Physiotherapy for Patients with Sciatica Awaiting Lumbar Micro-discectomy Surgery: A Nested, Qualitative Study of Patients' Views and Experiences.
BACKGROUND AND PURPOSE
Sciatica is a common clinical condition that can be extremely painful, disabling and life-changing. Whether conservative or surgical treatment for sciatica secondary to an intervertebral disc prolapse is most effective is still much debated. An important component of conservative treatment is physiotherapy, which aims to promote physical and psychological health for the patient, whilst resorption of the disc takes place. This paper reports a qualitative study of patients' views and experiences of a bespoke physiotherapy intervention for the treatment of sciatica.


METHODS
A qualitative study nested within a pilot randomized controlled trial of bespoke physiotherapy for the treatment of patients with sciatica awaiting lumbar microdiscectomy surgery. Patients randomized to receive bespoke physiotherapy in the intervention arm of the trial were invited to take part in semi-structured interviews. Twenty-one in-depth, semi-structured interviews took place. All interviews were recorded, fully transcribed and thematically analysed.


RESULTS
Most patients in the sample found the physiotherapy valuable, appreciating the individual nature of the approach, the exercises to reduce pain and discomfort, techniques for improving functional spinal movement, walking and dynamic posture, and manual therapy and cardiovascular exercise. A small number did not find the physiotherapy of benefit. Sixteen patients in the sample went on to proceed with surgery, but most of these found value in having had the physiotherapy first.


DISCUSSION
Many patients with sciatica appreciate the value of physiotherapy prior to surgery. Future research should examine patients' experiences of bespoke physiotherapy delivered within primary care. Copyright © 2016 The Authors Physiotherapy Research International published by John Wiley & Sons Ltd.
['Boote|Jonathan|J|', 'Newsome|Ruth|R|', 'Reddington|Michael|M|', 'Cole|Ashley|A|', 'Dimairo|Munyaradzi|M|']
D000328:Adult D000368:Aged D017586:Diskectomy D005260:Female D006801:Humans D055959:Intervertebral Disc Degeneration D007405:Intervertebral Disc Displacement D008297:Male D008875:Middle Aged D017060:Patient Satisfaction D026741:Physical Therapy Modalities D057285:Precision Medicine D036301:Qualitative Research D011788:Quality of Life D012585:Sciatica
sciatica physical therapy modalities qualitative research