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Abstract Background Few studies have investigated prognostic factors for patients with sciatica, especially for patients treated without surgery. The aim of this study was to identify factors associated with non-success after 1 and 2 years of follow-up and to test the prognostic value of surgical treatment for sciatica. Methods The study was a prospective multicentre observational study including 466 patients with sciatica and lumbar disc herniation. Potential prognostic factors were sociodemographic characteristics, back pain history, kinesiophobia, emotional distress, pain, comorbidity and clinical examination findings. Study participation did not alter treatment considerations for the patients in the clinics. Patients reported on the questionnaires if surgery of the disc herniation had been performed. Uni- and multivariate logistic regression analyses were used to evaluate factors associated with non-success, defined as Maine–Seattle Back Questionnaire score of ≥5 (0–12) (primary outcome) and Sciatica Bothersomeness Index ≥7 (0–24) (secondary outcome). Results Rates of non-success were at 1 and 2 years 44% and 39% for the main outcome and 47% and 42% for the secondary outcome. Approximately 1/3 of the patients were treated surgically. For the main outcome variable, in the final multivariate model non-success at 1 year was significantly associated with being male (OR 1.70 [95% CI; 1.06 − 2.73]), smoker (2.06 [1.31 − 3.25]), more back pain (1.0 [1.01 − 1.02]), more comorbid subjective health complaints (1.09 [1.03 − 1.15]), reduced tendon reflex (1.62 [1.03 − 2.56]), and not treated surgically (2.97 [1.75 − 5.04]). Further, factors significantly associated with non-success at 2 years were duration of back problems >; 1 year (1.92 [1.11 − 3.32]), duration of sciatica >; 3 months (2.30 [1.40 − 3.80]), more comorbid subjective health complaints (1.10 [1.03 − 1.17]) and kinesiophobia (1.04 [1.00 − 1.08]). For the secondary outcome variable, in the final multivariate model, more comorbid subjective health complaints, more back pain, muscular weakness at clinical examination, and not treated surgically, were independent prognostic factors for non-success at both 1 and 2 years. Conclusions The results indicate that the prognosis for sciatica referred to secondary care is not that good and only slightly better after surgery and that comorbidity should be assessed in patients with sciatica. This calls for a broader assessment of patients with sciatica than the traditional clinical assessment in which mainly the physical symptoms and signs are investigated.

The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the success rate after an episode of sciatica by using these cut-offs. A 12-month multicenter observational study was conducted on 466 patients with sciatica and lumbar disc herniation. The cut-off values were estimated by ROC curve analyses using Completely recovered or Much better on a 7-point global change scale as external criterion for success. The cut-off values (references in brackets) at 12 months were leg pain VAS 17.5 (0-100), back pain VAS 22.5 (0-100), Sciatica Bothersomeness Index 6.5 (0-24), Maine-Seattle Back Questionnaire 4.5 (0-12), and the SF-36 subscales bodily pain 51.5, and physical functioning 81.7 (0-100, higher values indicate better health). In conclusion, the success rates at 12 months varied from 49 to 58% depending on the measure used. The proposed cut-offs may facilitate the comparison of success rates across studies.

Background: Back pain is a major health problem and the most important disorder associated with sickness absence. This report presents experiences from a back pain outpatient clinic., Material and Methods: We collected demographic data, diagnoses on the referrals (ICPC) and in the outpatient clinic (ICD-9) and recommendations given to 206 patients, referred 1 January to 30 April 1998., Results: 41% were women (mean age 45), 59% men (mean age 44). Mean waiting time before appointment was 35 days compared to 49 days before the clinic was opened. 43% were prioritized for an appointment within two weeks; mean waiting time in this group was 16 days. 125 (63%) of 200 were referred with non-specific low back pain. Of these, 99 (79%) were given the same diagnosis in the clinic. 75 (37%) had a referral diagnosis of lumbar disk injury with radiation, of whom 46 (61%) were diagnosed with lumbar nuclear prolapse or lumbar spinal stenosis in the clinic., Interpretation: An outpatient clinic may be a useful way to organise the specialist health service system for back pain patients.

Background: A high number of patients attending outpatient clinics of rheumatology are control cases. This study aimed at investigating the causes of such controls and how necessary they are., Material and Methods: 400 consecutive control patients selected from a local hospital were included., Results: Inflammatory rheumatic diseases constituted 89% of the controls; rheumatoid arthritis was the diagnosis in 28% of cases. Routine control of patients with chronic disease was the main cause of control (41%). 15% of controls were regarded as partly or completely unnecessary; 95% of these were not repeated., Interpretation: The reasons for controlling patients in rheumatology should be better defined. Regular evaluation could result in improved service to outpatients.