If you’ve ever dealt with sciatica, you know the pain can be intense and unpredictable. You may go long periods without pain and then BAM! You move just right, and there’s that familiar pain shooting through your buttocks and down your leg again.
So, what’s going on? Why is your sciatica pain making an unscheduled appearance after its long (and much appreciated!) absence?
What Is Sciatica?
Sciatica is an intense nerve pain caused by injury, irritation, inflammation, pinching, or compression of the sciatic nerve.[1] It’s a bundle of nerves and is the longest and thickest nerve in your body.[2] It runs from your lower back, through your hips and buttocks, and down each leg.[2] When something pinches or inflames this nerve, it can lead to moderate to severe sharp, burning, or radiating pain in your lower back, buttocks, and legs.[1] You may also experience numbness, tingling, or muscle weakness in your leg.
Conditions that affect your sciatic nerve include a herniated disc, a bone spur, piriformis syndrome, spinal stenosis, or degenerative disc disease.[2]
So what keeps triggering debilitating sciatic pain?
Why Your Sciatica Pain Is Intermittent
Sciatic pain often isn’t constant. That’s because the underlying cause—like a bulging disc or muscle inflammation—can change depending on your movement, posture, or activity level.
For example:
- A herniated disc is a common condition that presses on the nerve only with specific movements.[3]
- Inflammation can flare up and settle down over time.[3]
- Tight muscles, like the piriformis in your buttocks, can compress the sciatic nerve temporarily, especially after sitting for long periods.[4]
These changing conditions can cause your pain to come and go. You might go days or weeks without symptoms, only to experience a sudden flare-up from something as simple as lifting a box or sleeping in the wrong position.
What Triggers Your Sciatica?
Several everyday things and a couple of surprising ones can trigger or worsen sciatic pain, including:
- Sitting too long, especially with poor posture [3]
- Lifting heavy objects improperly [5]
- Sudden movements that strain the back [5]
- Excess body weight, which puts extra pressure on the spine [4]
- Tight muscles or muscle spasms in the lower back or buttocks [6]
- Lack of physical activity, leading to stiff or weak muscles [3]
- Carrying items in back pockets and wearing tight pants are surprising causes of sciatica. Compression from your pants or sitting on bulky items, such as wallets or phones, in your back pocket can press on the sciatic nerve and trigger ‘back pocket sciatica’. [4]
- High heels or uncomfortable shoes can cause your weight to be unevenly distributed and push your pelvis forward. [4]
- Using tobacco products often affects circulation and can aggravate chronic pain conditions. [5]
Knowing your triggers is key to managing flare-ups and preventing them in the future.
What Can You Do If Sciatic Pain Keeps Coming Back?
If your sciatica pain is becoming an unwelcome repeat visitor, don’t ignore it. Recurring sciatica may be a sign that the root cause isn’t going away on its own. Here are a few self-care tips you can try to manage your sciatica flare-ups:
- Stay active [7]
- Use hot and cold therapy [5]
- Try physical therapy [7]
- Improve sitting and standing posture
- Alternative therapies include massage, acupuncture, and chiropractic care. [7]
- Take OTC NSAIDs (anti-inflammatory pain medication) [7]
Please note: If your pain keeps returning despite your best efforts, don’t ignore it. Schedule a consultation with your primary care physician (PCP) or a specialist in pain management.
Can a Pain Management Specialist Help Your Sciatic Back Pain?
Absolutely! A pain specialist will work hard to determine the root cause of your sciatica and provide a personalized treatment plan. Interventional pain management offers targeted relief through options like corticosteroid injections or spinal decompression, giving your sciatic nerve time to rest and heal. In some cases, minimally invasive procedures—such as spinal stimulator devices or radiofrequency ablation—can help reduce pain long-term. Your pain specialist will help you decide which treatments best fit your specific condition and lifestyle.
Avoid unnecessary suffering and downtime due to back, buttocks, or radiating leg pain when there are real solutions available. Stop letting intermittent sciatica interrupt your life and force you to live with excruciating pain. If your pain keeps coming and going—or is getting worse—reach out to a reputable pain management clinic to get the support and relief you deserve.
Resources:
- Yetman D. Why Your Sciatica Might Not Be Going Away. Healthline [Internet]. Published June 09, 2021. Accessed March 31, 2025. Available from: https://www.healthline.com/health/back-pain/why-is-my-sciatica-not-going-away
- Sciatic Nerve. Cleveland Clinic [Internet]. Accessed March 31, 2025. Available from: https://my.clevelandclinic.org/health/body/21618-sciatic-nerve
- Villines Z. Why is my sciatica not going away? Medical News Today [Internet]. Published October 23, 2020. Accessed March 31, 2025. Available from: https://www.medicalnewstoday.com/articles/why-is-my-sciatica-not-going-away#why-is-it-not-going-away
- U.S. Pain Foundation Editors. Five Surprising Ways You Might Be Worsening Your Sciatica. U.S. Pain Foundation. Published November 22, 2019. Accessed March 31, 2025. Available from: https://uspainfoundation.org/blog/five-surprising-ways-you-might-be-worsening-your-sciatica/
- Sciatica. Cleveland Clinic [Internet]. Accessed March 31, 2025. Available from: https://my.clevelandclinic.org/health/diseases/12792-sciatica
- Sciatica. NHS Inform [Internet]. Accessed March 31, 2025. Available from: https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/sciatica/
- Atlas SJ. Taming the pain of sciatica: For most people, time heals, and less is more. Harvard Health Publishing – Harvard Medical School [Internet]. Published March 15, 2022. Accessed March 31, 2025. Available from: https://www.health.harvard.edu/blog/taming-pain-sciatica-people-time-heals-less-2017071212048
