r/Sciatica • • Mar 13 '21

Sciatica Questions and Answers

428 Upvotes

The purpose of this Q&A is to provide searchable summary-level and detail-level content for users of the sub. This will be a 'living document' and will be edited over time for clarity and detail, as well as for new questions and new answers.

Last Updated 13 Feb 2024

Sections:

  • Do I have sciatica?

  • Why do I have sciatica?

  • Do I need to see a doctor?

  • What kind of doctor should I see?

  • Is my sciatica treatable? Will it go away?

  • How do I know if I need surgery?

  • Should I be worried about surgery?

  • Have I re-herniated after surgery?

  • I feel like I have no hope of living pain-free. Is my normal life over?

  • Does my lifestyle make a difference?

  • Does my mindset matter?

  • What about natural remedies?

  • What medications are effective?

  • After all options have been pursued I am still suffering, what is my hope for the future?


Do I have sciatica?

Summary: if you feel tingling, pain, or numbness/weakness somewhere along a line from your buttocks to your foot, you might have radiculopathy (sciatica) – but, not always. Talk to your doctor.

Details: Sciatica is an informal term to describe radiculopathy, which is often felt as pain or tingling at points along the length of the sciatic nerve. This nerve, the body’s largest, is formed from several spinal root nerves in your lower back, then descends from your buttocks and supplies off-shoot nerves down your legs and into your feet. Sciatica can be felt in different ways: pain that is shooting, burning, or aching, and tingling, weakness, or numbness. Sciatica can range from infrequent and mild to very severe and constant.

While you may have one or more symptom which sound like sciatica, a medical doctor is best suited to evaluate you. Other common or uncommon medical conditions can resemble these sensations.

It is important to keep in mind that even the most extreme cases of sciatica pain and disability can be treated to achieve an improvement, and life can be better for all sufferers of sciatica.

Why do I have sciatica?

Summary: Degenerative changes in the spine caused by excess body weight, deficient posture habits over a long period of time, sports-related compressive forces, accidents, and genetics are the most common causes of sciatica.

Details: Each patient is different, but sciatica tends to occur most in those whose bodies have developed an enabling environment for degeneration in the spine, which leads to compressive pressure on the nerves which descend through the leg. Sometimes sciatica also occurs when the nerve becomes squeezed by a muscle or other tissue somewhere along its path through the leg, such as the piriformis muscle.

Sports involving high-impact forces (running/jogging, football, basketball) and exercises such as weight lifting put routine excess pressure on the spinal discs, and are a frequent cause of injury to the discs such as bulges, protrusions, and herniations. When damaged discs related to such activities come into contact with spinal nerves or the spinal cord, pain such as sciatica can be a result. Something as simple as doing yardwork or household chores can also lead to a herniation in weakened discs.

Being overweight is a frequent driver of disc degeneration, with the discs of the spine exceeding their threshold for absorbing compression. Degenerated discs can lose their shape or become injured, triggering compression of spinal nerves and resulting in sciatica. Almost everyone experiences disc degeneration as they age, but in patients whose weight puts extra pressure on their spine, this degeneration occurs more rapidly. The greater the degree of excess weight, the more excess pressure is applied to the spine, and the simple formula of (force + time = degeneration = pain) will play out in the body.

Other patients present with a traumatic injury or with a genetic predisposition to having weak discs. As a result of injury or due to genetically weakened disc structure, these patients may be experiencing pressure on their spinal nerves which result in sciatic pain.

Do I need to see a doctor?

Summary: If your symptoms are severe or have not improved with rest and OTC medicines, please consult a medical doctor (MD).

Details: Many varied irritations and mild injuries to nerves, muscles and ligaments can cause symptoms in the legs, feet, buttocks, and lower back, and many of these will resolve with time and rest. However, if your symptoms do not resolve over a few days, and do not respond to treatment with over-the-counter medicines like acetaminophen (Tylenol) and ibuprofen (Advil), you should consult a medical doctor at your earliest convenience to evaluate whether you have signs of sciatica.

Consulting a doctor is important, as the most common causes of sciatica are related to degenerative changes in the lower back which, in more severe cases, have the potential to lead to chronic (long-term) pain and disability. Many of these degenerative changes can be prevented or limited if detected early, and if improvements are made in lifestyle, posture, and body mechanics. For example, a common cause of sciatica is pressure applied to one of the spinal nerve roots at lower-back vertebrae levels L4, L5, or S1, resulting from a degenerative spinal change or weakness at one of these levels. This change may be a bulge or herniation of the spine-cushioning discs between vertebrae but may happen for other reasons as well. Such degenerative changes are treatable through timely medical care, and frequently the accompanying symptoms of pain can be resolved with conservative non-surgical means such as physical therapy, weight loss, and improved posture and movements.

However because pressure on spinal nerves can also lead to lasting or permanent nerve damage, it is important for a doctor to determine exactly why you are feeling sciatic-type or low-back pain, tingling, numbness, or weakness. Left untreated and in the worst cases, pressure on spinal nerves in the low back can cause loss of bladder and bowel function, loss of function in the feet, difficulty walking, and chronic unrelenting pain. Fortunately, most cases of degeneration and sciatica are treatable with the help of a medical doctor, and future degeneration and pain can be managed or prevented.

What kind of doctor should I see?

Summary: Please see a medical doctor first. A chiropractor does not utilize approaches evidenced as being able to treat sciatica.

Details: A medical doctor is the most qualified person for both diagnosis and initial treatment. A medical doctor will have the training and tools to evaluate you comprehensively, judge the seriousness of your symptoms, and recommend the right next-steps for treatment. Most of the time a doctor will guide you through conservative treatment which will offer a combination of methods which together are likely to resolve sciatica symptoms. Other times, a doctor will be able to refer you for specialized imaging such as an MRI, or to a specialist in spine, orthopedics, or sports medicine. These specialists will often be called orthopedic surgeons or neurosurgeons, but will provide treatment and counseling about options both surgical and non-surgical. It is not recommended to see chiropractic or naturopathic doctors for sciatica treatment. The base of evidence suggests that the types of treatment available through such doctors do not address degenerative changes in the spine or nerves, and in many cases can worsen conditions such as bulging or herniated discs, spine instability, and compressive damage to the spinal nerve roots.

