Physiotherapy for Patients with Sciatica Awaiting Lumbar Micro-discectomy Surgery: A Nested, Qualitative Study of Patients' Views and Experiences.
Jonathan Boote, Ruth Newsome, Michael Reddington and 2 others
PMID 26914525WHAT IT FOUND
Patients awaiting microdiscectomy described up to six physiotherapy sessions as valuable when tailored.
Most who had surgery saw physiotherapy and surgery as helping together.
Key findings
01Of the 21 patients interviewed, 16 underwent surgery after physiotherapy and five did not proceed, with some saying physiotherapy relieved symptoms or surgery was too risky.
02Most patients found the bespoke physiotherapy valuable, appreciating tailored care, exercises, manual therapy, walking and posture work, and counselling, although a small number said it aggravated pain.
03Patients described sciatica before the trial as disrupting mobility, daily living, work, leisure, sleep and mood.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study interviewed 21 patients from one physiotherapy arm of a pilot trial, so it describes those patients' views rather than all people with sciatica. It was done in one National Health Service Trust in the UK, so it may not apply to other health systems. Data saturation was not reached for all interview topics, especially reasons for not proceeding with surgery, because only five patients did not have surgery. The paper reports qualitative experiences, not measured treatment effects, so it cannot show whether physiotherapy worked better than usual care or surgery.
The easy way to misread this
Do not read these patient views as proof that physiotherapy before microdiscectomy works or prevents surgery. The study is qualitative and small, and it reports what patients said about their experience, not measured outcomes.