Last Stages of Sciatica – A Guide to Understanding Progression and Treatment

Sciatica is a form of nerve pain that often originates around the buttocks and travels down each leg. It occurs when a herniated or bulging disc (or overgrowth of bone) pushes into the nerve canal in the spine and puts pressure on the sciatic nerve. This pressure sends pain into the lower body and can worsen over time. 

This guide will focus on the last stages of sciatica, including its symptoms and potential treatment options. It will cover both surgical and non-surgical interventions to help you live a more comfortable life. While treatment for sciatica is possible, even in its late stages, patients are always encouraged to seek treatment early on. Not only can you prevent pain from reaching unbearable levels, but you can also avoid severe complications that slow your recovery. 

Learn more about this condition and how to treat it. Knowing your options can help you make informed choices for your care.  

Understanding Sciatica and Its Progression

Before you can explore treatment options for sciatica, it helps to understand its root cause. Your spine is made up of vertebrae that are protected by shock-absorbing cushions called discs. Your nerve canal runs alongside your vertebrae and transmits information throughout your body. When you stub your toe, nerves in your foot send information up your spine to your brain, alerting you to the pain. 

Sometimes, the discs that protect your vertebrae break or get pushed out of place. This is known as a herniation. The discs are forced into the nerve canal, disrupting the flow of information. When a disc presses on your sciatic nerve, it creates a condition known as sciatica. This compression also occurs if other parts of the spine hit the nerve, like a bone spur.  

Sciatica has multiple stages as the herniated disc or bone spur pushes into the nerve. It might start with a mild ache in your back or sharp, unexpected pains when you move or sneeze. However, as the nerve compression worsens, the pain can get worse. Sciatica can cause chronic pain that shoots down your legs or causes them to throb for several hours. It can also create numbing sensations and muscle weakness because the nerves cannot properly communicate information. 

While mild sciatica can heal independently, you may need medical intervention if you enter the more advanced stages.   

Symptoms of Sciatica in Its Final Stages

Every person is different, so your symptoms may vary and their severity may change depending on your body. However, here are some of the most common sciatica symptoms as this condition enters its final stages. 

Severe and Chronic Pain

Pain intensifies in the final stages of sciatica, often becoming constant or debilitating. Pain is most commonly reported in the lower back, buttocks, legs, and feet. The pain can get so bad that it interferes with daily life. Not only will it make completing basic tasks uncomfortable, but it can severely limit mobility and inhibit restful sleep. 

During the later stages of sciatica, patients often cannot work because of their limited mobility and chronic pain. 

Nerve Damage and Loss of Sensation

Nerve compression, when left untreated, can cause permanent damage. Patients with severe sciatica often experience numbness and tingling in their legs and feet. In extreme cases, this nerve damage is lasting and can even lead to paralysis. 

You may also be experiencing nerve damage if you notice reduced reflexes or weakness in your legs. Your nerves are unable to send and receive information from your brain effectively. 

Loss of Bladder or Bowel Control (Cauda Equina Syndrome)

Along with affecting your legs, sciatica can affect other lower extremities. Loss of bladder and bowel control is the final stage of sciatica and constitutes a medical emergency. You may need immediate surgical intervention to prevent permanent damage.

When to Consider Surgery for Sciatica

The options available to sciatica patients depend on the severity of the condition. Patients who seek treatment early on may fully recover through non-surgical treatments. Doctors may prescribe physical therapy, epidural injections, medication, and hot and cold therapy to reduce the severity of the symptoms. Depending on your case, your doctor may recommend multiple treatment options that work together to treat the sciatica. 

However, if the sciatica doesn’t respond to these treatments or the condition is already entering its last stages, your doctor may recommend moving forward with surgical intervention. Surgery may be necessary to relieve pressure on the sciatic nerve and prevent permanent damage.

The Role of Disc Replacement in Treating Sciatica

Patients with advanced sciatica may benefit from disc replacement surgery, which removes and replaces the damaged disc with an artificial model that will remain in place. Surgical intervention immediately removes the damaged disc pushing on the sciatic nerve, allowing the body to heal.