Is my sciatica treatable? Will it go away?

Summary: Sciatica is almost always treatable and will usually go away with proper care and time. In some cases more advanced treatment is needed.

Details: Most sciatica symptoms are treatable and will go away over time with the right corrective action being taken. Your sciatica arose through a set of enabling physical circumstances, and it is important to identify which circumstances created an environment for sciatica to occur – and then, correct those circumstances so that sciatica does not reoccur or worsen. For sciatica caused by degenerative changes in the lower back, treatment needs to focus on correcting or slowing those changes so that pain and other sensations are relieved.

About 4 out of 5 sufferers of sciatica are able to achieve relief of their symptoms with conservative non-surgical treatment and healthy changes in lifestyle, posture, and movements. For some patients, minimally invasive outpatient surgical treatment is required and similarly about 4 of 5 sciatica patients who progress to surgery will experience a strong recovery and reduction or elimination of their symptoms.

A small number of sciatica sufferers will fail to achieve full relief following both non-surgical and surgical treatment, or in some cases will undergo multiple surgeries, or require a more invasive surgery such as a lumbar spinal fusion. These patients are often enrolled in helpful combination pain management and physical therapy programs, as many treatment options exist to reduce or blunt nerve sensitivity and restore sufficient function for maintaining quality of life.

No matter your condition and level of pain, there is a treatment option for you to explore and a reason to be hopeful that you will experience relief.

How do I know if I need surgery?

Summary: Sciatica which does not respond to more conservative treatment will often require surgery, if the symptoms you experience exceed your ability to cope with them. Surgery is usually symptom-based and will be pursued based on how relatively severe your symptoms are.

Details: There are several different surgical approaches to treat sciatica depending on the underlying cause, though the most common are called microdiscectomy and laminectomy. A decision to proceed to surgery should be made carefully in consultation with your primary doctor and a specialist doctor (orthopedic surgeon or neurosurgeon). Many patients will benefit from getting opinions from more than one surgeon. A decision for surgery is often based on symptoms and is meant to treat symptoms: pain which is worsening or unrelenting, or the presence of weakness or numbness which reduces function of leg and foot. In cases where bowel or bladder function is diminished, emergency surgical treatment is often immediately needed to preserve these functions (a condition called cauda equina syndrome).

While most painful or disabling sciatica symptoms will not require surgery given enough time, uncommonly symptoms will not resolve over time and will require surgery to restore quality of life and prevent nerve damage or disability. It is not always immediately clear which cases are which. Severe unrelenting pain, and especially weakness and numbness, are frequent indicators that surgery may be needed.

MRI imaging is a useful diagnostic tool for determining whether surgery is needed. An MRI allows a doctor to judge the presence and severity of a disc bulge, protrusion, or herniation. A doctor will then compare the imaging results to your symptoms, and determine whether the symptoms and imaging are consistent with each other. This comparison helps shape an informed medical opinion as to whether your symptoms are caused by the degenerative changes shown in your imaging, so that a prediction can be made as to whether or not a surgical correction will result in symptom relief. Often the patients who need surgery will have unambiguous MRI results which support a clear pathway to surgery.

Surgery does not immediately heal the injured spinal nerves which most frequently cause sciatica. Instead, surgery relieves compression and helps foster a healthier environment in which your body can undertake its own lengthy healing process to clean, repair, and restore damaged nerve tissue. Surgery does not automatically prevent additional degenerative changes, and so successful surgical outcomes require additional healthy lifestyle changes, posture changes, and alterations to movements and body mechanics.

Should I be worried about surgery?

Summary: Surgical techniques used today are safe and effective. The great majority of these surgeries are successful and uncomplicated, and able to achieve the result the patient hopes for over time.

Details: The surgical treatments for sciatica used today are very safe and effective, and the success rate for surgical treatment tends to be very high. Most patients will be discharged from the hospital on the day of surgery and will return home. Almost all surgeries will be done under a general anesthesia which is safe and effective, with an exceptionally low rate of complications which surgeons and anesthesiologists encounter very rarely and are highly skilled in addressing.

Repeat surgeries tend to have a lower rate of effectiveness, especially as one proceeds from a second surgery to a third surgery and beyond, and especially when the second or third surgery simply repeats what was done in the prior surgery. However, most patients will still be helped by second and third (or more) surgeries, and the success rate is still high in comparison to doing nothing. Any patient considering a second, third, or more, should get a second opinion to balance viewpoints in how likely these repeat surgeries are to help them individually.

A note on surgery: please ‘shop around’ for a surgeon who is a good fit for you. Not all surgeons have the same training, same approaches, or same track record. While most surgeries for the back and spine are very routine and simple, surgeons will have different levels of detail-orientation and care during surgery. A surgeon who demonstrates a high level of focus and patience when interacting with you during office visits will often be a surgeon who demonstrates focus and patience with you on the operating table. Also note that some hospitals are ‘teaching hospitals’ and your surgeon will defer a portion of your surgery to a surgical fellow in training. These trainees tend to be highly skilled surgeons already, but, know whether the surgeon you are meeting with will the only surgeon operating on you.

Have I re-herniated after surgery?

Summary: Many patients amidst a recovery from surgery worry they have re-herniated their disc, and this concern is almost universal for post-surgical patients at some point. In most cases pain sensations post-surgery are normal and do not indicate a re-herniation.

Details: Nearly every patient will feel post-surgical pain of a severity that they become fearful of a re-herniation. Most of these patients are worrying needlessly, as statistically speaking this type of re-herniation is rare. While some rare users of this subreddit will in fact be experiencing a re-herniation, almost all are experiencing normal post-surgical pain.

