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. 1998 Jun;32(2):174–177. doi: 10.1136/bjsm.32.2.174

Achilles tendon rupture and sciatica: a possible correlation

N Maffulli, A S Irwin, M G Kenward, F Smith, R W Porter
PMCID: PMC1756077  PMID: 9631229

Abstract

The association between Achilles tendon rupture and sciatica was investigated by questionnaire in 138 patients who underwent repair of an Achilles tendon rupture, and in a group of individuals nominated by the patients, matched for age, sex, and occupation. A total of 102 patients (74%) and 128 peer nominated controls (71%) replied to the questionnaire. Of the 102 respondent patients, 18 had an officebased job, 47 were involved in skilled nonmanual work, and 16 were retired. Back pain had been experienced by 63 of the patients who replied to the questionnaire, and by 91 (75%) of the individuals in the control group (difference not significant). In about 30% of both groups, the pain confined them to bed for at least two days, and resulted in absence from work. Thirteen of the patients and 16 of the controls had undergone thoracic, lumbar, or sacral radiography. One individual in each group had received surgery for back pain. However, 35 of 102 patients had experienced sciatic pain before Achilles tendon rupture. Pain of a similar nature had been experienced by only 15 individuals in the control group (12%) (p < 0.001). Using this study design, we found a highly significant association between Achilles tendon rupture and sciatica. We propose that this association could be due to impaired afferent signals from the lower leg, or to similar collagen or vascular anomalies of the vertebral disc and the Achilles tendon. 




