The January Issue of Spine, a leading source of information and business intelligence for workers in the health care industry, reports on a study that shows surgery provides more effective results than nonsurgical treatments for most patients with back pain related to a herniated disk. However, the same is not true for patient’s receiving workers’ compensation for work-related injuries.

No Better Results with Surgery for Workers’ Comp Patients

Researchers in the study examined data on 924 patients with sciatica, which is leg and low back pain related to a herniated intervertebral disk. The researchers were looking for possible differences in response to treatment between patients who were and were not receiving workers’ compensation. Workers’ compensation patients represented about 12 percent of test subjects.

As part of an indiscriminant trial, patients were instructed to undergo surgical or nonsurgical treatment such as, physical therapy, education/home exercise, and pain-relieving drugs. Results of the trial showed that while both treatments were effective, surgery provided more rapid improvement and better results up to two years after treatment. Patients who were not receiving workers’ compensation showed significant improvement after three months, and remained better after two years. However, the difference between surgical and nonsurgical treatment narrowed over time for the workers’ compensation patients. Near the end of two years, the workers’ compensation patients who had undergone surgery suffered pain and physical dysfunction similar to those who had undergone nonsurgical treatment.

Regardless of workers’ compensation status, the percentage of patients returning to work or placed on disability was comparable with or without surgery.

Sciatica Related to Herniated Disks

Sciatica related to herniated disks is a disabling condition and is a common reason for workers’ compensation claims. Previous studies have indicated that workers’ compensation status may be influential in the outcomes of treatment for herniated disks.

Results from this study show that surgery for herniated disks is not as effective in workers’ compensation patients, and that even though they recover faster initially, the benefits are short-lived. For patients not receiving workers’ compensation, surgery provided long-lasting medical benefits. Even after allowing for other patient characteristics, the difference remained.

The reason for the difference is unclear, and the findings are not meant to imply that workers’ compensation patients should not undergo surgery. That decision should be discussed with your medical provider.