The simple answer is “it depends”, which is probably not what you wanted to hear, but that’s the reality.
The main reason people with sciatica opt for surgery is that they are tired of suffering and want the quickest fix possible and often that means going under the knife.
I suffered a major scatica attack myself after a session of over-enthusiatic gardening, compounded soon after by a fall on a wet marble floor, during the last few months of 2006, so I can sympathise with the desire for a quick fix.
Some days during that period were traumatic - I could do nothing except curl up on one side and hope the pain would go away (often it only went away briefly).
In total, approximately 1.5 million people undergo operations around the world every year to relieve pressure on the sciatic nerve and the surgical procedure usually (but not always) brings them the relief they seek.
However, research indicates that over time, surgery may be no better than non-operative treatments such as rest, gentle stretching and back-strengthening exercises.
In a study published in the New England Journal of Medicine, researchers monitored 283 patients who had suffered with sciatic pain for at least six weeks.
Half of them were scheduled for surgery, and the other half were directed towards conservative treatments i.e. rest, gentle stretching and back-strengthening exercises, and, when needed, anti-inflammatories.
Various scales were used to measure dysfunction and disability and the investigators found that 95% of participants in both groups reported significant recovery after one year.
That’s good news for sciatica sufferers who are concerned about the risks of surgical complications, which can include bleeding, or worse, accidental nerve damage that can increase the pain. What’s more, surgery can cost a few thousand dollars, will leave you sore for a few weeks and requires a couple of months for full recovery.
As mentioned above, the reason for opting for an operation is speed because in most cases, pain relief and perceived recovery come faster with an operation than through exercise and medications. In fact, even in the current study, 39% of the patients who were initially assigned to receive conservative care opted for surgery anyway because they could no longer tolerate the pain.
Which course is right for you depends on your particular case. If you are getting progressively weaker or have pain that is searing and uncontrollable with conventional pain medications, you may need surgery quickly.
Except for such extreme cases, most surgeons will encourage you to wait a few weeks before an operation –which is often just long enough for you to notice an improvement with non-surgical techniques.
So in summary, you can see why the simple answer to surgery or not is “it depends”.
Myself, I managed to make it through the pain and huge inconvenience without surgery and I’m now back to 95%+ of my fitness and overall capability before the incident. At times it was a massive struggle, but I’m really glad I did it.
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