Diagnosis and treatment of sciatica

Jensen, Rikke Krüger; Kongsted, Alice; Kjær, Per; Koes, Bart W.

doi:10.1136/bmj.l6273

Cited by 94 publications

(114 citation statements)

References 29 publications

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“…We design this multicenter, parallel-group, patientassessor blinded RCT following the Consolidated Standards of Reporting Trials (CONSORT) and the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines [16,17]. The trial will be conducted in outpatient departments of 6 hospitals in 4 University of Chinese Medicine has approved the study protocol (version 2.0, 13 January 2020) with an approval number of 2020BZHYLL0105. It was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn) on 9th March 2020 with the registration number of ChiCTR2000030680.…”

Section: Methodsmentioning

confidence: 99%

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Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial.

Cai

et al. 2020

Preprint

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Background: Acupuncture is widely used for pain diseases while evidence of its efficacy for sciatica is insufficient. We aim to explore the feasibility and efficacy of acupuncture with different acupoint selecting strategies for sciatica induced by lumbar disc herniation.Methods: This is a multicenter, three-arm, patient-assessor-blinded randomized controlled pilot trial. 90 patients will be assigned randomly into 3 groups including disease-affected meridians (DAM) group, non-affected meridians (NAM) group, and sham acupuncture (SA) group in a 1:1:1 ratio. The trial involves a 4-week treatment along with follow-up for 22 weeks. The primary outcome is the change of leg pain intensity measured by the Visual-Analogue Scale (VAS) from baseline to week 4 after randomization. Secondary outcomes include functional status, back pain intensity, and quality of life. Adverse events will also be recorded.Discussion: The results will inspire the optimal acupuncture strategy for sciatica and help establish a better design as well as power calculation for a full-scale study. Trial registration: ChiCTR2000030680 (Chinese Clinical Trial Registry, http://www.chictr.org.cn, registered on 9th March 2020).

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Section: Methodsmentioning

confidence: 99%

“…NA 3 In the middle of Zhibian (BL54) and Huantiao (GB30) acpoints on the affected leg. NA 4 10 cun above the popliteal crease, in the middle of gallbladder meridian and bladder meridian on the affected leg. NA 5 5 cun above the popliteal crease, in the middle of gallbladder meridian and bladder meridian on the affected leg.…”

Section: Sa Groupmentioning

confidence: 99%

Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial.

Cai

et al. 2020

Preprint

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“… 36 , 92 In both OA and LBP, decisions about surgical care follow a stepped approach based on observed response to nonsurgical care (except for very special cases of trauma or progressive neurological deficits). 8 , 50 At the level of surgical assessments, risk stratification again has a role, which may mean that people with a high risk of poor outcome from surgery would not be recommended this treatment or are perhaps offered more intensive rehabilitation (Fig. 1 ).…”

Section: Key Message #2: It Is Not a Choice Between Stepped Care Omentioning

confidence: 99%

Risk-stratified and stepped models of care for back pain and osteoarthritis: are we heading towards a common model?

Kongsted

Quicke

Skou

et al. 2020

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“…Sciatica prevalence and incidence rates have been reported to be 1.2-43% and 1-37%, respectively; the large variations may be due to the differences in definitions or study population in the concerned studies [1,2]. Sciatica treatment intensity is dependent on disease severity, and the treatment can include exercise, manual therapy, medication, spinal injection and surgery [3].…”

Section: Introductionmentioning

confidence: 99%

Herpes zoster in patients with sciatica

Hsu

Lin

et al. 2020

BMC Musculoskelet Disord

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Background Several diseases are associated with herpes zoster (HZ). However, whether sciatica is a stressor leading to HZ development remains unclear. Here, we evaluated the occurrence of HZ in patients with sciatica. Methods The sciatica cohort consisted of patients first diagnosed as having sciatica between 2000 and 2012. All patients with sciatica were randomly age, sex and index year matched with control individuals without sciatica. The primary outcome was diagnosis of HZ. All individuals were followed until HZ diagnosis, withdrawal from the insurance, death, or December 31, 2013, whichever occurred first. HZ risk in the two cohorts was further analyzed with age, sex and comorbidity stratification. Results In total, 49,023 patients with sciatica and 49,023 matched controls were included. Female patients were more likely to have HZ development than were male patients [adjusted hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.02–1.12]. After adjustments for all the covariates, HZ risk was significantly higher in the sciatica cohort than in the control cohort (adjusted HR = 1.19; 95% CI = 1.12–1.25). Conclusion Sciatica increased HZ risk. Thus, HZ risk should be addressed whenever physicians encounter patients with sciatica, HZ vaccination should be considered especially those aged over 50.

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Diagnosis and treatment of sciatica

Cited by 94 publications

References 29 publications

Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial.

Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial.

Risk-stratified and stepped models of care for back pain and osteoarthritis: are we heading towards a common model?

Herpes zoster in patients with sciatica

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