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A trial of people with back pain and sciatica failed to find much difference in outcomes for surgical versus non surgical treatments. It's pretty debilitating having long term low back pain and sciatica - that's pain going into your buttock and down your leg. So much so, it's tempting to wonder whether you should just get it over with and have spinal surgery to whip the disk out. But the evidence that a diskectomy's worth doing is thin. A trial which randomised people with back pain and sciatica for at least six weeks and a proven protruding disk - to either surgery or usual care, failed to find much in the way of benefits. The average age of the 500 mostly men involved was 42. The trial was disappointing because many changed their mind and crossed to the other group - in both directions. But allowing for that, everyone improved significantly with few differences between surgery and non-surgical treatments apart from some greater reductions in the severity of sciatica. The reality is though that the placebo effect of surgery wasn't eliminated and what's really needed is a trial where a cut is made in the back but the person doesn't know whether they've actually had their disk out. Radical perhaps but then you'd know the value of surgery.
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