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STUDY DESIGN: Review of studies on sciatica prevalence and synthesis of available evidence. OBJECTIVE: To assess the studies on sciatica prevalence, discuss reasons for variation in estimates, provide suggestions for improving accuracy of recording sciatica in epidemiological and outcome studies so as to enable better evaluation of natural history and treatment effect in the presence of low back pain related sciatica. SUMMARY OF BACKGROUND DATA: Sciatica is a common cause of pain and disability. It is more persistent and severe than low back pain, has a less favorable outcome and consumes more health resources. However, sciatica prevalence rates reported in different studies and reviews vary considerably and provide no clear picture about sciatica prevalence. METHODS: A literature search of all English language peer reviewed publications was conducted using Medline, EMBASE, and CINAHL for the years 1980-2006. Two reviewers extracted data on sciatica prevalence and definitions from the identified articles. RESULTS: Of the papers retrieved, 23 were included in the review. Only 2 studies out of the 23 used clinical assessment for assessing sciatic symptoms, and definitions of sciatica varied widely. Sciatica prevalence from different studies ranged from 1.2% to 43%. CONCLUSION: Sciatica prevalence estimates vary considerably between studies. This may be due to differences in definitions, methods of data collection and perhaps populations studied. Suggestions are made on how to improve accuracy of capturing sciatica in epidemiological studies. [ABSTRACT FROM AUTHOR]

STUDY DESIGN: A modified Delphi study conducted with 28 experts in back pain research from 12 countries. OBJECTIVE: To identify standardized definitions of low back pain that could be consistently used by investigators in prevalence studies to provide comparable data. SUMMARY OF BACKGROUND DATA: Differences in the definition of back pain prevalence in population studies lead to heterogeneity in study findings, and limitations or impossibilities in comparing or summarizing prevalence figures from different studies. METHODS: Back pain definitions were identified from 51 articles reporting population-based prevalence studies, and dissected into 77 items documenting 7 elements. These items were submitted to a panel of experts for rating and reduction, in 3 rounds (participation: 76%). Preliminary results were presented and discussed during the Amsterdam Forum VIII for Primary Care Research on Low Back Pain, compared with scientific evidence and confirmed and fine-tuned by the panel in a fourth round and the preparation of the current article. RESULTS: Two definitions were agreed on a minimal definition (with 1 question covering site of low back pain, symptoms observed, and time frame of the measure, and a second question on severity of low back pain) and an optimal definition that is made from the minimal definition and add-ons (covering frequency and duration of symptoms, an additional measure of severity, sciatica, and exclusions) that can be adapted to different needs. CONCLUSION: These definitions provide standards that may improve future comparisons of low back pain prevalence figures by person, place and time characteristics, and offer opportunities for statistical summaries. [ABSTRACT FROM AUTHOR]

Study Design: Prospective inception cohort.Objective: To investigate the validity and use of a single question on the bothersomeness of low back pain (LBP) as a method of classifying the severity of symptoms among patients seen in clinical practice.Summary Of Background Data: There is no widely accepted method for classifying patients with nonspecific LBP in clinical practice. There have been no previous reports of the validity and use of a question on bothersomeness as a method of classifying patients with LBP.Methods: Consecutive patients (30-59 years old) with LBP consulting at 5 United Kingdom general practices (n = 1464) were mailed a questionnaire after consultation and 6 months later. Construct validity was assessed by comparing baseline responses on the single bothersomeness question with pain, disability, general health, and psychologic health measures. The ability of bothersomeness to predict outcomes at 6 months was assessed against pain, disability, work absence, and health care use.Results: A total of 935 patients (65%) completed baseline questionnaires. There were 776 (83%) patients who consented to enter the follow-up study, and 447 returned the 6-month questionnaire. At baseline, bothersomeness correlated with pain, disability, and other measures (P < 0.001), and had 80% sensitivity (61% specificity) to detect people in the highest category of pain and disability. People with bothersome LBP at baseline evaluation had an increased risk of work absence or health care consultations for LBP 6 months later (relative risks 2.8 and 1.9, respectively).Conclusions: There is evidence for the validity of a single bothersomeness question as a measure of LBP severity. It has the potential to provide a practical standard scheme for classifying patients with LBP in clinical practice. However, further work is needed to clarify its usefulness in a clinical setting. [ABSTRACT FROM AUTHOR]