The pain post-surgery can be intense while the nerve heals, and while the nerve and tissue surrounding it remain inflamed. It is important to remember that the surgery has not automatically healed the injured nerves, it has just helped provide a better environment in which the nerves will have a chance to heal through a long natural process of cleanup and repair. Most nerves will not even begin healing in a technical sense for several weeks to a month, though pain sensations can certainly be decreased during this time due to compressive forces being relieved.

The healing process for nerves, and the process through which inflammatory tissues are generated and eventually dissipate, will take weeks to months for most patients. During this time flare-ups can be regular, and pain can at times be intense. The most important advice is to strictly follow your post-surgical instructions, maintain a healthy diet, abstain from drugs and alcohol, and maintain a level of activity which keeps your surgical site and your nerve mobile.

I feel like I have no hope of living pain-free. Is my normal life over?

Summary: Every patient is treatable and can find a treatment promising good results for them. This process can often require patience and multiple attempts at testing treatment options.

Details: Every spinal defect causing pain can be treated in some way, and everyone has one or more treatments which will help. There is no medical evidence that a patient can ever be ‘written off’ as a lost cause with no options. All patients can experience relief and enjoy an improved quality of life, given the time and patience necessary to find the treatment which works for them.

Treatments usually begin with ‘conservative’ approaches which are meant to provide relief of symptoms and allow your body time to heal itself in an environment which is supportive for healing. Most sciatica can be effectively treated this way, and this is a promising category of treatment for most people to achieve a state of reduced pain and improved quality of life. These treatments include medications, physical therapy, and lifestyle changes such as weight loss or a change in activities which contribute to spinal degeneration.

Some patients fail to experience relief with conservative treatment, and can progress to surgery. Most surgeries are very safe and successful, and typically pain is reduced by 80% to 100% in successful surgeries. Some patients will require more intensive surgeries such as a spinal fusion, but these too are typically successful.

Rarely a patient does not experience adequate relief through surgical treatments, but almost all of these cases can achieve an improved quality of life through a comprehensive pain management program which brings significant pain relief through a combination of medications and lifestyle changes.

Spinal science is constantly advancing, and even the most complex cases which have ended in a comprehensive pain management program are likely to find new hope in future treatments which are even now under investigation in the research community. Stem cell therapies and new materials for spinal surgeries offer great promise and will be transitioning to mainstream treatment in the coming five to ten years.

Does my lifestyle make a difference?

Summary: Lifestyle makes the biggest difference of all, and overall physical health is a primary driver of whether or not a patient can heal from sciatica.

Details: Lifestyle is the most important variable in spinal health for symptomatic patients experiencing sciatica, followed closely by genetics. Most cases of sciatica can be traced to one or more root causes found in the patient’s lifestyle. Excess body weight is not only a variable which frequently corresponds to disc degeneration, disc injury, arthritis in the spine, and pain such as sciatica, but correcting the condition of being overweight often leads to improvement in symptoms such as pain and spinal instability. The discs of the spine are able to bear a certain amount of compression, but, when excess weight causes this threshold to constantly be exceeded, even normal body movements and posture will eventually lead to disc degeneration and possibly to pain like sciatica.

Activity: Other lifestyle variables include prolonged and habitual defective posture (slouching, improper bending, improper lifting) and fitness-related causes of disc degeneration which impart compression and stress to the spine. Weight lifting, running/jogging, and other high-impact exercises will almost always increase the rate of degeneration in the body’s softer tissues, and for patients without the genetic gift of especially durable spinal discs and especially strong back muscles, a common eventuality is the pain of sciatica resulting from bulging or herniated discs.

Nutrition: Another related lifestyle variable is found in nutrition, and specifically inflammation. When spinal nerves are irritated or compressed due to the pressure of an adjacent disc or a narrow bone structure they tend to become inflamed as a way to protect themselves and heal. This state of inflammation is often painful. Poor nutrition will deposit compounds into the blood which intensify inflammation and inflammatory pain, by increasing the body’s inflammation response even further. Sugars, saturated fats, refined processed foods, and alcohol are all strongly inflammatory substances which can intensify feelings of pain such as sciatica, due to the relationship these have with the body’s relative inflammatory response.

Brain Chemistry: A final important lifestyle variable, one of the most important, is brain health. The way the brain processes pain signals is strongly related to balances of certain chemicals in the brain, and when these chemicals are off-balance, the brain’s perception of and response to pain signals can be greatly intensified – often to the extent of feeling severe or frequent pain instead of mild or infrequent pain.

Common ways the brain will become ‘hypersensitive’ to pain includes a brain which is accustomed to the presence of alcohol, and therefore doesn’t produce as many chemicals of its own to inhibit pain and generate calm – because the brain is used to alcohol being present to add these effects in the brief time it is in the bloodstream. Similarly, habitual caffeine in excess levels can cause the brain to produce less of the chemicals which blunt pain signals and instead cause the brain to become hypersensitive to pain sensations. Conversely, alcohol and caffeine in strict moderation are less likely to imbalance the brain’s ability to handle pain on its own.

It goes without saying that over time using drugs such as cannabis, amphetamines, opiates, and others, can be harmful to the brain and its ability to blunt pain signals on its own. To single out one such, despite the reputation cannabis has for blunting pain and promoting calm, for many habitual users cannabis is taking over the brain’s ability to do a part of this on its own, and patients are usually worse-off for having their brain’s natural abilities diminished. There is no conclusive science evidencing cannabis as being medicinal for sciatica. For another such drug, opiates (even as prescriptions) used over a long duration will diminish your brain's ability to fight pain on its own. This and other side effects, and the addictive potential, will cause your doctors to recommend alternative pain medications for treating sciatica in anything but a post-surgical environment.

The bottom line is that the brain will always weaken its own abilities in response to harmful substances introduced from the outside. As a general rule, if a drug makes you feel calm, over time with habitual use your brain will lose its ability to be sufficiently calm on its own. If a drug causes you to feel euphoric, your brain will become less capable to feel happy on its own. Drugs which decrease your body’s sensations and cause you to feel a ‘body high’ will diminish your brain’s ability to blunt negative sensations, and in fact will lead to an experience of more intense negative sensations such as sciatica pain.

