Diagnosis and treatment of sciatica

To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority.

Imaging features of spine degeneration are common in symptomatic and asymptomatic individuals. We compared the prevalence of MR imaging features of lumbar spine degeneration in adults 50 years of age and younger with and without self-reported low back pain.

Review of studies on sciatica prevalence and synthesis of available evidence. To assess the studies on sciatica prevalence, discuss reasons for variation in estimates, provide suggestions for improving accuracy of recording sciatica in epidemiological and outcome studies so as to enable better evaluation of natural history and treatment effect in the presence of low back pain related sciatica. Sciatica is a common cause of pain and disability. It is more persistent and severe than low back pain, has a less favorable outcome and consumes more health resources. However, sciatica prevalence rates reported in different studies and reviews vary considerably and provide no clear picture about sciatica prevalence. A literature search of all English language peer reviewed publications was conducted using Medline, EMBASE, and CINAHL for the years 1980-2006. Two reviewers extracted data on sciatica prevalence and definitions from the identified articles. Of the papers retrieved, 23 were included in the review. Only 2 studies out of the 23 used clinical assessment for assessing sciatic symptoms, and definitions of sciatica varied widely. Sciatica prevalence from different studies ranged from 1.2% to 43%. Sciatica prevalence estimates vary considerably between studies. This may be due to differences in definitions, methods of data collection and perhaps populations studied. Suggestions are made on how to improve accuracy of capturing sciatica in epidemiological studies.