Sciatica Surgery Provides Only Short-Term Pain Relief, Which May Not Justify Risks: Study

Minimal benefits from sciatica surgery may not justify the risks compared to other treatment alternatives.

Individuals who suffer from sciatica pain may find relief with surgical treatments of the disc, but those improvements are often short lived and may carry potentially serious complication risks, according to the findings of a new study.

In findings published last month in the medical journal BMJ, researchers warned that patients who underwent sciatica surgery often only report pain improvement for less than a year, indicating the procedures may not be any better than alternative treatment options.

Sciatic is pain that travels along the path of the sciatica nerve from the lower back down the leg. Some people who suffer a “slipped” or herniated disc experience sciatica pain because it causes pressure or irritation on the roots of the nerve in the back.

In this new study, an international group of researchers led by the University of Sydney, Sydney Musculoskeletal Health conducted an analysis of clinical trials focusing on sciatica treatments. They compared surgical treatment with non-surgical treatments such as epidural steroid injections, placebo, or sham surgery among people with sciatic due to lumbar disc herniation.

Researchers analyzed data on 24 studies, which included 1,700 participants. Half of the studies compared discectomy surgery with nonsurgical treatment of epidural steroid injections.

Discectomy is a type of surgery done to remove the disc or portions of the disc pressing on the sciatica nerve root or the spinal cord. It can carry significant side effects such as blood clots, infection, excess bleeding, injury to other nearby nerves, reaction to anesthesia, and temporary relief of pain requiring repeat surgery.

Follow-up analysis was split into groups of six weeks or less, six weeks to three months, between three months and 12 months, and 12 months. Patients who did experience relief in sciatica pain by having surgery only saw improvement for one year or less before the pain returned.

The data also indicated surgery improved functional outcomes, like the ability to be active and move freely without pain, but those improvements also diminished within one year of surgery. People who underwent surgery experienced less disability, but the effect was moderate and lasted less than three months.

Researchers also noted, comparing surgery to epidural steroid injections, both offered similar reductions in leg pain. However, patients who underwent surgery and non-surgical procedures experienced side effects at a similar rate. Those included repeat disc herniation, post-surgical pain and wound infection.

“Discectomy might be an option for people with sciatica who feel that the rapid relief offered by discectomy outweighs the risks and costs associated with surgery”, said the authors of the study in conclusion.