How Disc Replacement Alleviates Sciatica

Disc replacement is a modern surgical option that directly treats the underlying cause of sciatica. If a herniated or degenerated disc is pressing on the sciatic nerve, this operation removes and replaces the damaged disc with an artificial model that will last for decades. This eliminates the chance that your sciatica returns unless another disc is impacted. 

Disc replacement is often preferred over spinal fusion because it preserves mobility, allowing you to retain your full range of motion once you heal. It is also less invasive and has a shorter recovery window, making it an easier operation for many patients.  

Who Is a Candidate for Disc Replacement?

Your doctor will decide if you are a candidate for disc replacement surgery, but this option is often preferred for patients in the last stages of sciatica. If the damaged disc is severely herniated or degenerated, there is limited opportunity for it to return to its proper place. If a patient’s body doesn’t respond to non-surgical treatments, they may need to consider surgical options. 

Your doctor will want to confirm that you are in good health before recommending surgery. They may ask you to quit smoking, change your diet, and improve your exercise habits (in a manner that doesn’t affect your sciatica) before approving you for the operation. 

Surgical Outcomes and Recovery

Artificial disc replacement has reported success rates that range from 75% to 93%. This is a highly successful range in the medical field, especially when treating advanced conditions. Patients who receive surgery for their spinal conditions report reduced pain levels, increased mobility, and a higher quality of life after they heal. Surgery is considered a permanent treatment for sciatica. 

Patients can expect the recovery timeline to take up to three months if they follow their post-operative instructions. In most cases, they can return to office work in less than a month, resume light sports within six weeks, and return to physical work within 12 weeks. This timeline might take longer for some people than others. 

While surgery can be disruptive to your life and limit your work, the long-term benefits are often worth it. The reduced or eliminated sciatica symptoms allow people to enjoy life again once they heal. 

Final Thoughts from Dr. Todd Lanman on Sciatica Treatment

Sciatica starts as back pain but progresses into your legs and feet. The pain levels can increase until they become too severe for you to navigate daily life. In its last stages, sciatica can lead to permanent nerve damage, loss of bowel and bladder control, and even paralysis. The earlier you identify sciatica symptoms and seek treatment, the lower your chances of experiencing these late-stage symptoms. 

If your sciatica has already progressed to the last stages, work with a spinal professional who can give you the surgical intervention you need. Dr. Todd H. Lanman is a leading spinal neurosurgeon who has 30 years of experience treating patients with sciatica and other back pain. He embraces disc replacement surgery to help patients restore mobility and quality of life. He can help you treat your sciatica and reclaim your ability to move, work, and play. 

You don’t have to live in pain. Request a consultation with Dr. Lanman for a personalized treatment plan to address your sciatica. You can also explore Dr. Lanman’s Top Doctors Directory to find a Top Doctor in A and Arthroplasty near you. 

FAQs

What are the symptoms of advanced sciatica?

When sciatica becomes more advanced, pain becomes worse and can become unbearable. You may notice numbness, tingling, or weakness in your legs and feet. In the last stages, you may lose control of your bladder and bowels because there is so much pressure on your nerves. 

Can sciatica lead to permanent nerve damage?

Mild forms of sciatica can heal independently, but severe cases can cause permanent nerve damage. Even if the nerve damage isn’t permanent, it could take several months or even years to heal. This is why early intervention is so important. 

When is surgery necessary for sciatica?

Surgery may be necessary for patients who don’t respond to non-surgical interventions like physical therapy and medication. It also might be necessary for late-stage patients that are already experiencing nerve damage. Surgery will take pressure off the sciatic nerve so the body can start to heal. 

How long does it take to recover from disc replacement surgery?

Every patient is different, but most people recover from disc replacement surgery within a month or two of the operation. It is much faster than spinal fusion and preserves your range of motion. Keeping up with your post-operative instructions can help your body heal on time.  

What are the risks of leaving sciatica untreated?

If your sciatica worsens, it could cause severe symptoms like loss of reflexes and paralysis. You may also experience loss of bladder and bowel control. The nerve damage from sciatica could be permanent or take several months or years to heal.