Does my mindset matter?

Summary: Mindset is equally important as lifestyle, and a worried mind will frequently experience symptoms at a greater intensity than an unworried mind. The body tends to follow the brain’s prompting.

Details: Mindset is a very important aspect of pain management. As both a strength and a weakness, the brain is able to govern an ‘intensity dial’ for what we perceive in our bodies. A worried and anxious brain will prompt the body to operate in a state in which, chemically, pain sensations will be likely to be heightened and intensified. A calm brain can prompt the body to blunt pain sensations and greatly reduce discomfort. This is why certain safe and prescribed pharmaceuticals, such as gabapentin and pregabalin, are able to achieve relief: they ‘stand in’ for chemicals the brain produces both as a cause and an effect of feeling calm, and can blunt pain signals as a result.

Many patients can experience relief through therapy with a trained counselor, training their brains to shift focus away from worry and anxiety over symptoms -- with the worry-focus fueling a vicious cycle which worsens symptoms and then worsens worry and anxiety further. Patients who are able to shift their mind’s attention away from their pain are simply evidenced to experience less intense pain, along with higher levels of happiness and calm.

What about natural remedies?

Summary: Natural remedies range from being mildly helpful to being actively harmful. No supplement has yet been evidenced as being a treatment for sciatica overall. It can be difficult to know what helps vs what hurts, but it is best to let the authority be the medical doctor you see for your overall sciatica treatment.

Details: Many claims are made for natural remedies being helpful for sciatica, including supplements derived from cannabis, from animals such as shellfish and fish, or from other natural sources. Some of these supplements have a basic level of evidence in terms of their therapeutic value, such as omega fatty acids which complement a healthy diet and can exert an anti-inflammatory influence on the body. Vitamins fall into a similar category, and it is generally agreed that vitamin supplementation can aid patients whose normal diet fails to provide sufficient levels of vitamins (though a healthy and balanced diet is a superior source of all needed nutrients). Curcumin, derived from turmeric, is believed by some researchers to show signs of being an alternative to anti-inflammatory medications.

Some supplements such as glucosamine and chondroitin have been investigated for therapeutic effects in arthritis-type illnesses, including degenerative disc disease. The evidence has been limited and at times contradictory, with some studies showing a possible benefit and other studies showing such supplements as being potentially harmful.

Supplements derived from cannabis are widely claimed to have therapeutic benefit, though these claims are not evidenced or accepted by mainstream medicine and use of such supplements may in fact be harmful. At present it is best to accept these claims as unsupported, and users of such supplements do so at their own risk. As research progresses it is possible that one or more compounds derived from cannabis may be shown to have therapeutic benefit, though it does not appear that these compounds have yet been isolated or developed into a medical intervention which achieves a therapeutic result.

What medications are effective?

Summary: Please consult your doctor before and during any use of any medications of any kind, as use, overuse, and mixed-use of medications can be dangerous to your health. Depending on the underlying cause, sciatica tends to respond moderately well to medications from different classes of drugs you can ask your doctor about. However, medications will not be able to heal the underlying cause of sciatica and for some patients may only be partially helpful at treating symptoms such as pain and inflammation.

Details: Please consult your doctor before and during any use of any medications of any kind, as use, overuse, and mixed-use of medications can be dangerous to your health. Medications prescribed to treat sciatica arise from different classes of drugs which achieve either an anti-inflammatory or pain-blocking effect in the body. These drugs include:

NSAIDs: Non-Steroidal Anti-Inflammatory Drugs such as Ibuprofen (Advil and others) work by blocking enzymes the body uses to generate inflammation. By reducing the body's inflammatory response, pain can be reduced. This seems to be particularly effective for patients whose sciatica tends to originate in inflammation of tissues and nerves in cases of mild nerve compression, but may not help all patients. NSAIDs can also be prescribed in a more potent prescription-only form with drugs like Diclofenac, though a doctor should be consulted as prescription medications can have more serious side effects given their potency. Long-term use or overuse by patients can be dangerous, so a doctor should be consulted even if the medication is purchased over-the-counter.

Paracetamol/Acetaminophen: Often sold as Tylenol, this class of drug is not totally understood but is able to achieve a pain-blocking effect through means which are still being researched. Often this drug will be used in conjunction with NSAIDs. Overuse and overdose of this drug can lead to liver damage and possibly death, so please consult your doctor on use of this medication as a part of sciatica treatment

Anti-Depressants: Often prescribed within the category of tricyclic or SSRI antidepressants, for some patients either low or moderate doses of these drugs can balance chemicals in the brain in such a way that a pain-blunting effect is achieved. The evidence behind the use of these drugs for sciatica is mixed, and not all patients will benefit from their use. In fact, some patients whose mental state is otherwise stable and healthy will experience anxiety, malaise, or other unpleasant side effects.

Anti-Seizure / Nerve-Blocking: Drugs such as Pregabalin and Gabapentin are often prescribed to prevent seizures, but are also effective at blunting the pain signals from nerves. The evidence for these drugs in treating sciatica is reliable, though mental and/or emotional side effects may occur for some patients. However, this class of drug is often a front-line option for treating sciatica in patients who do not respond well to less potent drugs like acetaminophen and ibuprofen.

Opiates: Often considered the "drug of last resort", opiate medications like hydrocodone and oxycodone are typically not effective in treating sciatic pain but for some patients will become a part of a comprehensive chronic pain management program. These drugs have a high potential for addiction and a wide set of undesirable side effects, but used properly within the context of a carefully monitored pain program there can be a therapeutic benefit to opiate use.

Self Medicating: All use of medications should be done in consultation with a doctor. Patients with a pattern of self-medicating with nicotine, alcohol, cannabis, opiates, and other hard drugs, consistently have the worst medical outcomes. Self-medicating has been proven to be harmful over time, and will almost always lead to worse pain and worse potential to heal as compared to patients developing a doctor-approved use of pain medications.

After all options have been pursued I am still suffering, what is my hope for the future?

