Surgery, pills work for sciatica pain

BOSTON, May 30 (UPI) -- Leg and back pain from pressure on the sciatica nerve is about the same a year after conservative medical treatment or surgery, say U.S. doctors.

"The major advantage of early surgical treatment is faster relief of sciatica," said Wilco Peul, a neurosurgeon at the Leiden School of Medicine in the Netherlands.

Peul said that sciatica -- a radiating leg pain that can limit mobility -- usually is relieved with either surgical or non-surgical therapy.

In fact after a year of treatment, sciatica pain in the 283 patients in his trial was virtually very low and very similar in patients who had opted for early surgery, waited for surgery or never had surgery to correct the problem.

Writing for Thursday's editions of the New England Journal of Medicine, Dr. Peul said that there was a similar result when disability scores were compared, a sharp drop in dysfunction scores when the patients underwent surgical disc relief while those receiving medication had a more gradual decline in pain. Conservative therapy consisted of medication or physiotherapy.

By about six months after either treatment was initiated patients felt about the same, and functioned similarly. The improvement in relief endured through the end of the one-year clinical trial.

"Patients whose pain is controlled in a manner that is acceptable to them may decide to postpone surgery in the hope that it will not be necessary, without reducing chances for complete recovery in 12 months," Peul said. "Early surgery remains a valid treatment option for well-informed patients."