Sciatica: Surgical Treatment May Provide Only Temporary Pain Relief What are the main findings

Response: According to our research published in the BMJ, surgery may provide better relief for leg pain and disability in individuals suffering from sciatica compared to non-surgical treatments. However, the benefits of surgery are only temporary and last up to 12 months. 

The current evidence available is of low to very low certainty, which suggests that surgery may only be a viable option for those who believe that the immediate relief is worth the potential risks and costs associated with the procedure. What should readers take away from your report?

Response: Discectomy may be an early option in people with a surgical indication if the benefits of rapid improvements in leg pain or disability outweigh the potential risks and costs. What recommendations do you have for future research as a result of this study?

Response: Trials evaluating discectomy were not blinded and had high crossover rates. Large placebo-controlled trials are needed to advance the field of surgical treatment for sciatica, but the use of placebo controls in surgical trials presents challenges. Additionally, identifying which group of people with sciatica are likely to benefit from early surgery is crucial for clinicians to make individualised recommendations.

We have no disclosures to report.


Liu C, Ferreira G E, Abdel Shaheed C, Chen Q, Harris I A, Bailey C S et al. Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials BMJ 2023; 381 :e070730 doi:10.1136/bmj-2022-070730

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Last Updated on April 27, 2023 by