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Selected References

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  1. Agius R. M., Lloyd M. H., Campbell S., Hutchison P., Seaton A., Soutar C. A. Questionnaire for the identification of back pain for epidemiological purposes. Occup Environ Med. 1994 Nov;51(11):756–760. doi: 10.1136/oem.51.11.756. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Balasubramaniam P., Prathap K. The effect of injection of hydrocortisone into rabbit calcaneal tendons. J Bone Joint Surg Br. 1972 Nov;54(4):729–734. [PubMed] [Google Scholar]
  3. Battié M. C., Videman T., Gill K., Moneta G. B., Nyman R., Kaprio J., Koskenvuo M. 1991 Volvo Award in clinical sciences. Smoking and lumbar intervertebral disc degeneration: an MRI study of identical twins. Spine (Phila Pa 1976) 1991 Sep;16(9):1015–1021. [PubMed] [Google Scholar]
  4. Boden S. D., Davis D. O., Dina T. S., Patronas N. J., Wiesel S. W. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990 Mar;72(3):403–408. [PubMed] [Google Scholar]
  5. Boshuizen H. C., Bongers P. M., Hulshof C. T. Self-reported back pain in fork-lift truck and freight-container tractor drivers exposed to whole-body vibration. Spine (Phila Pa 1976) 1992 Jan;17(1):59–65. doi: 10.1097/00007632-199201000-00010. [DOI] [PubMed] [Google Scholar]
  6. Brinckmann P., Porter R. W. A laboratory model of lumbar disc protrusion. Fissure and fragment. Spine (Phila Pa 1976) 1994 Jan 15;19(2):228–235. doi: 10.1097/00007632-199401001-00019. [DOI] [PubMed] [Google Scholar]
  7. Burkhart S. S., Wood M. B., Linscheid R. L. Posttraumatic recurrent subluxation of the extensor carpi ulnaris tendon. J Hand Surg Am. 1982 Jan;7(1):1–3. doi: 10.1016/s0363-5023(82)80002-6. [DOI] [PubMed] [Google Scholar]
  8. Eckhardt W. A., Palmer A. K. Recurrent dislocation of extensor carpi ulnaris tendon. J Hand Surg Am. 1981 Nov;6(6):629–631. doi: 10.1016/s0363-5023(81)80151-7. [DOI] [PubMed] [Google Scholar]
  9. Kenward M. G., Jones B. Alternative approaches to the analysis of binary and categorical repeated measurements. J Biopharm Stat. 1992;2(2):137–170. doi: 10.1080/10543409208835036. [DOI] [PubMed] [Google Scholar]
  10. Kitano T., Zerwekh J. E., Usui Y., Edwards M. L., Flicker P. L., Mooney V. Biochemical changes associated with the symptomatic human intervertebral disk. Clin Orthop Relat Res. 1993 Aug;(293):372–377. [PubMed] [Google Scholar]
  11. Kvist M., Józsa L., Järvinen M. Vascular changes in the ruptured Achilles tendon and paratenon. Int Orthop. 1992;16(4):377–382. doi: 10.1007/BF00189623. [DOI] [PubMed] [Google Scholar]
  12. Ma G. W., Griffith T. G. Percutaneous repair of acute closed ruptured achilles tendon: a new technique. Clin Orthop Relat Res. 1977 Oct;(128):247–255. [PubMed] [Google Scholar]
  13. Maffulli N., Dymond N. P., Regine R. Surgical repair of ruptured Achilles tendon in sportsmen and sedentary patients: a longitudinal ultrasound assessment. Int J Sports Med. 1990 Feb;11(1):78–84. doi: 10.1055/s-2007-1024767. [DOI] [PubMed] [Google Scholar]
  14. Maffulli N., Regine R., Angelillo M., Capasso G., Filice S. Ultrasound diagnosis of Achilles tendon pathology in runners. Br J Sports Med. 1987 Dec;21(4):158–162. doi: 10.1136/bjsm.21.4.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Olczyk K. Age-related changes in collagen of human intervertebral disks. Gerontology. 1992;38(4):196–204. doi: 10.1159/000213328. [DOI] [PubMed] [Google Scholar]
  16. Palmer A. K., Skahen J. R., Werner F. W., Glisson R. R. The extensor retinaculum of the wrist: an anatomical and biomechanical study. J Hand Surg Br. 1985 Feb;10(1):11–16. doi: 10.1016/s0266-7681(85)80006-1. [DOI] [PubMed] [Google Scholar]
  17. Rayan G. M. Recurrent dislocation of the extensor carpi ulnaris in athletes. Am J Sports Med. 1983 May-Jun;11(3):183–184. doi: 10.1177/036354658301100314. [DOI] [PubMed] [Google Scholar]
  18. Riihimäki H., Viikari-Juntura E., Moneta G., Kuha J., Videman T., Tola S. Incidence of sciatic pain among men in machine operating, dynamic physical work, and sedentary work. A three-year follow-up. Spine (Phila Pa 1976) 1994 Jan 15;19(2):138–142. doi: 10.1097/00007632-199401001-00003. [DOI] [PubMed] [Google Scholar]
  19. Rowland S. A. Acute traumatic subluxation of the extensor carpi ulnaris tendon at the wrist. J Hand Surg Am. 1986 Nov;11(6):809–811. doi: 10.1016/s0363-5023(86)80227-1. [DOI] [PubMed] [Google Scholar]
  20. Rowley D. I., Scotland T. R. Rupture of the Achilles tendon treated by a simple operative procedure. Injury. 1982 Nov;14(3):252–254. doi: 10.1016/0020-1383(82)90138-3. [DOI] [PubMed] [Google Scholar]
  21. Spinner M., Kaplan E. B. Extensor carpi ulnaris. Its relationship to the stability of the distal radio-ulnar joint. Clin Orthop Relat Res. 1970 Jan-Feb;68:124–129. [PubMed] [Google Scholar]
  22. Taleisnik J., Gelberman R. H., Miller B. W., Szabo R. M. The extensor retinaculum of the wrist. J Hand Surg Am. 1984 Jul;9(4):495–501. doi: 10.1016/s0363-5023(84)80100-8. [DOI] [PubMed] [Google Scholar]
  23. VULPIUS J. HABITUAL DISLOCATION OF THE EXTENSOR CARPI ULNARIS TENDON. Acta Orthop Scand. 1964;34:105–108. doi: 10.3109/17453676408989307. [DOI] [PubMed] [Google Scholar]
  24. Williams J. G. Achilles tendon lesions in sport. Sports Med. 1986 Mar-Apr;3(2):114–135. doi: 10.2165/00007256-198603020-00003. [DOI] [PubMed] [Google Scholar]
  25. Yahia H., Drouin G., Maurais G., Garzon S., Rivard C. H. Degeneration of the human lumbar spine ligaments. An ultrastructural study. Pathol Res Pract. 1989 Apr;184(4):369–375. doi: 10.1016/S0344-0338(89)80031-7. [DOI] [PubMed] [Google Scholar]

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