Sciatica Random Control Trials
When doctors want to know whether or not a specific treatment is effective, they look at a collection of studies and compare the results. The most reliable data comes from a specific type of study called random controlled trials (RCTs).
In a RCT, patients are assigned to groups randomly. This may be done by putting everyone in one group whose birthday was in an odd year. Everyone born in an even year is assigned to another group. Or a computer program can do it randomly.
Each group is treated differently and the final outcomes are compared. In this news report, six RCTs comparing discectomy to nonsurgical care for painful disc herniation are reviewed. The trials were conducted over a period of 25 years. So they were very different in design and approach.
Although there were many things that couldn't be compared in these six studies, they did agree on the following points:
Patients with sciatica do get better
Today's results in treating sciatica are much improved over 25 years ago
No matter which treatment was used, most patients had positive outcomes
Both treatment options appear to be safe; serious complications are rare
Surgery does not have to be done right away to have a good result
It appears from these six studies that surgery gives faster relief from painful symptoms. But long-term results at one, two, four, and 10 years later are no different. None of the six RCTs had a placebo group (patients who thought they were getting treated but were not). That is an important missing link that must be studied in future research.
What Do Six RCTs Show? In The BACK Letter. July 2007. Vol. 22. No. 7.Pp. 73, 82.