Sciatica surgery benefits are short-lived, research finds

New research from The BMJ shows surgery to relieve leg pain and disability in some people with sciatica is only beneficial for up to 12 months.  

Research, which was published this week, has unveiled that people who suffer with sciatica – a condition which causes pain, weakness, numbness or tingling in the leg, can be treated with surgery, but the effects only last for up to a year.

Experts have also discovered that surgery is not guaranteed to help with the condition, which has prompted them to suggest that surgery might only be worthwhile for people who feel that the rapid relief outweighs the costs and potential risks associated with the procedure.  

Sciatica is a common condition that occurs when a herniated or ‘slipped disk’ puts pressure on the lumbar nerve, causing pain, numbness and inflammation.

The pain is felt on the sciatic nerve, running from the lower back down to the legs. Sciatica usually responds to non-surgical treatment, but in about 20% of cases, the pain will persist for a year or more.

To conduct their research, researchers examined 24 clinical trials, which were made up of 1,711 participants, that looked at the effectiveness of discectomy – a surgical removal of the damaged proportion of a slipped disk in the spin – and found ‘very low to low certainty evidence’ that the procedure was superior to steroid injections and non-surgical treatment.

Despite those findings, researchers concluded that a discectomy might still be an early option for people with severe sciatica pain who need rapid relief.

Lead Author Chang Liu, PhD, a Research Fellow at the University of New South Wales in Sydney, Australia, said: ‘These findings challenge the notion that non-surgical treatment should always be the first line treatment for sciatica. In people with sciatica who regard rapid pain relief as an important treatment goal, and who feel that the benefits of discectomy outweigh the risks and costs, discectomy could be an early management option.’

Chang Liu added: ‘As a result of the treatment’s invasive nature and the substantial costs of surgery, we would encourage clinicians to discuss with their patients that discectomy can provide rapid relief of leg pain, but that non-surgical treatment can achieve similar results, although at a slower pace and with a potential chance of requiring delayed surgery if they do not respond to non-surgical treatment.’

Image: Piron Guillaume