YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==SCIATICA== 2 AUTHOR Bertin P AUTHOR Rochet N AUTHOR Arnaud M AUTHOR Treves R AUTHOR Desproges Gotteron R AUTHOR Charissoux JL TITLE Intradiscal injection of triamcinolone hexacetonide for acute, subacute, and chronic sciatica. Results at 3 months an open-prospectus study of 30 cases and review of the literature. SOURCE Clin Rheumatol; VOL 9, ISS 3, 1990, P362-6 (REF: 14) ABSTRACT The authors report an open study of 30 cases of intradiscal injection of triamcinolone hexacetonide in the treatment of sciatica. The patients were monitored at months 1 and 3. The results were judged to be good in 36.6% of the cases, moderate in 36.6% and poor in 26.7% of the cases. Two adverse effects were reported: 1 case of reversible urinary retention and 1 case of deficiency of the dorsiflexor muscles of the foot. The good results reported in previous series were only found in this study when the indications were restricted to certain favourable prognostic factors: duration of sciatica less than 6 months and CAT-scan appearance of discal hernia. This technique has the advantage of being simple, economical and nonallergic. On the basis of the encouraging results of the initial series, this technique should be considered as an interesting therapeutic alternative in sciatica. Larger series and double-blind studies, however, are necessary to confirm the initial results. 4 AUTHOR Nachemson AL AUTHOR Rydevik B TITLE Chemonucleolysis for sciatica. A critical review [see comments] SOURCE Acta Orthop Scand; VOL 59, ISS 1, 1988, P56-62 (REF: 84) ABSTRACT Intradiscal injection of chymopapain for the treatment of sciatica due to disc herniation has been used for more than 25 years, but is still under debate. We review the indications, complications, and clinical results, and discuss the tissue effects of chymopapain. The results following surgical disc removal versus chymopapain injection indicate that surgery with removal of the disc hernia through a small laminotomy remains the documented treatment of choice for patients with proven disc herniation and sciatica in whom conservative treatment has failed. 7 AUTHOR Benoist M AUTHOR Deburge A AUTHOR Busson J TITLE [Chemonucleolysis in the treatment of sciatica caused by herniated disk] SOURCE Presse Med; VOL 13, ISS 12, 1984, P733-6 (REF: 24) ABSTRACT Chemonucleolysis is an effective treatment of sciatica due to herniated lumbar disc after conservative treatments have failed. Provided the proper technique is applied and the patients are well selected (complete herniation or herniation within a narrow spinal canal being excluded), surgery can be avoided in the majority of cases. Chemonucleolysis does not in any way complicate subsequent surgery if required and post-nucleolysis surgery gives the same results as first intention surgery. The method, therefore, should not be regarded as an alternative to surgery but as the last stage of conservative treatment. Allergic reactions are the only true side-effects and require special precautions. 2 AUTHOR Pietri-Taleb F AUTHOR Riihimaki H AUTHOR Viikari-Juntura E AUTHOR Lindstrom K AUTHOR Moneta GB TITLE The role of psychological distress and personality in the incidence of sciatic pain among working men. SOURCE Am J Public Health; VOL 85, ISS 4, 1995, P541-5 ABSTRACT OBJECTIVES. The role of personality characteristics and psychological distress in the incidence of sciatic pain was investigated in a 3-year prospective study. METHODS. The study population consisted of 1149 Finnish men aged 25 through 49 years (387 machine operators, 336 carpenters, and 426 office workers) with no history of sciatic pain at the beginning of follow-up. The psychological distress and personality characteristics were assessed by the Middlesex Hospital Questionnaire and the Maudsley Personality Inventory. RESULTS. The 3-year cumulative incidence rate for sciatic pain was 22% among the machine operators, 24% among the carpenters, and 14% among the office workers. The multivariate analysis of psychological factors, taking into account individual and occupational factors, showed that only hysteria was significantly associated with the incidence of sciatic pain among the blue-collar workers. Among the white-collar workers, none of the psychological dimensions were associated with sciatic pain. CONCLUSIONS. These results are in accordance with previous relationships found between hysteria and low-back disorders. Further follow-up investigations are needed to elucidate the role of psychological factors in the occurrence of back problems. 3 AUTHOR Peate WF TITLE Occupational musculoskeletal disorders. SOURCE Prim Care; VOL 21, ISS 2, 1994, P313-27 (REF: 67) ABSTRACT Musculoskeletal disorders of the workplace include the acute, cumulative and chronic injuries or illnesses of the soft tissues which are caused by mechanical stress, strain, sprain, vibration, inflammation, or irritation. The successful management of occupational musculoskeletal disorders must account for workplace conditions (ergonomics and work practices), psychosocial factors, diagnostic uncertainties, and the need for active modalities (exercises and a progressive increase in activities of daily living), rather than passive (bed rest and traction). Although most occupational musculoskeletal disorders respond to conservative measures such as ice or heat, protective devices such as, neutral splints for carpal tunnel syndrome, nonsteroidal anti-inflammatory drugs, and progressive strengthening, resolution may take months. Prevention is often more important than treatment, and may entail workplace revisions and special worker training. Worker selection programs--strength testing, pre-placement radiographs, and inquiries about prior low back pain--have poor predictive value. 