Evidence, pain, and the poor old NHS

Eighteen months ago I suddenly developed severe pain in my left buttock, leg, and foot. It quickly became so severe that a friend drove me to the nearest cottage hospital—I was staying in the country at the time. Sciatica was diagnosed, and I was sent away with four pethidine tablets. My GP, consulted in London the next day, prescribed bed rest, analgesics, diazepam, and diclofenac, referred me for physiotherapy and an xray examination, and reassured me that I would get better in a few weeks.

Three weeks later the pain was intense and unremitting. I had to give a paper at a conference, and a medical colleague, spotting me lying on the floor in agony, arranged a scan. This showed what was described as a “nice” prolapsed disc. Again I was told that it would get better in a few weeks.

Why is there so little coherent knowledge about effective treatment regimens?

By this time, friends had advised an array of self help techniques, including …