Re: Treating sciatica in the face of poor evidence
Whilst it is clear that there is very little evidence in supporting any guide in drug choices in patients with lumbosacral radiculopathy, acute care physicians both in primary and secondary care often fail patients on another level.
This condition is often a chronic and debilitating one not only because of its physical manifestation but also its psychological consequences that are almost always underestimated. It has direct effects on simple daily activities like emptying the dishwater and there is extensive evidence to suggest it is infrequently accompanied by a certain element of depression.
I remember walking out of the MR scan suite with tears in my eyes thinking this would be the end of a healthy life style I always managed to match with a busy clinical one. I however stumble across a fantastic osteopath (not a clinician!) who had a very frank and amicable chat with me.
This condition is about understanding it, accepting it and most important implementing changes in your everyday life.
It is not the end of physical exercise or indeed the end of the world! The rush of endorphins I used to get at those spinning classes or weight-lifting sessions were replaced by those I gained at swimming or pilates classes.
Anxiety, stress (and depression?) increase the amount of pain which results in muscle spasms, a vicious circle.
The advice was clear and sound: change your life style and fight depression.
Four months after my injury, I was back at the gym and cope fine (ignore?) with my limb numbness.
More importantly, my professional vision changed completely and I found myself giving advice to patients about body posture, exercise, support rather than prescribing medications that notoriously make little difference.
A holistic approach is what is often most needed here, not a prescription pad!
Competing interests:
The author suffers from lumbosacral radiculopathy himself
Rapid Response:
Re: Treating sciatica in the face of poor evidence
Whilst it is clear that there is very little evidence in supporting any guide in drug choices in patients with lumbosacral radiculopathy, acute care physicians both in primary and secondary care often fail patients on another level.
This condition is often a chronic and debilitating one not only because of its physical manifestation but also its psychological consequences that are almost always underestimated. It has direct effects on simple daily activities like emptying the dishwater and there is extensive evidence to suggest it is infrequently accompanied by a certain element of depression.
I remember walking out of the MR scan suite with tears in my eyes thinking this would be the end of a healthy life style I always managed to match with a busy clinical one. I however stumble across a fantastic osteopath (not a clinician!) who had a very frank and amicable chat with me.
This condition is about understanding it, accepting it and most important implementing changes in your everyday life.
It is not the end of physical exercise or indeed the end of the world! The rush of endorphins I used to get at those spinning classes or weight-lifting sessions were replaced by those I gained at swimming or pilates classes.
Anxiety, stress (and depression?) increase the amount of pain which results in muscle spasms, a vicious circle.
The advice was clear and sound: change your life style and fight depression.
Four months after my injury, I was back at the gym and cope fine (ignore?) with my limb numbness.
More importantly, my professional vision changed completely and I found myself giving advice to patients about body posture, exercise, support rather than prescribing medications that notoriously make little difference.
A holistic approach is what is often most needed here, not a prescription pad!
Competing interests: The author suffers from lumbosacral radiculopathy himself