Abstract
Purpose and background
Although low back pain (LBP) with leg pain, is considered by most a poor prognostic indicator, it is at the same time believed to have a favourable natural resolution, and is often treated along similar lines to non-specific LBP, in line with current guidelines. It is unclear whether patients with LBP and leg pain are a distinct subgroup that might benefit from early identification and targeted interventions. We set out to investigate the impact of LBP with leg pain on health outcomes and health resources compared with that of LBP alone, and to explore which factors contribute to the observed disability outcomes.
Methods
A systematic literature search of all English language peer reviewed publications was conducted using Medline, EMBASE, and CINAHL for the years 1994 to 2009.
Results
Of the 89 papers retrieved, 9 were included in the review. The heterogeneity of data allowed only for narrative analysis of findings. All studies reported worsening baseline health status in terms of poorer self-assessment and increasing use of health care the further the radiation of leg pain. Differences in quality of life measures were higher for physical than for mental health dimensions. Pain and disability outcome at follow up assessment appeared to be less favourable in this group than for individuals with LBP alone.
Conclusion
LBP with leg pain is associated with poorer health outcomes and increased use of health resources. These findings argue for early identification of these cases by health care professionals and for pursuing effective treatments rather than simply treating similarly to non-specific LBP.
Conflicts of interest - None
Sources of funding - Arthritis Research Campaign, National Institute for Health Research.
This abstract has not been previously published in whole or substantial part nor has it been presented previously at a national meeting.
