica Symptoms and Treatment in Later Stages
Medically reviewed by Laura Campedelli, PT, DPT
Sciatica is a condition that causes nerve pain down the legs and affects many people at some point in their lifetime. While sciatica tends to resolve after several weeks with rest, exercise, and medications, sometimes sciatica symptoms can last much longer.
Advanced or chronic sciatica lasts over 12 months and can cause leg pain, numbness, and weakness, significantly interfering with daily activities.
This article will discuss chronic sciatica symptoms, treatment options, and when to see a healthcare provider.
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Symptoms of Advanced or Chronic Sciatica
Advanced or chronic sciatica often produces pain that travels down the back of the leg. In addition to pain, long-term sciatic nerve compression can also result in numbness, tingling, weakness, and instability of the legs, which can impact your ability to walk.
Severe nerve compression can progress to leg paralysis if the sciatic nerve is significantly damaged from chronic compression.
Takeaway
Sciatica can progress to nerve damage of the smaller nerves that branch from it and travel into the legs and feet. Nerve damage is broadly referred to as neuropathy and can result in pain, tingling, and loss of sensation.
Treatment Options for Disabling Sciatica
When sciatica becomes severe and disabling, affecting your ability to walk, more involved treatment beyond exercises and at-home treatments is typically needed to get pain relief.
Many cases of chronic and disabling sciatica are due to problems with the lumbar spine. Compression of the nerve roots that form the sciatic nerve can occur from bulging or herniated discs or spinal stenosis. If symptoms of sciatica persist beyond 12 months with little or no relief from exercise, physical therapy, or pain management techniques, surgery is often needed to treat severe sciatica symptoms.
Lumbar decompression surgery is a broad term that encompasses several different procedures that can be performed in the operating room to create more space in the lumbar spine and reduce nerve compression. During lumbar decompression surgery, your surgeon may perform:
Discectomy: A procedure to remove a portion of a damaged disc between vertebrae of the spine to alleviate nerve root compression from a bulging or herniated disc.
Laminectomy: A procedure to remove the lamina, a portion of the vertebrae causing nerve compression, especially if there is a bone spur (bony outgrowth) due to arthritic and degenerative changes in the spine.
Foraminotomy: A procedure to widen the foramina, the openings in the vertebrae where the nerve roots exit from the spinal cord, to reduce nerve root compression.
Spinal fusion: A procedure in which two or more vertebrae are fused together with metal rods and screws for stabilization, performed if an entire disc is removed, if multiple laminectomies were performed, or if one vertebra has slipped forward over another.
Learn More: Sciatica Surgery: Everything You Need to Know
How to Manage Advanced Sciatica: Daily Relief
To get daily relief from advanced sciatica symptoms, at home treatment methods like taking a warm bath or shower or applying a heating pad to your lower back or glutes may help relax tight muscles. This can help decrease tightness surrounding the sciatic nerve, which may help reduce some of your pain.
Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or nerve-pain medications can also be helpful.
Performing corrective or therapeutic exercises may also help reduce your symptoms. Sciatic nerve glides can help reduce tension along your sciatic nerve while low-back exercises that move your spine into forward or backward bending may help reduce nerve compression depending on the underlying cause.
Advanced sciatica, however, is often not very responsive to conservative treatment methods. If sciatica symptoms last more than 12 months, more involved treatment like injections or surgery may be needed to address symptoms effectively.
Can You Heal Chronic Sciatica?
Chronic sciatica can heal only if the underlying cause can be effectively treated. Chronic sciatica that lasts more than 12 months often results from spinal conditions such as herniated discs or spinal stenosis of the lumbar spine. These conditions narrow the available space around the nerve roots that exit from the spinal cord and merge to form the sciatica nerve.
When these conditions progress substantially, surgery is often performed to create more space in the spine through a discectomy, laminectomy, foraminotomy, or spinal fusion.
Sometimes sciatica is due to less common causes such as a tumor or an infection of the spine. In these cases, symptoms will not resolve until the underlying cause is treated. Tumors may need to be surgically removed while infections require aggressive antibiotic treatment to prevent spreading to other parts of the body.
Seeing a Pain Specialist to Form a Plan
Sciatica can be uncomfortable, but ongoing pain requires a consultation with a healthcare provider. Numbness, tingling, and weakness are all symptoms of concern that should be addressed with your healthcare provider as well. A pain specialist can help you by creating a treatment plan that involves:
Referrals to other healthcare providers
Medication
Physical therapy
At-home exercise
You should seek immediate medical attention if you have:
Severe pain
Difficulty walking
Bowel or bladder problems
Loss of movement or sensation in your legs
These are signs of a medical emergency and require urgent treatment.
Summary
Sciatica is a commonly occurring condition that results from compression of the sciatic nerve in the lower back or leg. Chronic sciatica occurs when symptoms last for 12 months or longer, which can include leg pain, numbness, tingling, weakness, and instability. When pain and other symptoms significantly impact your daily activities and ability to walk, seeing a healthcare provider to address your issues is needed.
For many cases of long-term sciatica, surgery is needed to create more space in the spine to reduce nerve compression from conditions like herniated discs and spinal stenosis.
Read the original article on Verywell Health.
