How long for sciatica to heal depends on the cause

If you come to this with the question “How long does it take sciatica to heal?” then the answer “how long for sciatica to heal depends on the cause” might seem unhelpful. But, bear with me.  I’ve been an osteopath in Edinburgh for nearly 30 years, so let me explain…

What does sciatica mean?

You must remember that “sciatica” is not a diagnosis.  It’s a description. So first you need to know the cause of your sciatica.  Only then can we answer the question about healing time. As a brief aside, sciatica means pain and/or pins and needles in the distribution of the sciatic nerve. That’s all. Simple, but unhelpful.  It would be like going to the doctor saying you have a pain in your head, and your doctor telling you that you have a headache.  Thanks a lot.  So “sciatica” doesn’t tell you much.

Causes of sciatica

Broadly there are two categories of sciatica.  Nerve compression sciatica and non-nerve compression sciatica.

Causes of nerve compression sciatica

Only about 1 in 1000 cases of sciatica has a serious underlying medical cause. Think of nasty diseases like cancer, vascular disease, neurological conditions etc. There are other questions we can ask you to screen for these illnesses.  About 5-10% are due to compression of a spinal nerve, caused by a disc bulging or prolapsing into the space occupied by the spinal nerve.  Here’s a link for more information on disc prolapses.

Causes of non-nerve compression sciatica

Sciatica can be caused by referred pain.  This is where a nerve supplies a large area.  You injure something in one part of that nerve’s distribution, but you can feel the pain anywhere else in that nerve’s coverage.

How long for sciatica to heal depends on the cause

So let’s start wth nerve compression sciatica due to a disc prolapse. This can take many weeks or many months to heal.  Here we’re talking about the disc healing AND the nerve calming down.  Both can take a long time.

Sciatica due to non-nerve compression depends on the tissue that’s been injured.  As well as whether you’re doing something that’s continuing to aggravate your injury.  Muscle injury can cause sciatica.  Simple muscle strain can heal in 2-4 weeks so long as you do the right things.  Ligamentous strain could also lead to sciatica, but is more likely to take 6-8 weeks.  You can have an annular strain (part of the disc); it will take much longer usually.  Potentially 8-12 weeks.  If you have piriformis syndrome causing sciatica, you have to get rid of the tightness in your piriforms.  This could be easy, and take a couple of weeks.  Or – as with all of these possible causes – if you don’t eliminate the contributing factors, it won’t heal.  If you want to get better, stop doing things that make the pain worse.

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