Can Sciatica Be Cured? What Goes Away and What Can Come Back

If sciatica has been running down your leg for weeks, the question on your mind is simple: will this ever go away for good? For most people, the pain does go away. Whether it stays away depends on what is pressing on the nerve, and that is the part most answers skip.

This guide explains what "cured" can mean with sciatica, how the cause changes the outlook, what each treatment can and cannot do, and the signs that mean you should get help now.

For most people, yes, in the way that matters most: the pain goes away. The NHS says sciatica usually gets better in a few weeks to a few months, though it can sometimes last longer. In a Dutch trial published in the New England Journal of Medicine in 2007, 283 people who had had severe sciatica for 6 to 12 weeks were assigned either to early surgery or to non-surgical care with surgery later if needed. By the end of the first year, 95% of people in both groups had reported a complete or nearly complete recovery at some point. Some later had symptoms come back, and at the two-year follow-up about 80% said they had recovered.

Two things keep it from being a simple yes. Sciatica can come back: the NHS says that if you have had it, there is a chance it could happen again. And when the cause is wear in the spine, such as spinal stenosis, non-surgical treatment can ease the symptoms but does not widen the narrowed canal behind them.

Sciatica is not a disease of its own. It is the name for pain, tingling or numbness that travels from your lower back or buttock down your leg because the sciatic nerve, or one of the nerve roots that form it, is irritated or pressed on. So "cured" can mean three different things:

• The pain is gone. This is what happens for most people, as the timelines above show.
• The cause is gone. A herniated disc can shrink back on its own, and surgery can remove what is pressing on the nerve.
• It never comes back. No treatment can promise this, because sciatica can return, even after surgery.

These do not always arrive together. With spinal stenosis, for example, the symptoms can ease while the narrowing stays. Knowing which kind of "cured" you are asking about makes the answer much clearer.

Sciatica has several possible causes. Cleveland Clinic lists causes including herniated discs, spinal stenosis, degenerative disc disease, spondylolisthesis (a vertebra that slips out of place), osteoarthritis, pregnancy, and tumors, cysts or other growths. Two of these, a herniated disc and spinal stenosis, behave very differently over time.

Most people get better without an operation. Cleveland Clinic says many cases improve within four to six weeks without medical treatment, and that most people feel better without needing surgery.

What helps while it settles is covered step by step in our guide to how to relieve sciatica pain: keep moving rather than resting in bed, use heat or ice, and ask a pharmacist about pain relief.

The NHS says to see a doctor if the pain has not improved after a few weeks of home treatment, is getting worse, or is stopping you from doing your normal activities.

Yes. The NHS says that if you have had sciatica, there is a chance it could happen again. It does not put a number on how likely that is.

Surgery does not rule it out either. A 2015 study that reviewed 90 earlier studies, covering 21,180 people who had lower back disc surgery, found that about 6% needed another operation within about two years because the same disc herniated again.

You cannot control every risk, but these steps may lower the chance of another flare, according to the NHS, Cleveland Clinic and Harvard Health:

• Stay active, with regular movement, stretching and core-strengthening exercise.
• Break up long periods of sitting. Harvard Health notes that extended sitting can raise your risk of sciatica and make it worse once you have it.
• Keep a healthy weight, since extra weight puts more strain on your lower back.
• Avoid tobacco. Cleveland Clinic says nicotine can reduce blood flow and weaken your spine.
• Use good posture when you sit, stand, lift and sleep.
• Do not push through back pain. Switch to low-impact activity such as walking or swimming when you need to.

It helps to know what each treatment is for, so you know what to expect from it.

Surgery removes what is pressing on the nerve. Cleveland Clinic describes a discectomy as removing part of a disc that presses on a nerve, and a laminectomy as removing bone that presses on spinal nerves. A microdiscectomy is a discectomy done through a small opening. NICE suggests considering this kind of decompression surgery when non-surgical treatment has not improved pain or function and imaging matches your symptoms.

Does it work better than waiting? In the Dutch trial above, people assigned to early surgery got relief from leg pain faster and felt recovered sooner. After one year, though, the results were similar: in both groups, 95% had reported a complete or nearly complete recovery at some point during that year, and the groups were still similar at two years. Many in the non-surgical group still had an operation later: 39% of them within the first year, and 44% within two years.

Cleveland Clinic says providers may suggest surgery if pain is severe, nerve damage is a concern or other treatments have not helped. For people whose sciatica comes from a herniated disc, the trial suggests that starting with non-surgical care can reach a similar place by the one-year mark, only more slowly. The trial did not include people with cauda equina syndrome or severe leg weakness, so its results do not apply to them. Surgery also does not guarantee the problem will not return, as the 6% figure above shows. Our guide to sciatica surgery covers the types of operation and recovery week by week.

For a smaller group, the pain lasts longer. Cleveland Clinic notes that in some cases symptoms can last longer and lead to ongoing pain, and that ongoing issues are more likely when symptoms are severe.

The nerve itself can also be affected. If a nerve is badly damaged, it can cause muscle weakness, such as foot drop, which makes it hard to lift the front of your foot when you walk. In rare cases, the nerve damage is permanent, leaving lasting numbness or loss of feeling in the leg. Cleveland Clinic lists muscle weakness among the serious symptoms to look out for, so get it checked rather than waiting it out.

If your pain has gone on for months, it is worth finding out exactly what is causing it. NICE advises against routine imaging outside specialist care, and says specialists should consider imaging, such as an MRI, only if the result is likely to change your treatment.

Most sciatica can be cared for at home at first. A few signs cannot wait.

Cleveland Clinic calls sciatica very common, and a common, painful problem attracts products and programs that promise a permanent cure. Be cautious. Sciatica has several different causes, and none of the guidance above, from the NHS, NICE or Cleveland Clinic, points to a single product or routine that cures it for good. Finding out what is causing your pain is a better starting point.

If your sciatica has not improved after a few weeks, keeps coming back, or a doctor has mentioned injections or surgery, an evaluation can tell you what is causing it and what your realistic options are. The spine team at Mountain Spine & Orthopedics evaluates sciatica, offers non-surgical care including epidural steroid injections, and performs surgery such as microdiscectomy when it is the right step. We see patients at locations in Florida, New Jersey, New York and Pennsylvania.

You can see a sciatica doctor at Mountain Spine, or if you already have an MRI, send it for a free MRI review.