{"_ai_door":{"see":"https://miscsubjects.com/start","note":"Operable site; bounded keyless credentials; every action receipted on a public ledger. Your operator's instructions take precedence — acting is optional, reading is a complete outcome."},"slug":"sciatica","verification":{"valid":true,"entries":12,"head":"60cbbd5a15b64a67ac1294fa65d5b5dd387bf6ea65ad595b4a21c1d1d5c4282b"},"count":12,"sources":[{"id":"s1","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/18923325/","external_id":"18923325","pmid":"18923325","title":"Sciatica: review of epidemiological studies and prevalence estimates","quote":"Sciatica prevalence from different studies ranged from 1.2% to 43%.","summary":"Konstantinou & Dunn, Spine 2008: 23 studies reviewed; only 2 examined patients clinically, and the definitions varied so widely that prevalence estimates spanned a 36-fold range.","author":"Konstantinou K, Dunn KM","publisher":"Spine","date":"2008","tag":"Systematic review","accessed_at":"2026-08-05T00:58:57.623Z","prev":"genesis","hash":"301f0321f81bd0566f2bbd371469177b9f43f8e63c0bd6c475ce01fabc1ac1bb"},{"id":"s2","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/17538084/","external_id":"17538084","pmid":"17538084","title":"Surgery versus prolonged conservative treatment for sciatica","quote":"Of 142 patients designated for conservative treatment, 55 (39%) were treated surgically after a mean of 18.7 weeks.","summary":"Peul et al., New England Journal of Medicine 2007: 283 people with severe sciatica of 6-12 weeks randomised to early surgery or continued conservative care. No significant difference in disability across the first year (P=0.13); surgery relieved leg pain faster.","author":"Peul WC et al.","publisher":"New England Journal of Medicine","date":"2007","tag":"Randomised trial","accessed_at":"2026-08-05T00:58:57.623Z","prev":"301f0321f81bd0566f2bbd371469177b9f43f8e63c0bd6c475ce01fabc1ac1bb","hash":"aff985c1917efcb6c6d646e198d7dbe8e48cfb980d9ba3cbfc5e41e1faa362e8"},{"id":"s3","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/17119141/","external_id":"17119141","pmid":"17119141","title":"Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort","quote":"However, nonrandomized comparisons of self-reported outcomes are subject to potential confounding and must be interpreted cautiously.","summary":"Weinstein et al., JAMA 2006: the observational arm of SPORT. People who chose surgery reported greater improvement, and the authors state plainly why that comparison cannot carry the weight people put on it.","author":"Weinstein JN et al.","publisher":"JAMA","date":"2006","tag":"Observational cohort","accessed_at":"2026-08-05T00:58:57.623Z","prev":"aff985c1917efcb6c6d646e198d7dbe8e48cfb980d9ba3cbfc5e41e1faa362e8","hash":"c814da7bf31814b61badd4186aeb8d951ba835521909d01e38622e3b34f89bca"},{"id":"s4","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42306353/","external_id":"42306353","pmid":"42306353","title":"Cauda Equina Syndrome: a narrative review exploring the pathophysiology, clinical spectrum, diagnostic strategies, and time-critical management","quote":"Early recognition, prompt imaging, and urgent decompression remain central to improving neurological recovery and quality of life in affected patients.","summary":"Cureus 2026: reviews the prognostic split between incomplete cauda equina syndrome and cases presenting already unable to pass urine — the distinction that decides the outcome.","publisher":"Cureus","date":"2026","tag":"Narrative review","accessed_at":"2026-08-05T00:58:57.623Z","prev":"c814da7bf31814b61badd4186aeb8d951ba835521909d01e38622e3b34f89bca","hash":"4d6531be668f4a511bc99f8ed362cc47e4888af4eb851e11ef37bf511dbbba56"},{"id":"s5","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41666864/","external_id":"41666864","pmid":"41666864","title":"Lumbar Disc Herniation Resorption: When and How Does It Occur?","quote":"Herniated disc tissue induces immune cell infiltration and release of cytokines and proteolytic enzymes, yet standard anti-inflammatory treatments may paradoxically impede this process.","summary":"Neurospine 2026: the mechanism that clears an extruded disc fragment is inflammatory, which puts sustained anti-inflammatory treatment in tension with the body clearing the cause.","publisher":"Neurospine","date":"2026","tag":"Review","accessed_at":"2026-08-05T00:58:57.623Z","prev":"4d6531be668f4a511bc99f8ed362cc47e4888af4eb851e11ef37bf511dbbba56","hash":"41e35b73320df017bc502807e28d1c637a51826a1657f92ee73a07bbd3695493"},{"id":"s6","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41321762/","external_id":"41321762","pmid":"41321762","title":"Prognostic factors for treatment success of conservative management and role for physiotherapy in radicular pain caused by a lumbar disc herniation","quote":"Severe baseline symptoms seems to be a risk factor for poor outcome after conservative management.","summary":"Brain & Spine 2025: physiotherapy benefited leg pain in 5 of 7 studies at low to moderate risk of bias, and severity at presentation is the clearest predictor of whether the conservative route