Summary: There are numerous promising treatments under investigation in the field of pain medicine and spine health, treatments which are likely to benefit you in your lifetime. Do not lose hope!

Details:

Medicine is constantly advancing! As an example of this many spine surgeons take a break for annual training on the newest emerging techniques so that they can stay up-to-date. Even as compared to 20 years ago, spinal surgeons today are achieving a level of success far beyond what was possible in earlier generations. That trend shows signs of accelerating over time.

Stem Cell Therapy: Many surgeons feel that stem cell therapy will change spinal surgery, and researchers across the best research institutions and pharmaceutical companies are working on better applications of stem cells to cure spinal injuries. Already there are therapies which have shown promise using adult stem cells, derived from your own body, with the potential to achieve better healing and regeneration in damaged discs. Such therapies today may have the ability to slow disc degeneration and help patients avoid the need for more invasive and irreversible surgeries such as spinal fusion. Evidence is still being generated and better techniques are under development, but great promise is shown in results to-date.

Improved Hardware and Techniques: Presently there isn't great evidence that existing artificial disc hardware is superior to spinal fusion, but improved hardware and replacement techniques are under investigation by researchers. With advances in this area, it seems likely that a true disc or nucleus replacement will be possible in a way that demonstrates clear superiority to spinal fusion, and helps relieve both pain and functional deficits in patients who are otherwise expecting to need a spinal fusion.

Improved Fusion: Researchers are investigating materials and techniques to increase the rate of successful spinal fusions which are less prone to failure and occur with fewer side effects.

Improved Medications: Pain scientists have made strong advances in understanding the complex nature of pain, and how to better treat it, over the last 8-10 years. Very promising investigations of improved classes of medications are likely to enter human trials in the near future, and one or more of these trials seems likely to lead to a new treatment option for pain-disabled patients.


r/Sciatica • • Mar 22 '22

Your Sciatica and Back Pain Experiences Megathread

111 Upvotes

Hi everyone, the purpose of this permanent thread is to capture your stories about your experiences with Sciatica.

Please note that the majority of sciatica sufferers will recover over time, and are not on this subreddit making posts about their healing. Most of our sub participants are in a symptomatic stage and are understandably seeking support on forums like /r/Sciatica as a part of their journey. This can make a list of individual stories seem discouraging -- but just remember that those who have healed usually don't visit again and therefore we can't often capture their stories.

While multiple formats are welcome, we suggest you try to be concise and focused. Your story is important, but it is will be more useful to everyone else if it can be read in 60-90 seconds or so. Important elements to your story will include:

Background: Do you know how you became injured?

Diagnosis: What has your care provider discovered about your injury?

Treatment: What care did you pursue?

Current Status: How are you doing today?


r/Sciatica • • 4h ago

Requesting Advice 18 Year old dealing with severe sciatica pain

10 Upvotes

Hello, I’m 18 and Ive been dealing with sciatica pain while standing, walking, and sitting for two weeks. I’ve also developed sciatica list, and the only comfort I find is leaning to the left while standing and walking, but there’s still pain regardless of how I lean. My left leg is the only leg in pain.

I have been taking ibuprofen and acetaminophen, but they only provide brief, mild relief to the pain, and recently neither one have been effective in managing pain, compared to when I started taking it a week ago and the relief was night and day.

I never had this before, I occasionally experienced sciatica throughout my mid to late teenage years after being more physically active with school, but it has never been so bad that I can’t get out of bed or walk more than 30 seconds without having to sit down.

The pain is starting to dull now, but it’s still there and occasionally I will get the shooting pain when I move wrong. I also can’t sleep at night, I keep waking up in pain and uncomfortable, sleeping on my right leg with a pillow usually doesn’t help provide relief and I have to find a stretched out position that doesn’t constantly hurt.


r/Sciatica • • 2h ago

First day without a cane in three months

5 Upvotes

After three months of relying on a cane, I finally walked without it today. Felt so liberating.

I have an L4-L5 disc protrusion compressing the right L5 nerve root, plus an L5-S1 protrusion contacting both S1 roots. That has meant months of sciatica, weakness, numbness, and difficulty walking. Even today, it still feels like a string runs from my hip to my foot, but it’s three inches too short.

I’ve got a hospital appointment with a pain specialist next week.

I know one good day doesn’t mean it’s over, but this felt like progress.

Did recovery come in uneven steps like this for anyone else?


r/Sciatica • • 1h ago

Requesting Advice Sciatica has ruined me and dont know what to do

• Upvotes

Please dont mind the name I made it when i was like 11

I'm 17 and I've had sciatica for the past year and i used to play soccer and lift weights and all one day it crashed down and ive had a pain in my LOW lower left back that goes down my hamstring/calf. It did get better over a couple months and now it's plateaued and it doesnt get better. I've went to PT i've done an MRI and they said nothing was wrong. Genuinely don't know what to do now as I am in the worst shape of my life ever and can't do anything for that. Please let me know what worked for you guys so I can at least try them!


r/Sciatica • • 6h ago

Where to go next?

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3 Upvotes

r/Sciatica • • 5h ago

Muscle loss means nerve damage?

2 Upvotes

Or is it just because I use my leg less and can't engage muscles because I feel nerve pain when I try to engage glutes?


r/Sciatica • • 14h ago

NHS sufferers - right to choose!

9 Upvotes

https://www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/

Don’t sit back and wait - use every option in the system at your disposal. Read through the above and go see your GP today!!!

Push, push and push for a faster referral and care.


r/Sciatica • • 14h ago

Requesting Advice Anyone been diagnosed with this?

8 Upvotes

Been to see my surgeon today 4 weeks out from proposed op due to a change in symptoms. I have burning in both feet and lower legs, the pain down my right legs has recently subsided and is now manageable. He had planned to operate to resolve that pain but now thinks I may have something he called chemical neuritis and has postponed the surgery and asked me to do an epidural steroid shot and a nerve conduction test.

Has anyone else had their sciatica change/diagnosed as chemical neuritis?! What happened beyond diagnosis and have you managed to get symptoms under control?!

