Physiotherapy for Sciatica; Is Earlier Better?
Condition: Sciatica; Low Back Pain; Radiculopathy
MeSH terms: Radiculopathy; Sciatica; Low Back Pain
Study type: Interventional
Phase: Phase 3

Summary: 
      This study aims to evaluate the whether receiving physiotherapy early after onset of the
      problem is better than waiting a few weeks to see if it gets better before starting
      physiotherapy. 80 people with sciatica will take part in the study, half of which will
      receive physiotherapy 2 weeks after seeing their G.P. The other half will receive
      physiotherapy at the usual time, around 6 weeks after seeing their G.P.
    

Detailed description: 
      Sciatica is a relatively common problem which is often caused by nerve compression or
      irritation due to a lower back (Lumbar) disc prolapse. The problem is likely to improve in
      time as the body heals itself. However, this can take many months or sometime years. Sciatica
      can be a very painful condition, it may cause pins and needles, numbness or weakness in the
      legs affected. This, can cause great difficulty for people carrying out normal day to day
      activities.

      Physiotherapy is often used to help people with sciatica but in many places in the United
      Kingdom it can take many weeks or months to begin therapy.

      This study aims to see if having physiotherapy at 2 weeks after the patient has seen their
      G.P helps them get back to normal day to day function. This will be compared with another
      group of patients who will have physiotherapy at the 'usual' time of around 6 weeks after
      they have seen their G.P.The investigators will also be interviewing participants for their
      views of sciatica and physiotherapy. Each patient will receive a goal orientated
      physiotherapy management programme with achievement of those goals acting as secondary
      outcomes. Primary outcomes are feasibility objectives including patient recruitment rates,
      acceptability of outcome measures and intervention and rates of adverse events.

      This is a pilot study which means that the investigators won't be directly comparing the 2
      groups, but seeing if doing a full-scale study in the future is going to be feasible.The
      investigators will do this by measuring several different things, such as whether patients
      want to take part in the study or not, whether the tests the investigators will perform are
      the right tests and to see if the patients and physiotherapists find the treatment useful.
    

Intervention name(s): Physiotherapy
Intervention type(s): Other
Intervention description(s): The aims of physiotherapy are to promote physical and psychological health for the patient, and in doing so promote and improve function. In light of the evidence to suggest spontaneous resorption of the disc fragment occurs, physiotherapy provides support and guidance for the patient to manage their symptoms whilst resorption takes place. The physiotherapy regimen will be tailored to the individuals' requirements. It will be goal orientated, and assessed using a biopsychosocial approach based on 7 different elements; neurological dysfunction, motor control of movement of the lumbar spine and pelvis, movement restriction in the lumbar spine and pelvis, psychological barriers to recovery, advice and education, functional-based exercise and pain.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment