Surgery or Conservative Care for Sciatic Pain?

Surgery or Conservative Care for Sciatic Pain?


When a patient discovers they have sciatica due to lumbar disc herniation, one of the first questions they have to answer is whether or not they wish to undergo surgery. Numerous studies have explored that question, and a 2010 review of the literature on sciatica treatment brings us closer to an answer.

The study revealed there is inconsistent evidence on whether surgery is more beneficial than conservative care. In the review, researchers evaluated several studies comparing surgery to prolonged conservative treatment for sciatica due to lumbar disc herniation.  They discovered that many of the leading studies were subject to bias towards surgery­­­a bias which may have tainted the results.
Only two of the leading studies were considered to have low bias. One found that surgery provided faster relief of leg pain, but that differences between surgery and conservative care diminished after 1-2 years. At the annual follow-ups, both groups of patients had substantially improved. Another study confirmed that there were no major differences between conservative care and surgery in the long-term.

Despite that one study suggested that surgery may provide faster relief, the initial benefit may be out weighed by the costs and risks of surgery, researchers said.

They concluded that more research is needed to understand which patients may benefit more from surgery and which will benefit more from conservative care. Since both may be equally effective in the long term, for now, it's up to patients to decide whether surgery is worth the additional cost and risk.

Jacobs, WC, M. van Tulder, M Arts, SM Rubinstein, et al. Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review." European Spine Journal 2011;20(4): 513-22.

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Why Chiropractic is the Best Solution for Sciatica Pain


Sciatica and chiropracticSciatica and chiropractic
Sciatica pain is often so debilitating that it forces people to miss work and other normal activities.  Of all patients with low-back pain, sciatica patients have the highest level of disability (1).  In fact, patients with sciatica are disabled for an average of 72 days according to Norwegian public-health records.
Fortunately, a recent study offers hope to sciatica patients: chiropractic care can speed the recovery from sciatica flare ups and allow patients to return to work sooner (2).

The study evaluated 44 Norwegian workers after they came to the hospital with severe sciatica pain. Most of those patients had been experiencing pain for three or more weeks prior to their hospital visit.
The hospital chiropractor examined each patient to evaluate his/her posture and gait, range of motion, and palpation of the lumbar spine.

The chiropractic then performed various joint adjustments to the spine and other limbs that had been injured through patients compensating for pain. Ice treatment was also used to relieve soft tissue soreness.Patients were treated daily in the hospital and later three times a week for the first two weeks. Some patients needed additional follow-up treatment but typically did not exceed 14 treatments.

In matter of 21 days, 91% of patients returned to work full-time. Two patients returned to work part time. Researchers concluded this study demonstrates the potent benefits of collaboration between chiropractors and orthopedic surgeons. Chiropractic care can put an end to your sciatica pain so you can begin living your life fully again.

Posted in chiropracticChiropractic NewsSciaticasciatica treatmentUnderstanding Sciatica
  1. Arana E, Marti-Bonmati L, Vega M, et al. Relationship between low back pain, disability, MR imaging findings and health care provider. Skeletal Radiology 2006;35(9):641-7.
  2. Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.