"Just Stay Active"...Not Really Effective Advice for Sciatica!

Reference:1. Hilde G, et al: Advice to stay active as a single treatment for low-back pain and sciatica. Cochrane Database Syst Rev. 2007 Jul 18;(2):CD003632.
2. Croft PR, et al Outcome of low back pain in general practice: a prospective study. BMJ. 1998 May 2;316(7141):1356-9.

THE MYTH: 90% of patients with low back pain recover within 4 weeks irrespective of treatment (Croft et al 1998)

THE EVIDENCE: After 1-year only 25% of patients with low back pain are symptom-free with no functional limitations (Croft et al 1998)

It is true that 90% of patients with back pain will stop consulting their GP about their condition; however, it can certainly not be assumed that the patients have recovered.

Regrettably the majority continue to have pain and disability a year later even though their GP has told them, “take these NSAIDs, don’t worry, be happy and you’ll get better!”

The most recent conclusions by the Cochrane Database on ‘Sciatica’ states that: “the best available evidence suggests that advice to stay active alone has little or no effect for patients with sciatica.”

This is an excellent conclusion in favour of Physiotherapy intervention! How you may ask?

Based on clinical practice guidelines, many Physicians feel re-assurance and advice just to stay active, are good enough…therefore Physiotherapy referral is not needed!

There are many studies supporting that a detailed assessment is required to determine the preferred direction of movement…one cannot possibly believe that back pain cures itself by just “staying active”.

Even if it does, unless you resolve the mechanical cause, recurrence rate is up to 80%!

Posted on: July 25, 2008


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