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Sciatica from a slipped (herniated) disc

What does the treatment involve?

Editorial consensus.
Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical versus nonoperative treatment for lumbar disc herniation:
four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine 2008;33:2789800.


How soon will I feel better?

Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical versus nonoperative treatment for lumbar disc herniation:
four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine 2008;33:2789800.
Editorial consensus for the Joint Injections column


Which treatment gives the best long-term results?

Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical versus nonoperative treatment for lumbar disc herniation:
four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine 2008;33:2789800.
Editorial consensus for the Joint Injections column


What are the main risks/side effects associated with this treatment?

NICE. 2010 Neuropathic pain: the pharmacological management of neuropathic pain in adults in non-specialist
settings Available online: http://www.nice.org.uk/nicemedia/live/12948/47949/47949.pdf
Complication rates of three common spine procedures and rates of thromboembolism following spine surgery
based on 108,419 procedures: a report from the Scoliosis Research Society Morbidity and Mortality Committee.
Citation: Spine, November 2010, vol./.is. 35/24(240-9), 0362-2436;1528-1159 (2010 Nov 15). Author(s): Smith JS,
Fu KM, Polly DW Jr, Sansur CA, Berven SH, Broadstone PA, Choma TJ, Goytan MJ, Noordeen HH, Knapp DR Jr,
Hart RA, Donaldson WF 3rd, Perra JH, Boachie-Adjei O, Shaffrey CI
Smith JS, Shaffrey CI, Sansur CA, et al. Rates of infection after spine surgery based on 108,419 procedures: a
report from the Scoliosis Research Society Morbidity and Mortality Committee. Spine 2011;36:55663.

Editors: Ben Dropkin, Thom Walsh, Michael Lewis, Alf Collins, Bert Fichman, Glyn Elwyn.
ISBN: 978-0-9575461-4-1
Creative Commons License: Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND 3.0)

TM

Manchikanti L, Malla Y, Wargo BW, et al. A prospective evaluation of complications of 10,000 fluoroscopically
directed epidural injections. Pain physician;15:13140.


How will the treatment impact my ability to work?

Editorial consensus for all columns.
Dahm KT, Brurberg KG, Jamtvedt G, et al. Advice to rest in bed versus advice to stay active for acute low-back
pain and sciatica. The Cochrane database of systematic reviews 2010;:CD007612.


Will I need any other treatment?

Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical versus nonoperative treatment for lumbar disc herniation:
four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine 2008;33:2789800.
Editorial consensus for Managing without Injections or Surgery and Injections columns

Unless specified otherwise, this evidence document applies to the UK, US, and Spanish versions of the Option Grids
and uses the same evidence base. For update dates, please refer to the Option Grid.

Editors: Ben Dropkin, Thom Walsh, Michael Lewis, Alf Collins, Bert Fichman, Glyn Elwyn.
ISBN: 978-0-9575461-4-1
Creative Commons License: Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND 3.0)