Sciatica surgery involves removing disc herniation, which causes the pain associated with the said affliction. Treating sciatica primarily aims to ease any leg pain and other related symptoms. If conservative care fails to elevate the pain, then surgical discectomy may provide the effective relief for many sciatica cases. Though further studies need to be conducted to determine the long-term effects of surgical intervention as well as the optimal timing of performing the said surgery.
Conservative care and disc surgery are considered both relevant treatment options for sciatica patients. If a patient is looking for a quicker relief for the associated pain, surgical intervention may be preferred. It must be noted that there is still no study that shows any significant difference in success rate for surgery over conservative care. It is therefore important for patients to talk to their health care providers and discuss the benefits and downsides of both options before making any personal choices. This understanding is crucial since a patient’s treatment preference affects and influences a treatment’s end result.
As mentioned before, sciatica is diagnosed based on a patient’s history and physical examination. The first step – conservative care – in treating sciatica involves educating the patient to stay active, continue his daily activities, and acquire adequate pain treatment. At this point, imaging is still not necessary. If a patient fails to show any sign of improvement after 6 to 8 weeks of conservative care, he will be then referred to another medical specialist – a neurologist, rheumatologist, or spine surgeon depending on succeeding findings. Surgery may already be considered at this stage. Sciatica cases that show other symptoms such as cauda equina syndrome, acute severe paresis, or progressive paresis also merit early referral.
Although they are still limited, more and more evidence-based studies are becoming available on how effective surgery is for sciatica. The lack of findings when it comes to the long-term effects of both treatment options is the main reason why many would first opt to undergo conservative care only to go with disc surgery later on. If a patient is hesitant about surgery, patient preference is respected, and he can continue with his decision to stick with conservative care.