24 Apr 2023 • Sciatica is a common condition that can cause pain in the legs due to a herniated disc in the back. Treatment usually starts with exercise and medication, and surgery is only considered if other treatments haven't worked. However, the effectiveness of surgery for sciatica is uncertain, and recent reviews have had shortcomings.

A new review investigated the effectiveness and safety of surgery compared to non-surgical treatment for sciatica caused by a herniated disc. The review found that surgery reduced leg pain and disability compared to non-surgical treatment and epidural steroid injections, but the benefits decreased over time. The review also found that there wasn't an increased risk of adverse events with surgery.

International guidelines recommend surgical treatment for sciatica caused by a herniated disc if non-surgical treatment isn't effective. The review supports these recommendations, but also suggests that surgery might be a good option for people who need rapid pain relief and are willing to accept the risks and costs of surgery. The review recommends that clinicians discuss the benefits and risks of surgery with their patients and that non-surgical treatment can still achieve similar results, although at a slower pace.

Source: BMJ | Read full story