Sciatic Leg Pain:Is Nonsurgical Treatment Right for You?

Intense pain in the legs or buttocks (sciatica) may develop when a lumbar disk slips (herniates). Some people may require surgery to relieve pressure on nerves in the area. But for most people, sciatica symptoms go away on their own or with nonsurgical treatments.

A new study published in the Archives of Physical Medicine and Rehabilitation(Volume 93, page 690) evaluated how often sciatica pain returns after nonsurgical treatment.

The 79 participants in the study all had magnetic resonance imaging (MRI)-confirmed slipped disks. Each received nonsurgical treatment for sciatica leg pain, including oral medications, physical therapy and corticosteroid injections, and they were pain-free for at least one month. Investigators followed this group for a year.

Recurrence. The sciatica leg pain returned in 25 percent of participants. The length of time it took for the original episode to resolve was the only factor that predicted whether leg pain would return. For every month that passed prior to complete resolution of sciatica leg pain, there was a 25 percent increase in the chance of recurrence. More than half of leg pain recurrences occurred within three months after leg pain resolved. Only 6 percent of recurrences happened in patients who were pain-free for nine months.

Bottom line: If you have sciatica leg pain in conjunction with a herniated disk, you should ask your doctor about the relative merits of surgical versus nonsurgical treatment. It's important to individualize treatment decisions in this situation.

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