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Physiotherapy for Sciatica - Is Earlier Better?

What is Sciatica?

Sciatica is the name used for the condition where you can experience pain, pins and needles, numbness and/or weakness in one or both legs.  Sciatica often lasts only a few months but can last a lifetime.

What causes it?

Sciatica is caused by nerves in the lower back being squashed or irritated. The most common cause of the compression is a disc prolapse in the lower back.

A disc prolapse

How does this affect people?

Some people have terrible pain and difficulties with everyday living, including work, hobbies and life.  Other people have no problems whatsoever.

Treatment - Surgery or Physiotherapy?

Surgery helps people get better quicker than physiotherapy but research has shown that people who have either surgery or physiotherapy have the same results at about a year after.  Surgery has some risks associated with it that physiotherapy doesn't. 

When should treatment start?

We know early treatment for back pain is better than delayed treatment but this hasn't been studied in people with sciatica.  It seems logical that if you treat the problem early then this would be better, but it may be that it gets better on its own.

The current problem

We don't know if having physiotherapy early after sciatica starts is better than waiting for a few weeks or months before starting treatment.

POLAR trial design

The study aims to recruit 80 patients with sciatica who will be split into 2 groups.  Both groups will receive up to 6 sessions of physiotherapy, 1 group within 2 weeks of seeing their doctor and the other group will wait for 6 weeks before receiving their treatment.

Treatment is based on the individuals goals

Targeted physiotherapy will be individually tailored to meet the goals of the participant. 

The study is being led by Michael Reddington, NIHR Clinical Doctoral Research Fellow and Spinal Extended Scope Physiotherapist at Sheffield Teaching Hospitals NHS Foundation Trust. It is as part of an NIHR Clinical Doctoral Research Fellowship awarded to Mr Reddington.

Study contact details
Name Role Email Contact Number
Michael Reddington Chief Investigator mreddington1@sheffield.ac.uk 07511 283 778
Mark Pinkerton Research Nurse mark.pinkerton@nihr.ac.uk 07831 176 159