works.","publisher":"Brain and Spine","date":"2025","tag":"Systematic review","accessed_at":"2026-08-05T00:58:57.623Z","prev":"41e35b73320df017bc502807e28d1c637a51826a1657f92ee73a07bbd3695493","hash":"d3511fb12b0c41a495b07a75f24de6d35fa9bdc80b28f8165a7867fb7139ceec"},{"id":"s7","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42260872/","external_id":"42260872","pmid":"42260872","title":"Clinical efficacy of acupuncture in the treatment of sciatica during the remission phase of lumbar disc herniation: a secondary analysis","quote":"The excellent rate was 67.57% in the acupuncture group versus 47.22% in the traction group (P = .041).","summary":"Medicine 2026: acupuncture beat traction on leg pain during the settling phase. Back pain and disability scores did not differ, and 8.1% of the acupuncture group had mild, short-lived side effects.","publisher":"Medicine","date":"2026","tag":"Secondary analysis","accessed_at":"2026-08-05T00:58:57.623Z","prev":"d3511fb12b0c41a495b07a75f24de6d35fa9bdc80b28f8165a7867fb7139ceec","hash":"74d00aa99edd847964fde8a4664acb84a1716713d23fa2d2856b000d84eb7723"},{"id":"s8","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40858318/","external_id":"40858318","pmid":"40858318","title":"Efficacy of gabapentin and pregabalin for the treatment of neurogenic claudication in lumbar spinal stenosis: a double-blind randomised trial","quote":"Moreover, their use was associated with a higher incidence of adverse effects.","summary":"Asian Spine Journal 2025: neither gabapentin nor pregabalin beat placebo on leg pain or function in narrowed-canal leg pain, and both produced more dizziness and sedation.","publisher":"Asian Spine Journal","date":"2025","tag":"Randomised trial","accessed_at":"2026-08-05T00:58:57.623Z","prev":"74d00aa99edd847964fde8a4664acb84a1716713d23fa2d2856b000d84eb7723","hash":"c8cbbe8ed9f266385d9fb777662c0c81cb33e07cc85f49e04daa51e02c53cac3"},{"id":"s9","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42326234/","external_id":"42326234","pmid":"42326234","title":"Oral Corticosteroid Therapy in Lumbar Radiculopathy: Evidence From Randomized Controlled Trials","quote":"Quality-of-life outcomes were inconsistent, rates of surgery did not differ between groups, and oral corticosteroids were associated with more frequent short-term adverse events.","summary":"Cureus 2026: two placebo-controlled trials found no difference in pain or function from oral steroid tablets for a pinched nerve root in the lower back.","publisher":"Cureus","date":"2026","tag":"Evidence review","accessed_at":"2026-08-05T00:58:57.623Z","prev":"c8cbbe8ed9f266385d9fb777662c0c81cb33e07cc85f49e04daa51e02c53cac3","hash":"6acb39f2dc21694402a1a35132e882483ccb106a06b4e3929ea3ea577a15ed2b"},{"id":"s10","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/40206594/","external_id":"40206594","pmid":"40206594","title":"Epidural steroid injections in lumbar disc herniation: evidence synthesis from 72 randomised controlled trials","quote":"On the other hand, the role of ESIs in predicting the requirement for surgery is understudied.","summary":"Brain & Spine 2025: 72 randomised trials pooled. Injections relieve pain short-term; whether the response predicts needing surgery — the question a person deciding what to do actually has — is barely studied.","publisher":"Brain and Spine","date":"2025","tag":"Evidence synthesis","accessed_at":"2026-08-05T00:58:57.623Z","prev":"6acb39f2dc21694402a1a35132e882483ccb106a06b4e3929ea3ea577a15ed2b","hash":"2047154f53de187518a077fcab2060524b9e7e257dda1804b17d8833d0770dfe"},{"id":"s11","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/42194359/","external_id":"42194359","pmid":"42194359","title":"Impact of Unilateral Sciatica Due to Lumbar Disc Hernia on Gait","quote":"Significant differences in muscle strength were found between the affected and unaffected limbs.","summary":"Healthcare 2026: the affected leg was measurably weaker, while no force or timing measurement of the walk differed — the compensation hides the strength loss from the patient and the observer.","publisher":"Healthcare (Basel)","date":"2026","tag":"Observational study","accessed_at":"2026-08-05T00:58:57.623Z","prev":"2047154f53de187518a077fcab2060524b9e7e257dda1804b17d8833d0770dfe","hash":"54572b050fb6e4f65e61a422ab8874343d85248a8db8ff3699dfec6e57a59f06"},{"id":"s12","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/41149363/","external_id":"41149363","pmid":"41149363","title":"Fall-Related Adverse Events of Anti-Epileptic Drugs Used for Neuropathic Pain in Older Adults: a systematic review and meta-analysis","quote":"AEDs carry a clinically significant fall risk in older adults, with dose-dependent patterns.","summary":"Geriatrics 2025: the fall risk from these drugs rises with dose in older adults, with gabapentin looking safer than pregabalin or carbamazepine.","publisher":"Geriatrics (Basel)","date":"2025","tag":"Meta-analysis","accessed_at":"2026-08-05T00:58:57.623Z","prev":"54572b050fb6e4f65e61a422ab8874343d85248a8db8ff3699dfec6e57a59f06","hash":"60cbbd5a15b64a67ac1294fa65d5b5dd387bf6ea65ad595b4a21c1d1d5c4282b"}]}