How are low back pain (LBP) and sciatica treated?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Doubt remains regarding the relative efficacy and cost-effectiveness of surgical versus nonsurgical treatment approaches. An important longitudinal study was performed by Henrik Weber, who randomly divided patients who had sciatica and confirmed disk herniations into operative and nonoperative treatment groups. [34] He found significantly greater improvement in the surgically treated group at 1-year follow-up; however, the 2 groups showed no statistically significant difference in improvement at 4 to 10 years. [34] Two prospective cohort studies compared the surgical and nonsurgical management of lumbar spinal stenosis and sciatica due to lumbar disk herniation. [35, 36] The results and conclusions were similar in both studies. For patients with severe symptoms, surgical treatment was associated with greater improvement and satisfaction. This distinction persisted, but diminished over time. [35, 36, 37]

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