Vishwadha
Chander OCTOBER 2, 2019 / 4:41 PM
(Reuters Health) - One
in four older Americans has experienced the sharp, sometimes disabling, pain of
sciatica, and these older adults are more prone to have other illnesses and
lowered quality of life, a new U.S. study suggests.
Based on surveys of
more than 1 million men and women, researchers found that about one quarter had
been diagnosed with this common form of back pain that usually begins in the
spine and radiates down the leg.
Compared to people
without a history of sciatica, those with the condition tended to have higher
rates of other physical ailments and depression, researchers note in the
Journal of the American Academy of Orthopaedic Surgeons.
Previous research has
shown that sciatica is common, but the current study looks at how the disorder
affects patients over the years, said Dr. Joseph Maslak of the Cleveland Clinic
in Ohio, who led the study while a surgical resident at Northwestern University
in Chicago.
Maslak and his
colleagues analyzed data collected between 2007 and 2012 in annual surveys of
people over age 66 with coverage under Medicare, the federal health program for
the elderly. In addition to general background information, the surveys asked
participants about chronic medical and mental health conditions, daily
activity, and how they felt about their physical health. Researchers followed
up with willing participants after two years.
Of the roughly one
million people included in the analysis, 250,869 said in their original
interview that they had been diagnosed with sciatica, and 750,083 had no
history of the condition. After two years, 112,260 patients with sciatica
completed follow-up interviews along with 355,236 people without sciatica.
The researchers found
that people with sciatica were more likely to suffer from other health issues
like hypertension, heart disease, obesity and stroke. Around 72% of patients
who reported having sciatica also had hypertension, for example, compared with
63% of those without the condition.
More sciatica patients
also had coronary heart disease, a history of heart attacks, chronic
obstructive pulmonary disease, inflammatory bowel syndrome, diabetes and were
“notably” more likely to report a recent fall.
Rates of self-reported
depression were also nearly double (34%) among people with sciatica compared to
others (16%). After two years, these rates fell only slightly in both groups.
Similarly, 48% of
people with sciatica described their own health as fair to poor in the baseline
interview, compared with 25% of people without sciatica, and there was little
improvement in either group two years later.
The study was not
designed to determine whether sciatica directly causes other physical or mental
health conditions or is influenced by them, the authors note. But it’s
certainly possible that patients suffering from the effects of sciatica may be
more susceptible to depression, or patients with depression may have an altered
reaction to sciatica pain, for instance.
Given the strong
associations seen between sciatica and other common health conditions, “these
patients should be approached holistically,” the study authors write, “with
sciatica being potentially an indicator of overall health.”
This study is important
for doctors to identify patients for appropriate multidisciplinary care, Maslak
told Reuters Health in an email. “This will help decrease costs and improve the
quality of life.”
The study “does raise
interesting questions about sciatica causing mental and physical discomfort,”
said Dr. Houman Danesh, director of the Division of Integrative Pain Management
at The Mount Sinai Hospital in New York city, who was not part of the study.
“The Medicare
population is an at-risk group of patients, and continued research is necessary
to afford them the care they deserve,” Maslak said.
It is also important
for patients to focus not just on pain reduction but to have goals, Danesh
said.
“They should say, ‘I
want my pain to be less so that I can get on my knees and play with my
grandchildren or play basketball with my son for two hours.”
SOURCE: bit.ly/2oh9VHa Journal
of the American Academy of Orthopaedic Surgeons, online September 9, 2019.
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