Surgery for Sciatica: Early Symptom Relief Is the Only Real Benefit

Surgery often is recommended for patients with sciatica who do not improve after receiving conservative treatment for 6 weeks. To compare two treatment strategies, Dutch researchers recruited patients who had severe sciatica pain 6 to 12 weeks after presenting to their general practitioners. Patients were referred for magnetic resonance imaging and evaluated by a neurologist, who confirmed that disk herniation was the cause of symptoms. Finally, 283 patients were randomized to early (within 2 weeks) diskectomy or continued conservative treatment provided by their general practitioners, with surgery if needed for intractable pain. Research nurses were involved in pain management in the conservative-treatment group.

Early surgery provided quic…