Does Severe Sciatica Require Surgery?

Sciatica is one of the most common and painful conditions that affects the lower back, radiating down the leg along the sciatic nerve. At SamWell Institute for Pain Management, in Colonia, Englewood, and Livingston, New Jersey, Dr. Jay M. Shah and Dr. Kevin Ko offer unmatched expertise in diagnosing and treating sciatica.

While mild sciatica often improves with conservative treatments, severe cases may require surgical intervention to address the underlying cause. However, surgery is never our first line of action. 

What defines severe sciatica?

Sciatica causes pain, tingling, numbness, or muscle weakness that typically impacts your lower back, buttocks, and legs. While mild cases often resolve with time and home care, severe sciatica can result in:

• Chronic pain: lasting for weeks or months that affects daily activities and quality of life
• Neurological symptoms: significant muscle weakness, foot drop, or loss of reflexes
• Bowel or bladder dysfunction: severe nerve compression can cause incontinence, requiring immediate medical attention

These symptoms signal a more significant underlying issue, such as a herniated disc, lumbar spinal stenosis, or spondylolisthesis. 

What we do before recommending surgery

At SamWell Institute for Pain Management, we always exhaust nonsurgical options before considering invasive procedures. Our comprehensive and tailored approach includes:

Physical therapy

Personalized physical therapy helps strengthen the muscles supporting your spine, improves posture, and increases flexibility. Guided exercises and stretches target sciatic nerve pain and promote healing.

Medications and injections

Anti-inflammatory medications reduce swelling and alleviate nerve pain.

Epidural steroid injections deliver medication directly to the inflamed nerve, providing significant pain relief.

Lifestyle modifications 

We work with you to make helpful changes, such as improving ergonomics, managing your weight, and incorporating regular exercise. These adjustments help lower strain on the sciatic nerve.

Advanced minimally invasive procedures

When conservative methods aren’t enough, we offer innovative outpatient procedures that bridge the gap between nonsurgical treatments and surgery, such as spinal cord stimulation or radiofrequency neurotomy.

Most people experience significant relief through this multifaceted approach, but if you have unresolved, debilitating symptoms, we consider your surgical options.

What kind of surgery can help severe sciatica?

When surgery is necessary, we focus on minimally invasive solutions to minimize recovery time and maximize results. Two effective procedures we offer include:

Minimally invasive lumbar decompression (MILD)

This technique relieves pressure on the sciatic nerve caused by spinal stenosis. During the procedure, we carefully remove a small portion of the lamina (a bony structure in the spine) to create more space within the spinal canal. This reduces nerve compression, alleviating sciatica symptoms.

MILD is an excellent option if you want to avoid traditional, open back surgeries. It requires only a small incision, resulting in less tissue damage and faster recovery.

VertiFlex™ Superion™ procedure 

The VertiFlex procedure uses an interspinous spacer to gently separate the vertebrae, relieving pressure caused by conditions like lumbar spinal stenosis. This FDA-approved device is inserted between the bones in the lower spine, creating stability and restoring space around the nerves.

VertiFlex is another minimally invasive solution with proven success in reducing pain and improving mobility, making it a top choice for patients requiring surgical intervention for sciatica relief.

To schedule a sciatic consultation with our experts, call SamWell Institute for Pain Management, or book an appointment online. We’re committed to providing personalized care to help you return to living pain-free.