Studies on the efficacy of surgery for sciatica have produced conflicting results. An estimated 5-10% of patients that undergo microdiscectomy suffer from recurrent disc herniation after the operation. For patients undergoing another common sciatica surgery, lumbar laminectomy, 20-30% do not experience significant improvements in pain and function. Surgeries for sciatica also carry the risks of nerve root damage, infections,cerebrospinal fluid leakage, and more.
Recent research suggests that many sciatica patients could avoid the risks of surgery with exercise and chiropractic therapies. In a study published earlier this year in the journal Spine, Danish researchers tested the efficacy of active conservative treatment in patients who would normally qualify for surgery.
Half of the patients were assigned to perform symptom-targeted exercises while the other half were assigned sham exercises. The latter were designed to increase blood circulation but did not specifically target back pain. Patients were also advised to stay as active as possible without aggravating their leg pain.
By the end of the eight-week treatment, both groups had statistically and clinically significant improvements in pain, global assessment, functional status, and vocational status. But those in the targeted exercise group experienced substantially better outcomes. Although this isn’t the first study linking exercise with improved outcomes in sciatica patients, the findings confirm that surgery is not the only option for treating severe sciatica.
Previous research has also shown that patients with sciatic pain who may normally qualify for surgery could benefit from chiropractic care. In a 201o study comparing chiropractic adjustment to microdiscectomy , 63% of patients experienced substantial improvements with chiropractic treatments.
Albert HB and Manniche C. The efficacy of systematic active conservative treatment for patients with severe sciatica: a single-blind, randomized, clinical, controlled trial. Spine 2012; 37(7):531-42.