Should You Have Surgery For Sciatica?

If you have sciatica and find that rest and pain medication are not working to relieve your pain, should you consider surgery? Recent research provides the answer. Sciatica refers to leg pain caused by a herniated disk in the spine that presses on the sciatic nerve. People with sciatica often experience intense pain that radiates into the buttocks, down the thighs, and into the calves, and often into the feet. Surgery can provide fast pain relief for sciatica, but you might do just as well without an operation, a study finds. In this study, researchers randomly assigned 281 people with sciatica for at least six weeks to have surgery to decompress the nerve; or, to receive conservative treatments such as pain medication and exercise. On average, people who had sciatica surgery felt their leg pain was better after four weeks while it took about 12 weeks for those who did not have surgery to note improvement. But within one year, 95% of the study participants said they felt significantly better, no matter which sciatica treatment they had.

Bottom line advice: If you are experiencing searing pain or numbness in your leg from sciatica and conservative treatment is not working, then surgery may be right for you. On the other hand, if you feel you can handle the leg pain and are willing to postpone sciatica surgery, you might find that you don’t need it. Always discuss options with your doctor.

The New England Journal of Medicine  Volume 356, page 2245

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