PEOPLE WITH ruptured discs (or slipped disc) in their lower backs usually recover whether or not they have surgery, say researchers. A study — conducted over two years on nearly 2,000 patients in the United States — found that surgery appeared to relieve pain more quickly, but that most patients recovered eventually, whether they underwent surgery or not. There was no harm in waiting.
Surgeons said the finding was likely to change medical practice. The study, published in The Journal of the American Medical Association, is the only large and well-designed trial to compare surgery for sciatica with waiting for nature to take its own course.
The study was controversial from the start, with many surgeons saying they knew operations healed better. In the end, neither waiting nor surgery was a clear winner. Most patients fared well with whatever treatment they received. While one group opted for surgery, another received physical therapy and anti-inflammatory drugs.
Patients who had surgery often reported immediate relief. But in three to six months, patients in both groups reported a marked improvement. After two years, about 70 per cent of patients in the two groups said there was a “major improvement”. No one who waited had serious consequences, and no one who had surgery had a disastrous result.
“It says you don’t have to rush into surgery,” said Dr Steven R. Garfin, chairman of the department of orthopaedic surgery, University of California.
Sciatica is caused when a ruptured disc impinges on the root of the sciatic nerve and is characterised by pain. Many surgeons had feared that waiting would cause severe harm, but those fears were proved unfounded.