Abstract
Background: Sciatica is an important cause of pain and disability but relatively few studies have looked at predictors of outcome in sciatica populations. Prognostic studies in non-specific low back pain are more common, but it has been suggested that the prognostic indicators for sciatica may be different. Our aim was to systematically review and describe the literature investigating the predictors of outcome in sciatica populations.
Methods: A systematic literature search of the databases (Medline, EMBASE, and CINAHL) and reference list of identified articles was conducted. Studies were included if they described subjects with sciatica, had a follow-up period of at least three months and measured outcomes including pain, disability, recovery, psychological outcomes or return to work. Methodological quality was assessed using a 15 item checklist.
Results: 596 papers were identified but only 12 met the criteria for inclusion. A combination of individual (e.g. gender, BMI), biomedical (e.g. size of disc prolapse, neurological deficit), social (e.g. job satisfaction, social status, manual labour) and psychological (distress, mental health) predictors of outcome were reported.
Conclusions: There are few high quality studies that have investigated prognostic factors associated with persistence of sciatic symptoms. Those identified explored a range of different factors, in a variety of settings and in subjects with variable duration of symptoms. Although the studies are difficult to interpret due to heterogeneity of the techniques used in analysis and presentation, they seem to suggest that clinical, occupational and individual factors might be more strongly associated with outcome than psychological factors in sciatica populations.
Conflicts of Interest: None
Funding: None
Correspondence should be addressed to: SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
