Chronic Sciatica: When Injections and Therapy Stop Working

Understanding the Next Steps Through Accurate Diagnosis and Expert Care

Sciatica is a term many people are familiar with—often described as a sharp, shooting pain that travels from the lower back down to the legs. For most patients, physiotherapy, medications, and injections bring relief. But what happens when these treatments no longer work, and the pain becomes chronic and debilitating?

At DRHC Dubai, we regularly see patients who have tried everything—from painkillers to steroid injections—and still live with persistent sciatic pain. In this blog, we aim to raise awareness about chronic sciatica, why it may resist standard treatments, and how accurate diagnosis can open the door to more effective solutions.

What Is Chronic Sciatica?

Sciatica occurs when the sciatic nerve, the largest nerve in the body, is compressed or irritated—usually due to a herniated disc, bone spur, spinal stenosis, or degenerative disc disease. Chronic sciatica is when this pain lasts more than 3 months and does not respond well to traditional conservative treatments.

Common symptoms of chronic sciatica include:

Persistent burning or sharp pain in the lower back, buttocks, or legs
Numbness or tingling along the nerve pathway
Muscle weakness in the affected leg
Pain that worsens with sitting, bending, or lifting
Difficulty walking or standing for long periods

Why Do Injections and Therapy Sometimes Fail?

1. Misdiagnosis or Incomplete Diagnosis

Not all leg pain is due to sciatica. Conditions like piriformis syndrome, hip joint problems, or vascular issues can mimic sciatica. If the underlying cause isn’t properly identified, treatments won’t work—no matter how advanced they are.

2. Structural Problems Requiring More Than Conservative Treatment

In cases of severe disc herniation, spinal instability, or narrowing of the spinal canal (spinal stenosis), injections may only offer short-term relief. Once the pressure on the nerve becomes too great, more targeted intervention is necessary.

3. Nerve Damage

Chronic compression of the sciatic nerve can eventually lead to nerve degeneration or permanent damage. At this stage, physical therapy alone may not be enough to reverse the symptoms.

Importance of Accurate Diagnosis at DRHC Dubai

At DRHC Dubai, we emphasize a diagnostic-first approach. Understanding what’s truly causing the nerve pain is the only way to plan an effective treatment.

Our diagnostic methods include:

MRI scans to view herniated discs, spinal stenosis, or tumors
CT scans for a more detailed view of bones and joints
Nerve conduction studies and EMG to assess nerve function
Spine specialist evaluations to distinguish between sciatica and other similar conditions

By getting the right diagnosis, we avoid unnecessary treatments and focus on what will work long-term.

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When Is Surgery the Next Step?

Surgery isn’t always the first solution, but in cases of chronic, treatment-resistant sciatica, it may be the best option—especially when:

Pain persists beyond 3-6 months despite therapy and injections
There is significant nerve compression on imaging
You experience progressive muscle weakness or numbness
There are signs of cauda equina syndrome (a medical emergency with loss of bladder/bowel control)
Your quality of life is severely affected

Surgical Options for Chronic Sciatica at DRHC Dubai

Our expert orthopedic and neurosurgical team performs minimally invasive and advanced spinal procedures, including:

Endoscopic spine surgery – A modern, less invasive option with faster recovery
Laminectomy – Removal of bone or tissue narrowing the spinal canal
Spinal fusion – Stabilizing the spine in cases of instability
Endoscopic spine surgery – A modern, less invasive option with faster recovery
Microdiscectomy – Removal of part of a herniated disc pressing on the nerve

We personalize each treatment based on the patient’s age, symptoms, spine condition, and recovery goals.

Living Pain-Free Starts with the Right Team

Chronic sciatica doesn’t have to be a life sentence. If you're no longer finding relief with injections or therapy, it may be time to re-evaluate your diagnosis and explore new treatment options.

At DRHC Dubai, we combine medical expertise with state-of-the-art technology to provide accurate diagnosis, comprehensive care, and advanced solutions for spine and nerve conditions.
Book a consultation today at DRHC Dubai and take the first step toward lasting relief.