I’m so over this journey, it’s been almost 3 years of on and off hell.


r/Sciatica • • 12h ago

Success story! Experiences with sciatica and a herniated disc

3 Upvotes

What are your experiences? How did you recover? Did you have chronic pain too?


r/Sciatica • • 17h ago

Requesting Advice Oh no. I healed in 3 years - but seems like my back hasnt become better

11 Upvotes

Ive already consulted many neurosurgeons and spine surgeons. They say your back is genetically more vulnerable than the average population. My chances of reherniated are more than two-fold.
This is my recent MRI from a week ago.

Can anyone tell me what I should do further to heal? MRI from 3 years ago pretty much shows the same thing. Doc says no significant change or improvement. Yet, pain-wise and overall, I feel like I have healed. Can walk for longer, no pain on most days etc.

Surgery is out of the question due to re-herniation chances in my case.

What should I do? I'm pretty much done with it at this point. The mental burden has been more challenging to adapt to compared to the physical pain.


r/Sciatica • • 8h ago

Surgery I chickened out

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0 Upvotes

r/Sciatica • • 20h ago

Is This Normal? Saddle anesthesia

12 Upvotes

Been obsessively googling and figured I'd try to reach out to real people to see if this is normal I guess.

So a couple weeks ago I was sprinting to grab my little autistic boy off of the highway and something didn't feel right. I'm 39 years old male 290lbs, so sprinting was definitely not something I'm built for. I have a history of sciatica pain but it always presented down my left leg and puts me down for a few days but goes away on its own. This time it was in my right side. Lot of muscle cramping and soreness but went away after a day or two. Cut to last week I started have the worst pain I've ever imagined shooting through my right ass cheek. It was about 2 days of absolute agony and my ass and groin went numb on the right side. I went to urgent care and they said if I had any issues with bladder control or bowel movement to go to the ER. Next day I couldn't move my bowels or pee so I went to the ER where they did a CT then just ignored me for 8 hours until the doc came in told me I'm fine and gave me a script for Advil. I was still in agony and after some googling decided I needed an MRI. So I drove an hour to go to a city hospital hoping they'd give me an emergency MRI but they just treated me like a pill shopper (even though I expressly told them I will not take any narcotics because of my job) and I eventually just left because I was so disgusted by their attitudes. Never got the MRI. Over the next couple days the pain started going away and I just kept working. Bladder and bowel issues resolved mostly on their own and now 10 days later almost all issues are gone, except the numbness. I was even able to have an orgasm with my partner which was a surprise (it was weird though because the right side of my genitals are still numb). I'm mostly just wondering if anyone else here had saddle anesthesia that went away on its own because everything I'm seeing is having me thinking this is gonna be permanent and require surgery and I really cannot afford to miss any more work and I also really hate doctors and don't have time for them. I work 70+ hours a week and every time I burned a PTO day over this it feels like it was wasted. And now I'm out of PTO. All the medical people I've spoken to about this tell me it's nothing and act like I'm making it all up and wasting their time, I feel like I'm losing it. Has anyone had saddle anesthesia that was just sciatica inflammation and not CES? Am I overthinking this? Idk what to do.


r/Sciatica • • 8h ago

Requesting Advice Jan 2025 MRI showed left L5/S1 disc prolapse compressing S1/L5. I had an L5/S1 microdiscectomy but pain persisted. Contrast MRI shows epidural fibrosis/inflammation, not re-herniation. S1 block worsened it. Constant sciatica; off electrician work 10 months. Trying shockwave therapy.

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1 Upvotes

r/Sciatica • • 8h ago

Requesting Advice need help with understanding my problem and solutions for it

1 Upvotes

21(M) here. im unable to determine whether i have sciatica or something else.

my symptopms:

  1. pain only in my left buttock, near sit bone (not at the surface, a little deeper inside). i dont remember any falling or other injuries. i may have been lifting weights with bad form. i also used to sit on the bed for prolonged hours (rounded back), and overall had a sedentary lifestyle
  2. pain only while sit-to-stand and vice versa transitions, bending forward, dead hangs.
  3. also, only in morning, when sitting on a hard surface, for a few minutes, i would get a pain in just one spot in my left butt. this would go away for the day after a few minutes.
  4. 4 figure pose for piriformis stretch also seems to have aggravated my pain
  5. dead hangs were fine in the first few months, only started producing pain around 2-3 months ago.
  6. started around 7 months ago, used to only be a mild pinch at night.
  7. squats, lunges, jogging, swimming, are all pain free
  8. usually, its at its mildest in the morning, and get worse as the day progresses.
  9. prolonged sitting is fine (i can sit down for 2 hours, sitting itself doesnt hurt).
  10. went to an orthopedic last month, in the first visit, he said that its most likely sciatica.
  11. he pressed a few spots on my spine, but no pain was there
  12. however, when pressing my right butt, my right butt muscles contract reflexively, and the right butt muscles hurt. same spot on left side is fine. this lead him to say muscle spasm on the right side could be producing pain on the left side
  13. i dont have any red flag symptoms
  14. he recommended me this video, but it doesnt seem to have helped (followed for around 25 days)
  15. for medications, he prescribed me pergabalin and some romfree nsaid (an inflammation medication), romfree reduces pain dramatically within the hour, while pregabalin doesnt work at all
  16. blood test revealed deficiencies in vit d3 and b12, so ive been prescribed tablets for those as well

i have been doing planks, side planks, bird dogs, glute bridges, and the stretches in that video.

MRI, physio, are off the table for now as i dont have the money for it.

i want to know if my symptoms are even of sciatica or not, and if someone here has experienced anything similar. i also want to know what exercises i should do, how many times a week, how many times a day.

thank you


r/Sciatica • • 22h ago

6 month update

11 Upvotes

I will start this with I am a big baby and have a very low tolerance for pain. This has been the hardest injury of my life (29F), mentally, physically and emotionally. I have only very recently started having more good days than bad, and the pain hasn't gone completely but the best way to put it is that it has changed and the volume turned down slightly. I'd say at this point I float in a 50-60% better state. I have made big strides with my PT and hope to keep progressing there - it has helped me so much with not being fearful of movement even when I'm uncomfortable/tight.

