Overview of Sciatica
Sport Trial Surgical treatment for sciatica may be worth it however many patients do as well with non-operative treatment at two years. The recently published Spine Patient Outcomes Research Trial is a government funded multi-clinic study. The study found slightly better outcomes for surgical treatment of sciatica than nonsurgical treatment. 60% chose surgical treatment in the surgical arm and 45% chose surgery in the nonsurgical treatment group. This large number of patients changing groups prevented direct comparison. The clear message was that leg pain was more completely relieved by surgery than non-operative treatment.
Non-operative treatment can be effective and people may do well with it but surgery works better for leg pain related to disc herniation. Surgery is definitely not for every patient. All patients should be treated initially with conservative measures and if they are not improving they may do well with a surgical treatment. In general, discectomy is for patients with leg pain and not for patients with only back pain from degenerated discs. A physician may say that surgery will help your leg pain but if you are unwilling to try surgical treatment you may do well with non-operative methods. Today there are many people claiming no one should have surgery for disc herniation and there are others who claim leg pain patients should have surgery right away. The truth is neither approach is correct for any given person. Hopefully this and other well supported prospective randomized trials will smooth out regional variations in standards of care in practice.