Signs Your Sciatica is Improving and Not Getting Worse

As a Physical Therapist I Use These 5 things to Makes Sure Your Sciatica is Healing

1. Centralization of symptoms
2. Improved leg strength
3. Improved sciatic nerve mobility
4. Improved pain intensity or frequency
5. Ability to walk or move

Remember, sciatica is a collection of symptoms that often includes leg pain/burning, weakness, and sensation changes.

1. Centralization of Symptoms (Pain, Burning, or Numbness)

‍Pain, tingling or burning that moves upward from the leg toward the spine. Or, the central of the body. This shift indicates healing as the nerve irritation reduces further from the extremities. It's a good sign and if that is happening then keep on the path. It doesn't happen in all people with sciatica but most, especially those with sciatica from a disc issue. This can happen during exercise or movement. It's interesting but when a patient tells me that their glute pain is worse but they have less leg tingling. That's a sign to stay on course! 

Centralization vs Peripheralization of Sciatica

Centralize means coming toward the center of the body and in this case it's the spine. Peripheralize means go away from the spine into the leg, foot or calf. We use this phenomenon to track when to push and when to pull back. Let me give you an example.

When someone completes an exercise and they notice that their back pain increased but they have less foot pain. Then we completed another set of an exercise with more back pain but but now their pain is gone in the foot and only in their calf. That's a good signs of centralization.

Does Pins and Needles Mean My Sciatica Getting Better?

Pins and needles can indicate different things:

• Positive Sign: If you were completely numb and begin to feel pins and needles, it often means the nerve is healing. Think of that feeling when you leg falls asleep.
• Irritation: If pins and needles occur during specific activities (e.g., sitting on a couch), it may mean the nerve is irritated. Avoid such positions or movements to prevent further irritation.

It’s important to monitor the context in which pins and needles occur and consult a professional if symptoms or pain worsens and stays that way.

2. Improved Strength in the Leg

Strengthening of the leg or foot (e.g., being able to perform more single-leg calf raises) reflects nerve healing. I often include these when I'm working patients recovering from sciatica.

3. Improved Sciatic Nerve Mobility

‍The ability to bend over with less pain is a good indicator. If you’re no longer keeping your back excessively straight when bending, it’s a sign of progress. We will use tests such as slump testing and ability to bend over to test this. You can also notice improve nerve mobility with walking. Walking glides the sciatic nerve as well.

Check out the end of the video to see the slump test and how to see if you need to improve your nerve mobilty! 

4. Reduced Pain Frequency or Intensity

While pain intensity may remain, experiencing pain less often throughout the day is a positive sign. Likewise, if the intensity of the pain remains the same but it's less often. That is also a sign of nerve healing.

5. Ability to Move or Walk

Most don't know that walking moves the sciatic nerve. If you have ever had severe troubles walking due to leg or back pain you may have already noticed this. If you can notice that you can walk longer without pain or that you are having less tlingling with waking, that is also a sign of sciatica improving.

How Long does Sciatica it take to Heal?

Let's be clear many people have 100% improvement. Fully healed does happen. In just a few weeks some can be 100% better. Only 20-30% may have symptoms at 1 year. The healing time for sciatica varies widely depending on the severity of the condition, your treatment plan, and how well your body responds. Recovery can range from a few weeks for mild cases to several months for more severe conditions. Persistent improvement in strength, mobility, and reduced symptoms are key markers of recovery.

The Final Stage of Sciatica is Leg or Calf Strength

The final stage of sciatica healing often involves regaining strength. While tingling and pain may resolve earlier, weakness in the foot or calf (e.g., foot drop) is usually the last symptom to improve. Tracking and addressing this weakness can indicate full recovery of the sciatic nerve.

I have seen so many patients still have some residual weakness but it wasn't limiting at all.

Here is What I tell My Patients to Speed up Their Sciatica Recovery

Sciatica relief or recovery can be easy or very challenging. I have seen some bounce back quick and other take a while. Sometimes you are just dealt a poor hand but you still have to play your cards. The great news is that there are many resources out there to help. This can be YouTube, PDFs, books and more. When in doubt, please consider working with a professional to help you learn your body and symptoms. Try to stay away from injections and imaging early on.

The more you know the better off you are.

A positive mindset and go getter attitude can go a long way. Try to stay moving, use heat when needed, watch out for scary symptoms, and learn what feels good for you and follow the patterns of your pain. Don't forget that NO ONE knows your body better than you! 

In conclusion, tracking your sciatica recovery using these five key indicators—centralization of symptoms, improved strength, increased nerve mobility, reduced pain frequency or intensity, and enhanced ability to move or walk—can help you stay on the right path. Healing times vary, but consistent progress in these areas is a strong sign that your sciatic nerve is recovering. While setbacks may happen, staying informed, monitoring your symptoms, and making adjustments as needed will keep you moving forward. Remember, patience and persistence are key, and seeking professional guidance when necessary can make a significant difference. Most importantly, trust your body and stay proactive in your recovery journey!