Natural history and prognostic indicators of sciatica.

OBJECTIVE

Sciatica is thought to have a good clinical outcome, but in fact, its natural history is not well known.

STUDY DESIGN AND

SETTING

We studied a prospective cohort of 3,164 workers from the French national electricity and gas company. In this cohort, 622 subjects suffered from sciatica in 1991. The predictive factors of the persistence or recurrence of sciatica after 2 years were identified by multivariate analysis (logistic regression).

RESULTS

Of the 622 subjects with sciatica in 1991, 55% still reported its symptoms in 1993 and 53% in 1995. Of those who had recovered from sciatica in 1993, 61% still had low back pain and 27% of them long-lasting low back pain in 1993. The factors predictive of the persistence or recurrence of sciatica in 1993, identified by multivariate analysis, were: driving at least 2 hr/day, carrying heavy loads at work, a high level of psychosomatic problems, and sciatica symptoms the year before study inclusion.

CONCLUSION

Recovery from sciatica is less frequent than expected. Attention should be given to occupational and personal factors associated with persistence or recurrence of sciatica.