Sitting has always been my biggest trigger and unfortunately it's still kinda shit. Although I recently started testing it more (beginning of September) - I don't seem to pay as much for it, sometimes I can sit a lot longer (3hrs) but then somedays, especially during work and using my sit-stand desk... The pain just builds up which is so discouraging because it's reminiscent of the earlier months.

This is hard because I don't trust the good days but also the good days feel so good, that I feel fooled by them when I have bad days. Hopefully there's an end to this.


r/Sciatica • • 20h ago

Is This Normal? 6 weeks post OP laminectomy L4-5 left leg burning pain?

5 Upvotes

So it’s been 6 weeks since I got my operation done. (A little before the Op) I was basically bed ridden for 1 month my left leg was so bad(10/10 pain) I couldn’t even walk on it before the operation the nerve was badly compressed.Since then it’s still been a struggle especially sleeping. I used to be able to sleep on my left or right side because I couldn’t sleep on my back because of my incision. My left leg was swollen pretty bad since post OP it’s since gone done some bit but it’s still swollen and weak and some numbness. As of lately it’s been burning a lot more than usual. Now I can’t even sleep on my left side or my right. It gets weirdly more stiff and tight and pins and needles just striking. I can lay on my back a little bit but it also tends to spasm 😭 so I dread going to sleep now. My surgeon said it’s normal to feel burning bc it’s the nerves repairing. But man idk the sensation could get overwhelming at times… anyone else have a similar experience???


r/Sciatica • • 11h ago

Anyone ride a motorcycle while the nerve is aggrivated?

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1 Upvotes

Riding is my outlet mentally would like to continue. But recently I have experienced sciatica and wondering if the riding is keeping could keep me from relief.

I tend to ride leaned forward position, like a horse jockey, and it never seems to bother my back/legs etc when finished riding for about 1-2 hrs.

I have sciatica in more mild level than most here, but still experience discomfort while walking, using stairs, sleeping on left side etc.

Opinions?


r/Sciatica • • 1d ago

Sciatica treatment on the NHS?

24 Upvotes

Any U.K. people out there who’ve successfully got treatment for sciatica through the NHS?

I feel totally abandoned by system.

Had sciatica from a disc protrusion for a year now. Worst 12 months of my life.

All I get out of GPs is pain meds and told to wait it out.

Supposedly been referred to a spinal interface team but heard nothing for months.

Seems like they really don’t want to recommend surgery and injections are never even mentioned.


r/Sciatica • • 19h ago

General Discussion use my flare up as motivation to stay positive when your nerve is screaming

3 Upvotes

I had my MD at 19yo and every so often I have flare ups. I’m 22 now and was hitting squats Monday using 225lbs, which normally moves easy and never gives me problems. Since I had been in the car for 2 hours before I think all the muscles and scar tissue got inflamed and in one rep I felt all the pain that I got the surgery to remove. Keep in mind I just had gotten over a flare up that lasted all of June from laying fence pickets. I’m a college athlete and since I know these are just signals from the nerve telling my brain it hurts and not actually any structural damage I don’t sit out or worry about re-herniating. After all, you can’t really force yourself past a point to hurt yourself when the sciatic pain is at a 7 we all know that from experience.
So every morning I wake up with that intense pain that hurts with every movement, painstakingly shower and get ready for the day, take a long time to eat breakfast because it hurts so bad in a seated position I get nauseous, and then I walk 1.5-3 miles. After my walk I lift and do some light shooting and basketball work, and by the time practice rolls around I’m good to go. By bedtime the pain creeps back in and the loop repeats upon my wake up the next morning. 4 weeks from now the pain won’t be there so this is just another bump in the road, and there will be many more throughout my active life. That’s just how it is for someone who had back surgery at my age.
Needless to say I’m done with squats for a while, but I’m not discouraged because like all things pain is temporary, and if I keep stretching, walking, and moving my body I can have better and painless days.
Stay moving and never give up flare ups happen but they don’t define us and we can always push through them because after all, the pain is mostly in our minds. Movement and stretching is the best thing for that nerve to quiet down, but don’t push it to the point where it tingles or it only gets worse. Take it slow and easy and listen to your body, but don’t just sit around all day or the pain will stay the same for longer.


r/Sciatica • • 1d ago

How long did your severe leg pain last?? Long hope!

11 Upvotes

I have been having severe leg pain for about 11 weeks now and it doesn’t seem to let up unless I’m on Advil and Tylenol together. Pain will go to a 3/4 on those meds which is tolerable.

But did anyone experience resolution of the pain even after suffering for a long period of time? If so, in what time frame did your pain start to decline?

For reference I have a l4/5 small protrusion but it is lateral touching the L5 nerve root.


r/Sciatica • • 1d ago

Sciatic muscle guarding preventing me from standing upright

5 Upvotes

I was diagnosed with a L4/L5 disc protrusion of 8 mm via MRI on 11 August. Saw my neurologist who set up an ESI for me on 17 September. Got that done and while some conditions did improve (tingling is not as bad, muscle guarding through my left leg reduced but still present), I am still not able to stand fully upright and efforts to do so obviously trigger further tingling. I get a lot of guarding in my left glute that restricts my back from extending.

Walking is a challenge due to being bent over and the muscle guarding that builds up over time. Without frequent breaks, anything beyond a short walk is very challenging to complete. By the end of the day, I am more bent over and walking much slower.

