Like with any pain or injury, if untreated for a long duration of time, sciatica can be harder to alleviate if symptoms are highly irritable. With non-operative treatment and time, most sciatica will go away on its own in the time frame of weeks or months.

In this article, we’ll discuss all questions related to what happens if sciatica is left “untreated.”

I’m defining untreated as not going through formal physical therapy, chiropractic, or other musculoskeletal rehab programs.  

How long can sciatica be left untreated?

Theoretically, if you don’t have any progressive neurological symptoms such as weakness, numbness, tingling, and bowel and bladder changes, then it could left untreated, indefinitely. 

The best thing you can do for yourself in regards to sciatica is to keep moving in ways that doesn’t make your symptoms worse. In fact, it’s recommended to get back to your normal activities as soon as possible. If you regularly lift weights, walk, run, etc, get back to those activities within reason. 

Let’s define within reason. You shouldn’t do activity that is severely flaring up symptoms. You’ll need to find the amount and intensity (speed, amount of weight) that allows you to stay moving without making symptoms significantly worse. 

If you’re unable to find a mode and amount of activity that helps with symptoms after 2-3 weeks, I recommend seeking out a professional. Your first stop should be a physical therapist if you do not have progressive neurological symptoms. 

A physical therapist or other musculoskeletal rehab provider will be able to point you in the right direction and help guide you through the path to recovery. 

I recommend any of the providers from Barbell Medicine or Clinical Athlete as they are the most up-to-date with the most evidence-based, non woo-woo based care. 

How do you know when sciatica is serious?

Sciatica becomes a more serious problem if you are experiencing difficulty in going to the bathroom, urination or bowel movements, or if you cannot control these. 

Additionally, if you are experiencing progressive numbness, tingling, and weakness in one or both legs, this would be indicative of a more serious problem that you should get evaluated as soon as possible.

 

Various causes of this type of weakness, numbness, and tingling include disc herniations, stenosis, and/or cauda equina syndrome. Cauda equina syndrome is very rare so don’t jump to the conclusion that you have this without being evaluated by a professional. 

Can you get paralyzed from Sciatica?

It is very unlikely that you would become paralyzed from sciatica. You would literally need to ignore all of your symptoms of progressive weakness, numbness and tingling. In my 5 years as a physical therapist i’ve never met anyone who has ignored symptoms to this point. 

I’m sure someone reading this will be able to tell me otherwise, however, it’s incredibly rare and if you just pay attention to symptoms and get treatment to help, you will be okay. 

I think it’s more likely to be struck by lightning. 

What can happen if you don’t seek treatment when symptoms are really bad is that the pain could stick around for a long time and your mobility levels could significantly decrease. This could have a negative effect on your overall health as you wouldn’t be able to exercise as much. 

In any case, seek help, and you’ll more than likely be on the right path and onto healing. 

Is sciatica life-threatening?

No, sciatica is not life-threatening. It can be incredibly painful however it is not cancer, an infection, or any other type of life-threatening condition. 

The only time it could become a contributor to a life-threatening condition is if it exacerbated a mental health crisis and then you start having suicidal thoughts. Sometimes pain can become so great that mental health becomes affected. 

If you have been struggling with sciatica, and depression, and are having any suicidal thoughts please call the suicide hotline #. No one should struggle alone and you deserve to be healthy and feeling better. 

What triggers sciatica?

Unfortunately, we don’t have any good research to say what exactly causes sciatica. 

In most cases, there is not one event in particular that causes sciatica, but rather it comes on gradually and worsens over time. 

Like with most health issues, important factors to consider are:

  • Exercise and fitness levels
  • Sleep quality and duration
  • Social engagement levels and quality of life
  • Stress levels
  • Other risk factors of metabolic disease such as overweight or obesity. 

We can reduce our risk of sciatica and all other health conditions by doing the following.

  • Meeting the American Academy of Sports Medicine Exercise guidelines
    • 30 mins of moderate aerobic activity, 5 days per week (150 mins total per week)
      • Or 75 mins of vigorous aerobic activity per week
    • 2 days of resistance training (weight training) per week
  • Maintaining a normal body weight.
  • Prioritizing sleep quality (harder for new parents)
  • Managing stress levels
  • Eating a diet rich in leafy greens and protein and monounsaturated fats

Can you unpinch the sciatic nerve?

pinched nerve

A common belief is that the reason for sciatic pain is due to the nerve itself being pinched or compressed. 

While this is the case in some people due to disc herniation, stenosis, or cauda equina syndrome, this is not the whole story. 

Since there are also people who have a “pinched nerve,” and have no symptoms, there is likely something else going on. 

It’s hypothesized that sciatica is more of an inflammatory condition to the sciatic nerve, triggered in the presence of the absence of compression at the nerve root level. 

Basically, sciatica pain can occur with or without compression of the nerve root. So, the logical conclusion would be that it’s likely not the compression itself, but the failure of the body to modulate the inflammatory response. 

Can untreated sciatica cause irreparable nerve damage?

Like we discussed before, it is unlikely that sciatica will cause irreparable nerve damage unless you completely ignore the problem and let it get to a point where you can no longer control your bowel and bladder or pick your leg up. 

Are you at higher risk of suffering cauda equina syndrome?

No, you are not at a higher risk of developing cauda equina syndrome. Yes, you can develop cauda equina syndrome and this likely starts with having sciatica, however like we discussed above, CES is a vary rare condition and can successfully be treated surgically or non-surgically (depending on the surgeon).

Are you at higher risk of losing motor control and sensation?

motor control
A man in black sportswear does an acrobatic handstand on a ring outdoors

You could lose motor control and sensation if symptoms continue to worsen. If you seek treatment early with a rehabilitation professional it is likely you will never get to the point of losing motor control or sensation. 

Will you require surgery if you leave the condition for too long?

Some people will require surgery if pain levels simply will not go away. Generally my advice to my patients is to not consider surgery unless the pain lasts for > 3-6 months. Additionally, if there is no motor control loss and no numbness or tingling, then surgery is generally not indicated. 

Some folks will have such severe pain that they require a surgical procedure but again, this is a very low percentage of people. 

I recommend most people go through a high-quality rehab program before they consider going down the spinal surgery route. 

Summary

  • Sciatica will usually get better on its own if you try to stay active within reason as you are recovering
  • If you have worsening numbness, tingling, weakness, and bowel and bladder changes, seek the help of a physical therapist or other rehab professional
  • If you’re having pain for more than 2-3 weeks and you aren’t able to get any relief on your own, seek help from a rehab professional
  • Most people will not need surgery
  • Most people do not have cauda equina surgery
  • Untreated sciatica is unlikely to cause irreversible nerve damage. Our body is highly adaptable. As long as symptoms are not progressing and getting worse, this is an unlikely event. 

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