Is Surgery Better for Lumbar Disc Herniation with Sciatica? Not Necessarily.
"The pain down my leg is driving me crazy!"
Sciatica is maddening.
Sciatic leg pain is pain typically caused by a lumbar spine disc condition in the low back that puts pressure on a spinal nerve root which supplies messages to your legs and feet. Granted, some of us deal with pain better than others, but sciatica that travels down the leg, into the foot, and maybe even into the toes, wears on even the toughest person. All you want is relief. That is the point when thoughts often turn to surgery to relieve the leg pain sciatica, sometimes when they need not turn to surgery so quickly.
Let's consider two published studies in which non-surgical care not requiring invasive procedures fared better for the relief of sciatic leg pain.
First, researchers did a review of published medical reports about lumbar spine disc herniation with leg pain (sciatica) outcomes.
- Short-term pain relief results are similar for surgical and non-surgical care of patients with disc herniation and sciatica.
- Long-term results are not statistically different for surgical and non-surgical care for relief of leg pain.
These researchers suggest that aggressive rehabilitation may actually be better when cost, complications and disease associated with surgery are considered. (1)
Second, for 10 years, another group of researchers followed 400 patients with sciatica (leg pain) due to a disc herniation. Some leg pain patients had surgery; some were treated non-surgically (physical therapy, epidural steroid injections, back exercises, spinal manipulation, bed-rest, narcotic drugs). The surgically treated leg-pain-with-disc-herniation patients had worse symptoms and function than those who were non-surgically treated.
- At 10 years, surgical and non-surgical patients are equal for back surgery occurence:
- 25% of the surgically treated disc herniation and leg pain patients had at least one more lumbar spine surgery
- 25% of the non-surgically treated sciatic leg pain with disc herniation patients had at least one lumbar spine surgery
- At 10 years, 69% of the surgically treated and 61% of the non-surgically treated sciatica patients reported improvement. Improvement was reported as better, much better, or completely pain-free.
Work and disability outcomes were similar in the two groups. (2)
If you are considering surgery for your low back and leg pain, contact Dr. Atiyeh in Plymouth about our non-surgical treatment plan that may well be the answer to relieving your sciatica (leg pain) with a disc herniation pain.
- Memmo PA, Nadler S, Malanga G: Lumbar disc herniations: A review of surgical and non-surgical indications and outcomes. Journal Of Back And Musculoskeletal Rehabilitation 2000;14(3):79-88
- Atlas S, Keller RB, Wu YA, Deyo RA, Singer DE: Long Term Outcomes Of Surgical And Non Surgical Management Of Sciatica Secondary To Lumbar Disc Herniation: 10 Year Results From The Maine Lumbar Spine Study. Spine 2005; 30(8):936-43