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Natural history and prognostic indicators of sciatica
Florence Tubach1, Julien Beauté, Annette Leclerc
1INSERM U88, Hôpital National de Saint Maurice, 94415 Saint-Maurice Cedex, France. florence.tubach@bch.ap-hop-paris.fr
Journal of Clinical Epidemiology
|May 6, 2004
Summary
Sciatica recovery is less common than assumed, with over half of patients experiencing persistent symptoms two years later. Occupational factors like driving and heavy lifting predict ongoing sciatica pain.
Area of Science:
- Occupational health
- Epidemiology
- Clinical outcomes
Background:
- Sciatica is often presumed to have favorable clinical outcomes.
- However, the natural history and long-term prognosis of sciatica remain poorly understood.
Purpose of the Study:
- To investigate the long-term natural history of sciatica.
- To identify predictive factors for sciatica persistence or recurrence.
Main Methods:
- Prospective cohort study of 3,164 workers from a French national company.
- 622 subjects with sciatica in 1991 were analyzed.
- Multivariate logistic regression identified predictive factors for sciatica persistence after 2 years.
Main Results:
- 55% of sciatica patients still had symptoms in 1993, and 53% in 1995.
- Among those recovered by 1993, 61% reported low back pain, with 27% having long-lasting pain.
- Predictive factors for persistent sciatica included: driving ≥2 hr/day, heavy load carrying, high psychosomatic issues, and prior sciatica symptoms.
Conclusions:
- Recovery from sciatica is less frequent than commonly believed.
- Occupational (driving, heavy loads) and personal factors (psychosomatic issues, prior symptoms) are associated with sciatica persistence.