Stem cell injection is the leading minimally invasive alternative to disc surgery, backed by clinical trials and two Chinese meta-analyses showing less pain and disability. Exercise supports every treatment, epidurals give short-term relief, and surgery remains for emergencies and cases that do not respond.
| Treatment | Evidence | Guideline position | Typical relief |
|---|---|---|---|
| Stem cells into discRecommended | Clinical trials incl. a randomised trial; meta-analyses show less pain and disability | Specialist regenerative option | 12 months+, up to 10 years in one study |
| 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 |
| 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 |
Sources on our sources page.