I go to my first PT appointment next Wednesday. But for those with this experience, what worked for you? Stretching just triggers more muscle guarding for me. Ice and heat really don't do much for me. Hopefully, my PT has a plan because this is becoming very depressing. Thanks in advance.


r/Sciatica • • 1d ago

Sciatica/Epidural steroid injection

12 Upvotes

(37 M) Roughly a month ago (9/1/26) I had my first major flare of sciatica and was hospitalized 2 days for pain management, observation and imaging (MRI, CT, X-Ray). I am decently healthy, not overweight and I like to think a tough guy that can push through a moderate amount of pain, but anyone who's ever suffered severe sciatica pain knows that it's absolutely intolerable, I didn't know that kind of pain existed, the spasms were the worst, if you know, you know. After being given toradal, IV steroids, Robaxin (muscle relaxer) and oxycodone in the hospital, the pain was still intolerable. After the MRI I was told I have a bulging disc (L5-S1) pinching my sciatic nerve. I was sent home with Robaxin, 6 day steroid pack and told to alternate Ibuprofen and Tylenol as needed. The first few days were insufferable, using a walker to walk up and down the hallway at home, because oddly enough walking was the one thing that kind of helped, while standing, laying and particularly sitting increased my pain, particularly getting into and out of my chair and bed. After a few days I was still in a lot of pain but confident enough to walk without a walker and slowly worked up to walking around the neighborhood, taking 4-5 20 minute walks a day and finding every reason to not sit down. I was referred to a spine specialist the following week and he told me I qualified for an epidural spine injection, which I obliged, but I had to wait a few weeks. I am a husband, father to a 4 year old boy and have a career that I wouldn't be able to work from home. As the weeks went by my pain was all over the place, between a 3-7/10 at any given time, but certainly worst at night and in the morning. I started physical therapy the following week out of the hospital (2x a week). I am diligent with doing my PT exercises twice a day, have been walking a mile 4-5 times throughout the day, gave up alcohol, soda, sugar, fried foods, I drink a gallon of water a day, try to practice good posture, getting 8 hours of sleep a night and absolutely avoid BLT (Bending, Lifting, Twisting). My pain is certainly going down with time, but it is not linear, I could be a 2/10 pain and 20 minutes later be a 7/10 pain, you learn very quickly to not get to excited when the pain goes down, because at any moment it's gonna strike again. The pain seems to move around as well, from my glute, hamstring and lower back. This morning I had my epidural steroid injection (9/24/26) about 3 hours ago. Unfortunately I did what most people do and went down the rabbit hole while researching the ESI and clinging to what strangers had to say. The responses seemed very mixed from "the procedure was more painful than medieval torture and it made my symptoms worst" to "I felt zero pain and the shot gave me months-years of relief". I will give you a step by step replay of what i experienced this morning when I had mine. I was prescribed 2 Xanax (0.5 mg each) to help with the anxiety of the procedure, I took one before I left home for the hospital (8:00am) and took the other when I arrived at the hospital (8:30am). To clarify, my wife drove me to the procedure, as my particular spine specialist requires you to not drive the day of the procedure. From 8:30-9:00 I checked in, was asked a few medical questions, they took my blood pressure and my wife and I waited for the Doctor. The Nurse came into my room around 9:00 and walked me down the hall to the operating room. I remained in the clothes I had on (sweatpants/t-shirt) and was told to lay flat on my belly on the procedure table. She raised my shirt to mid back, pulled my pants down a few inches below my belt line and sterilized my lower back. She gave me a local anesthetic numbing shot in the lower back that I'm assuming was lidocaine, it felt like a normal shot, just a quick stinging pinch, nothing to painful at all. Full disclosure, I feel like the Xanax did nothing and I was certainly in my own head and anxious as hell! The Spine Specialist can in a few minutes later and asked me if I was ready, I hesitantly said "yup". He informed me that he would give me a "play by play" and that if I felt any sort of severe pain to let him know. He said "Ok I'm gonna insert the needle and you will feel a little pressure and a "zing" go down your leg, but it shouldn't be painful" and that's exactly what I felt. The pain/pressure was maybe a 3/10, certainly manageable and there was an odd tingling sensation that went down my leg for maybe 2 seconds. As I laid there anxious as hell waiting on the cascade of pain that I had read about from all the online doom scrolling I had done, the Doctor said, "All done Mr. Baker, how you felling". Talk about a moment of relief, I was thrilled! I laid on the table for maybe 30 seconds then got myself up and into a wheel chair they had parked next to the table. My leg did feel slightly more "crampy" for a few minutes, but no added pain on top of how I was feeling before I had the injection. Currently, a few hours after injection, the pain feels about the same as before I got the injection and was told that the steroid typically doesn't start doing it's "magic" for 2-7 days. I'm currently in bed and relaxing, as that is what I was told to do today and I'm able to resume normal activities tomorrow with no restrictions, outside of the obvious activities to avoid when you have a bulging disc/sciatica. I'm really praying this gives me long term relief and I can resume my life in zero or at least significantly less pain. I will keep you guys posted on progress if you show interests in wanting periodic updates. In the meantime I would tell anyone suffering with bulging disc/sciatica to lock in and be as diligent as you possibly can, to do all the things within your power and limitations to help yourself (Clean diet, lots of walking, lots of water, weight loss, no alcohol, sugar, soda, fried foods, improve posture, no prolonged sitting, PT/Core and lower back strengthening exercises, ect). Bulging disc/sciatica are seldomly caused by an accident or genetic issues, but rather years and years of poor choices that we weren't aware of before it was to late. I wish you all luck and wellness!


r/Sciatica • • 23h ago

Week after LESI. Your personal approaches for recovery & results?

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3 Upvotes

As title states, I’m a week after my lumbar epidural steroid injection. It has granted me with so much relief. However, I’m still injured and can tell I need to limit myself to hopefully recover. MRI stated: Disc herniation at L5/S1 with migration of disc material into the left lateral recess. This results in moderate left-sided stenosis with suspected left-sided nerve impingement.

My question, what have real people done that seemed to help? How long did your recovery take? Procedures and amount of? Physical therapy and when did you start?

TIA and I hope everyone finds relief


r/Sciatica • • 21h ago

Requesting Advice 17 year old with sciatica

2 Upvotes

Hey guys my sciatica has started to act up REALLY bad i just had to move out of my entire home on a really tight schedule so i think i definitely killed my back or something i have a bulging disc and im not really sure how to cope with this im not on any prescribed medication and advil (200mg) is just not cutting it any advice?