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Evidence Table: Disc and Sciatica Treatments
Every common treatment for herniated discs and sciatica rated by evidence and guideline position, with sources.
- Reviewed by Dr James Bristol, MD, PhD
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Medically reviewed by Dr James Bristol, MD, PhD · Updated 2026-11-14
Exercise-based care has the strongest evidence for disc-related back pain and sciatica. Epidurals give short-term relief. PRP and stem cells show promise in small studies. Surgery speeds leg-pain relief for some but long-term results are often similar.
| Treatment | Evidence | Guideline position | Typical relief |
|---|
| Staying active, exercise | Strong | Recommended (NICE) | Long term |
| Physiotherapy | Strong | Recommended | Long term |
| Gabapentinoids for sciatica | Weak | NICE: do not offer | Little |
| Oral steroids for sciatica | Weak | NICE: do not offer | Little |
| Epidural steroid injection | Moderate | NICE: consider for acute severe sciatica | Weeks to months |
| PRP into disc | Small RCT | Not in guidelines | Months in small study |
| Stem cells into disc | Pilot studies, small RCT | Not in guidelines; research | 12 months+ in small studies |
| Microdiscectomy | Strong for faster leg relief | For red flags or persistent severe sciatica | Long term for many |
| Spinal fusion for low back pain | Weak | NICE: not outside trials | Varies |
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