Should I Consider Surgery for My Sciatica?

About 40% of Americans experience sciatica in their lifetimes. It’s a common condition that develops when your sciatic nerve — the largest nerve in your body — gets compressed or irritated. It causes pain that radiates from your lower back down through your hips, buttocks, and legs, and that pain can be debilitating.

Many people find relief from sciatica pain with conservative treatments like rest, physical therapy, and medications. But when symptoms persist or worsen, you’re not out of options. Surgery can be a long-lasting solution, and David A. Wiles, MD, is here to share more information about sciatica surgery to help you decide.

Understanding sciatica

Sciatica often develops from an underlying condition that compresses your sciatic nerve over time. Common examples of potential underlying conditions that could increase your risk of sciatica are herniated discs, spinal stenosis, and degenerative disc disease.

When the nerve gets compressed, it can cause symptoms, including intense nerve pain, tingling, weakness, and even numbness in one or both legs. For some people, sciatica only causes mild discomfort. But for others, sciatica can cause severe pain that significantly impacts their quality of life.

We typically start by recommending non-surgical treatments for sciatica. Options include physical therapy, anti-inflammatory medications, and corticosteroid injections. Many people find these treatments help alleviate symptoms over time.

Most cases of sciatica improve within a few weeks to months with care. However, when these treatments fail to provide relief or when neurological symptoms like muscle weakness or loss of bowel or bladder control occur, it might be time to consider sciatica surgery.

When to consider surgery for sciatica

Dr. Wiles might recommend sciatica surgery if you’ve exhausted conservative treatments and you have significant pain that persists for more than six to twelve weeks. If this impacts your quality of life, and you can’t perform basic tasks like walking, sitting, or standing without discomfort, surgery may offer a solution.

Sometimes, sciatica surgery is necessary when you have signs of nerve damage, like progressive leg weakness, foot drop, or loss of bowel and bladder function. These symptoms can indicate cauda equina syndrome, a rare condition that requires immediate surgical intervention to prevent permanent damage.

Weighing the pros and cons of sciatica surgery

Surgery can provide relief from severe sciatica, and many patients experience significant pain relief and improved mobility following surgery. Still, it’s critical to weigh the risks and benefits before making your decision. As with any surgical procedure, there are potential risks, including infection, blood clots, and nerve damage.

Dr. Wiles offers comprehensive surgery consultations to help answer your questions. We review your medical history and discuss your symptoms and any previous treatments you’ve tried before making our recommendation.

Surgical options for sciatica

If you’re considering surgery for sciatica, several types of surgical procedures are available, depending on the underlying cause of your nerve compression.

Microdiscectomy is a minimally invasive procedure that involves removing part of a herniated disc pressing on your sciatic nerve. It’s an option when a herniated disc is the primary cause of sciatica pain.

Laminectomy removes part of the vertebrae (the lamina) to relieve pressure on your sciatic nerve. Typically, we recommend this option when spinal stenosis is the cause of sciatic nerve compression.

In more severe cases, Dr. Wiles may recommend spinal fusion to stabilize your spine and prevent further nerve compression, especially when there's significant degeneration in your spine.

When conservative treatment isn’t enough to manage your sciatica pain, surgery might be the key to helping you return to a pain-free life. Dr. Wiles offers consultations for people in Chattanooga, Bristol, Kingsport, and Johnson City, Tennessee, and he can help you find a solution that fits your needs. Call our office at 423-459-9800 or request an appointment online now.