Reasons for rheumatology department admission in 125 patients with disk-related sciatica.
OBJECTIVE
To identify medical and nonmedical reasons for admission of disk-related sciatica patients.


METHODS
125 patients were evaluated prospectively using a 25-items questionnaire, including seven items on medical reasons, four on psychological reasons, four on work-related reasons, six on social and family reasons, and four on miscellaneous reasons.


RESULTS
Severe nerve root pain (34%), motor loss (17%), atypical clinical manifestations (13%), severe low back pain (8%), and/or sphincter dysfunction (4%) were recorded in only 55% of patients, and only 16% had at least two of these reasons. A minority of patients were admitted to avoid premature surgery (13%) or to try one more conservative approach prior to surgery (15%). Seventy-five per cent of patients reported at least one of the psychological reasons listed in the questionnaire (irritability/fatigue, 66%; anxiety, 42%; depression, 26%; panic disorder, 21%), 50% reported at least one work-related reason (workaholism, 21%; job offer, 16%; self-employed, 14%; fear of losing their job, 11%), 66% reported at least one social or family reason (living alone, 34%; one or more dependents younger than seven years of age, 32%; too many demands from household members, 22%; one or more dependents older than seven years of age, 8%; need to care for another person, 9%; important upcoming family or personal event, 6%), and 26% reported at least one miscellaneous reason (firm belief that sciatica can be cured only by inhospital treatment, 10%; desire to put pressure on the employer or on an expert, 7% and 6%, respectively; admission via the emergency room without prior medical advice, 6%).


CONCLUSIONS
In France, the reason for admission of patients with disk-related sciatica is frequently a mixture of physical, psychological, and social problems, with only 55% of patients having a symptom requiring inhospital management.
Berthelot
J M
JM
Rheumatology Department, Nantes Teaching Hospital, France.
Glemarec
J
J
Laborie
Y
Y
Varin
S
S
Maugars
Y
Y
D000328:Adult; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications*; D008297:Male; D010146:Pain / Q000209:etiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012585:Sciatica / Q000209:etiology*