Sciatica Pain and Weakness: Is Surgery The Answer?

When patients seek medical care for a painful disc herniation and a motor deficit (muscle weakness, limping, or a dropped foot), the motor deficit sometimes becomes an overriding concern, steering patients toward early surgery.  

A recent Netherlands study has disputed that notion.  

While the motor deficit did improve significantly faster with surgery, the long term recovery was the same.  At one year, complete recovery of motor deficit was found in 79% of subjects treated surgically and 83% of subjects receiving conservative nonsurgical treatment.  

However, these results do not apply to all patients with motor deficits.  Patients with cauda equina syndrome (severe compression of nerves below the spinal cord) and rapidly progressing motor problems often do require earlier surgery to resolve.