4 AUTHOR Heliovaara M AUTHOR Makela M AUTHOR Knekt P AUTHOR Impivaara O AUTHOR Aromaa A TITLE Determinants of sciatica and low-back pain. SOURCE Spine; VOL 16, ISS 6, 1991, P608-14 ABSTRACT Several factors were studied for their association with the prevalence of chronic low-back syndromes, sciatica, and unspecified low-back pain (LBP) in 2,946 women and 2,727 men (age range, 30-64 years) participating in the Mini-Finland Health Survey, a project aimed at comprehensive evaluation of the population's health. On the basis of a standardized clinical examination, a physician diagnosed sciatica in 5.1% and LBP in 11.6% of the subjects. Those with a previous traumatic back injury had a 2.5-fold risk of having sciatica or LBP. The fractions of sciatica and LBP attributable to such back injuries were estimated to be 16.5% and 13.7%, respectively. Sum indices of both physical and mental stress at work were found to be directly proportional to the prevalence of sciatica and LBP. Smokers had an increased risk of LBP, and body height was related positively to the prevalence of sciatica. These associations, however, were inconsistent between sex and age subgroups. In the presence of osteoarthritis in the knee, hip, or hand, LBP was prevalent (adjusted odds ratio [OR], 5.3; 95% confidence interval [CI], 4.1-6.9), but sciatica was not (OR, 1.1; 95% CI, 0.7-1.7). Diabetics were found to have a significantly decreased prevalence of LBP (OR, 0.4; 95% CI, 0.3-0.8). Many factors, independent of each other, determine the occurrence of chronic low-back syndromes. The determinants of sciatica and LBP are different to some extent. 3 AUTHOR Wickstrom G AUTHOR Hanninen K TITLE Determination of Sciatica in Epidemiologic Research SOURCE Spine, Vol. 12, No. 7, pages 692-698, 20 references, 19871987 ABSTRACT A study of the relationship between sciatica and clinical observations of back pain was conducted. The cohort consisted of 252 male concrete reinforcement workers and 231 painters, age range 20 to 64 years. Questionnaire data dealing with the subjects' experiences of back pain extending into a leg, obtained in a previous study of the effects of heavy work loads on musculoskeletal system function, were used in conjunction with clinical observations of pain experienced when the subjects performed a battery of tests of muscle function. The test battery included forward bending, sideward bending, and restricted leg raising, and testing of isometric abdominal muscle strength, extensor hallucis muscle strength, and gluteus medius muscle strength. Pain on bending forward or sideward and decreased trunk muscle strength were correlated with sciatic pain during the past month in the concrete reinforcement workers. Among the painters only pain on bending forward was clearly associated with sciatic pain. Difficulties in defining the occurrence of degenerative back disease and quantifying the effects of mechanical loads in epidemiologic studies were discussed. The authors recommend that research on the effects of heavy physical labor on the back include conducting a structured inquiry of sciatic pain in the past month or year and determining pain and restrictions on bending by clinical examinations 4 AUTHOR Heliovaara M TITLE Occupation and Risk of Herniated Lumbar Intervertebral Disc or Sciatica Leading to Hospitalization SOURCE Journal of Chronic Diseases, Vol. 40, No. 3, pages 259-264, 19 references, 19871987 ABSTRACT The relationship between occupation and hospitalization for herniated lumber intervertebral disc or sciatica was investigated in a large population sample of Finnish men and women. A case control study of 592 men and women who had been hospitalized for herniated lumbar intervertebral disc or sciatica was conducted. In men, the risk of hospitalization due to herniated lumber intervertebral disc or sciatica varied significantly with occupation. The highest relative risks were found among motor vehicle drivers, whose risk of herniated disc or sciatica was four times that of professional workers. Relative risks were also elevated among industrial occupations, especially metal and machine workers. In women, the relative risk of being hospitalized due to herniated lumber disc or sciatica was highest among industrial occupations and lowest among housewives who reported no other previous occupation. Relative risks for female industrial workers were more than two times those of female professional workers, but this difference was not significant, due to confounding factors. However, lower self assessed strenuousness of work was significantly associated with lower risk in women. The authors conclude that the great variation in the risk rates of lumbar disc lesions suggests considerable potential for primary prevention, and they identify an urgent need for intervention studies in preventive industrial medicine.