You've Done Everything Right — So Why Is the Pain Back?
You've sat through the physical therapy sessions. You've taken the prescriptions. Maybe you even had a cortisone injection — or two. Some of you reading this have taken the most significant step of all: spinal surgery. And yet, weeks or months later, that deep, burning, radiating pain down your leg returned.
You are not imagining it. You are not weak. And you are absolutely not alone.
As Dr. Matthew T. Jacobs, Chiro-Physician at The Disc Doctor in Murfreesboro, Tennessee, I see patients in exactly this situation every single week. The first thing I tell them is this: recurring sciatica almost always means the root cause was never fully addressed. The pain relief strategies worked on the symptom — but the structural problem driving that symptom remained untouched.
This article explains why that happens, and what a different approach looks like.
What Sciatica Actually Is (And Why It Matters)
The sciatic nerve is the largest nerve in the human body. It originates from the lower lumbar spine (L4–S3), passes through the buttock, and travels all the way down to the foot. When any structure along that pathway compresses or inflames the nerve, you feel it — often as a sharp, electric, or burning pain that radiates from the low back through the glute and down one or both legs.
The most common causes of sciatic nerve compression include:
- Herniated or bulging discs — the most frequent culprit, where disc material presses directly on a nerve root
- Degenerative disc disease — loss of disc height that narrows the space nerve roots exit through
- Spinal stenosis — narrowing of the spinal canal, often age-related
- Piriformis syndrome — when the piriformis muscle tightens around the sciatic nerve in the buttock
- Spondylolisthesis — a slipped vertebra creating nerve impingement
- Facet joint dysfunction — arthritic or inflamed facet joints referring pain along the nerve pathway
Notice something? Every single one of these is a structural or biomechanical issue. None of them resolve on their own by swallowing a pill or receiving an injection.
The 6 Real Reasons Your Sciatica Keeps Coming Back
Failed Back Surgery Syndrome: When Surgery Didn't Fix It
There is an actual clinical term for what you may be experiencing: Failed Back Surgery Syndrome (FBSS). This does not mean your surgeon made an error. It means that the surgery achieved its intended goal — but the underlying complex of issues causing your sciatica extended beyond what a single procedure could address.
FBSS is more common than many patients realize. Research consistently shows that a significant percentage of patients undergoing lumbar surgery for sciatica report continued or recurring leg and low back pain within one to five years of the procedure.
If you have had spinal surgery and your sciatica has returned, it is critical to have a thorough, non-invasive evaluation before pursuing any additional surgical intervention. Many post-surgical patients find meaningful relief through conservative care when the remaining structural contributors are properly identified and treated.
How Dr. Matthew T. Jacobs Approaches Recurring Sciatica
At The Disc Doctor, Dr. Jacobs practices as a chiro-physician — a clinician trained both in chiropractic medicine and in advanced diagnostic and therapeutic protocols for disc and nerve conditions. This allows him to take a comprehensive view of your spine rather than focusing on a single painful level or symptom.
What to Do If Your Sciatica Has Come Back
If you're reading this after yet another flare-up — after trying what felt like everything — here is the most important thing to understand: the absence of lasting relief is diagnostic information. It tells you that the structural driver of your pain has not yet been fully addressed.
The approach that works is not necessarily the most aggressive one. It is the one that correctly identifies your specific pattern of nerve compression and addresses it with the right combination of decompression, alignment correction, and rehabilitative support. That is exactly what Dr. Matthew T. Jacobs and the team at The Disc Doctor are trained to provide.
