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What Would You Do With Your Disc Herniation?

Almost 250 years ago, Contunnius of Naples wrote that it was important to distinguish between nervous sciatica and arthritis of the hip. This remains the case today and perhaps it is even more important since we have an ever increasing number of interventions available to us. It is just over 70 years ago that Mixter and Barr eloquently demonstrated that the surgical removal of a disc herniation could relieve sciatica. This has resulted in great enthusiasm for meddling with discs. On the other hand, Hakelius and subsequently Weber documented that the long term outcome of sciatica managed conservatively was the same as with surgical intervention. And now the Dutch have confirmed that finding.1 This gives us the dilemma of how best to control the pain in the short term?