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Is Having Surgery the Best Way to Treat Sciatica?


Because of symptoms such as burning or tingling sensations and pain radiating down one leg, sciatica is difficult to ignore. However, it is often possible to manage the discomfort related to sciatic nerve irritation with conservative, or nonsurgical, methods. Still, there are times when surgery ends up being the best option. This article explains what patients with sciatica need to know when making this determination.

How Is Daily Life Affected?

Surgery may be the best option for sciatica if it is increasingly difficult to get through your day. This could involve difficulty walking, an inability to comfortably sit for long periods of time, trouble sleeping through the night, or pain triggered as you make various movements. If sciatica is making it extremely difficult or nearly impossible to do what you normally do on a daily basis, surgery may end up being the best option.

What Is Your Response to Nonsurgical Remedies?

Patients with sciatica are typically advised to try various conservative remedies for several weeks or months before surgery is recommended. Unless symptoms are potentially life-threatening or extremely severe, nonsurgical treatments and remedies recommended for sciatica usually include:

• Medication to reduce inflammation around the sciatic nerve
• Massage therapy to relax nearby tissues
• Hot/cold therapy to manage pain flare-ups
Sciatic nerve stretches and gentle exercises to strengthen muscle groups in the same area
• Therapeutic injections to improve results from physical therapy

If you are still not able to manage your sciatica symptoms with any of the above nonsurgical remedies, your doctor may recommend surgery. Surgery may ultimately provide welcome relief if other efforts are not working.

What Other Symptoms Are Associated with Your Sciatica?

Under certain circumstances, surgery may be the best option for sciatica sooner rather than later. Whether or not this applies to you is largely dependent on the cause of your sciatica and how the nerve is affected. Surgery may be the best option when sciatica is associated with:

• A loss of motor and sensory function in the lower body
• A loss of bowel and/or bladder control
• Lumbar spine cysts, abscesses, or tumors
• An infection in the pelvic region

Another instance when surgery may be the best option for sciatica is if you have bilateral sciatica, referring to irritation of the sciatic nerve affecting both legs. This is more likely to happen with a multilevel herniated disc, although it is also possible to have a single-level herniation that results in bilateral sciatica.

Exploring Your Options

When determining if surgery is suitable for your situation, start by getting an accurate diagnosis. This is important because there needs to be a structural source of your sciatica—such as a herniated disc—for surgery to be a viable option. If this applies to you, further explore your options by considering:

• The nature and extent of your symptoms
• The level of disruption to your daily life
• Your response to nonsurgical treatments
• Your normal level of activity

If surgery is appropriate for you and an option you are willing to consider, talk to your doctor or a specialist to determine what procedures may work well for you. The most common type of surgery performed for sciatica is a
microdiscectomy when the source is a herniated disc in the lower back area.

Patients who have had discectomies for herniated discs may experience sciatica if their discs reherniate, which often occurs if there is a large hole in the outer ring of the disc after surgery. Fortunately, there’s a new treatment available. Barricaid is a device shown to reduce the risk of reherniation by closing the hole in the disc after a discectomy, and 95 percent of Barricaid patients didn’t undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and doesn’t require any additional incisions or time in the hospital. 

To learn more about the Barricaid treatment, ask your doctor or contact us at 844-288-7474.

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