Surgery may be the quickest way to sciatica pain relief, but surgery is not usually the first treatment for sciatic pain. Most people with sciatica will respond to non-surgical treatments such as analgesics (pain medications), muscle relaxants, physical therapy, and injections in the lower back. Recovery can take up to 1-2 months, but often spine surgery is not needed.
Spine surgery may be the first choice for sciatica pain relief if the pain is caused by cauda equina syndrome, spinal/epidural abscess, spinal fracture, or tumor.
Surgery is a very effective way to relieve sciatica pain.1,2 Procedures include microdiscectomy, foraminotomy, and laminectomy, among others. In some cases, artificial disc replacement or spinal fusion may be required to effectively treat sciatica pain. Spine surgery can quickly relieve sciatica pain by physically removing the bone, disc, or other tissue that is pressing on the nerve and causing pain. Non-surgical interventions can be helpful, but they usually take longer to work.
Surgery for sciatica is generally more expensive than non-surgical treatments. Likewise, even minimally invasive spine surgical procedures are associated with surgical risks and require at least some time to recover. Sciatica surgery provides excellent outcomes over the first several years after the surgery—better than non-surgical treatments.2 However, sciatic pain may return four years or more after microdiscectomy, foraminotomy, and/or laminectomy.
If you are going to have sciatica surgery, it only makes sense to do your part to make sure you have the best chance of success.
Unfortunately, there is no one-size-fits-all treatment for sciatica pain, which means most patients need to try a few treatments to see which works for them. Some patients opt for the “kitchen sink” approach in which they start medications, physical therapy, strength training, and flexibility exercises all at once. Others like to take a more focused approach by trying one of these treatments for a while to see if it works before moving on to the next one. Some people get rapid relief from steroid injections in the lower back while others do not. The best approach is to discuss your non-surgical treatment options with a spine surgeon who is an expert in the surgical and non-surgical treatments for sciatica pain.
The costs of sciatic surgery can vary greatly depending on the surgeon, the type of sciatica surgery or surgeries, health insurer, and even region of the country, among other factors. Contact your doctor to discuss costs of the procedure and insurance coverage.
None of the side effects that may occur after surgery for sciatica are considered common. Possible complications (side effects) of sciatica surgery include blood loss, thrombosis (blood clot), infection, and nerve injury. It is also possible that the sciatica surgery does not relieve the pain as expected.
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