Journal of Pain Management & Medicine

Abstract

Treatment Options for Sciatica: Surgery, Epidural Injections, and Osteopathic Manipulative Treatment

Leonard B Goldstein, Roya Vahdatinia, Victoria Troncoso and David Shoup

Understanding the etiology and optimal treatment options for sciatica is a frequently discussed medical topic. This study analyzes treatment options-specifically surgery, epidural steroid injections (ESI), and osteopathic manipulative treatment (OMT)-for sciatic radiculopathy due to lumbar disc herniation. A review of several studies comparing surgery to non-surgical intervention, surgery to ESI, ESI to conservative care, and OMT is discussed. There is no consensus on the usefulness of ESI; several studies illustrated efficacy while numerous others did not conclude statistical significance, and rather, highlighted the adverse effects. In contrast, OMT is considered a non-invasive first-line approach to achieving relief from sciatica, while surgery is a last resort in the uncomplicated patient.