At any one point in time, 1% of the US population is suffering from sciatica due to a herniated disc causing a pinched nerve. Having sciatica does not necessarily mean that surgery is going to be necessary, although it may feel as if the pain is so bad one needs it.
What is the right time for surgery for sciatica?
If a person has no problems with bowel or bladder function, and there are no motor deficits and weakness involved, then surgery for sciatica becomes simply a quality-of-life decision. This means that the patient will need to consider how bad the pain is and gauge that versus the relief being obtained from nonoperative treatments.
If the symptoms are simply pain down the leg along with some electrical sensation and pins and needles feeling, then considerable conservative treatment should be trie prior to opting for surgery. In textbooks, the usual advice is to attempt conservative treatment for 6 to 8 weeks prior to considering an operation.
If an individual is dealing with more severe issues, then surgery should be considered sooner. This will include one condition that is a surgical emergency called cauda equina syndrome. In this syndrome, the patient’s spinal cord is being compressed and it can lead to permanent bowel and bladder problems if not addressed right away. While rare, it is a surgical emergency.
Another issue that is important but not an emergency is when an individual does have significant muscle weakness. This may include a foot drop which is difficulty lifting up one’s foot due to a pinched nerve. When this occurs consideration should be given to surgery. It can be watched for 6 to 12 weeks, but it is unclear after that whether or not it will ever improve even if a technically perfect surgery to un-pinche the nerve being compressed.
So with cauda equina syndrome, surgery is mandatory. With motor weakness, surgery should be considered and if the motor weakness is getting worse or not improving over time, then the nerves being pinched should be operated on.
And lastly, if an individual is simply having pain and numbness and is not getting better despite considerable conservative treatment over a 6 to 8 week period, then surgery can be considered as a quality-of-life decision. Studies have shown that while surgery can get patients back to work sooner and out of pain faster with surgery, the end result is the same at one year if surgery can be avoided. So that’s a consideration.
The Florida Pain Network connects those in pain with pain management clinics throughout Florida. This includes pain clinics in Orlando, Tampa pain management clinics, Fort Myers, Port St Lucie and many more. Simply visit THIS PAGE to find clinics close to you or call (877) 877-8556 for assistance.