Table 2.
Baseline characteristics of sciatica patients by referral status (to spinal specialist services) and unadjusted and adjusted odds ratios of association with referral
| Not referred (n = 372) | Referred (n = 57) | Unadjusteda OR (95% CI) |
Adjustedb OR (95% CI) |
|
|---|---|---|---|---|
| Block 1 | ||||
| Impaired performance at work or cannot do jobs around the house: Yes*, n (%) | 200 (53.8) | 43 (75.4) | 2.64 (1.40, 4.99) | 2.17 (1.13, 4.17) |
| Block 2 | ||||
| Intensity of usual back pain in the last 2 weeks, mean (SD) | 7.0 (2.2) | 7.4 (2.1) | 1.10 (0.96, 1.26) | |
| Intensity of usual leg pain in the last 2 weeks, mean (SD) | 6.7 (2.3) | 8.0 (1.8) | 1.32 (1.14, 1.53) | |
| Intensity of current back pain, mean (SD) | 5.4 (2.7) | 6.3 (2.6) | 1.13 (1.02, 1.27) | |
| Intensity of current leg pain, mean (SD) | 5.5 (2.9) | 6.9 (2.5) | 1.20 (1.07, 1.34) | 1.17 (1.05–1.31) |
| Sciatica Bothersomeness (0–6): total score, median (IQR) | ||||
| Leg pain | 5 (3, 6) | 6 (4, 6) | 1.58 (1.22, 2.05) | |
| Numbness or tingling in leg, foot or groin (Paraesthesia) | 4 (2, 5) | 5 (3, 6) | 1.25 (1.06, 1.48) | |
| Weakness in leg or foot | 3 (1, 4) | 4 (2, 5) | 1.20 (1.04, 1.38) | |
| Back or leg pain while sitting | 4 (3, 5) | 5 (3, 6) | 1.34 (1.09, 1.65) | |
| Sciatica bothersomeness composite score (0–24): mean (SD) | 14.6 (5.1) | 17.6 (4.5) | 1.13 (1.06, 1.21) | |
| Block 3 | ||||
| Pain self-efficacy (0–60), mean (SD) | 34.1 (14.5) | 28.0 (15.0) | 0.97 (0.95, 0.99) | – |
| Illness perception (identity), median (IQR) | 6 (5, 7) | 6 (5, 7) | 1.23 (0.96, 1.57) | |
| Block 4 | ||||
| What is worse: Leg pain is worse, n (%) | 206 (55.4) | 35 (61.4) | 1.28 (0.72, 2.27) | |
| Tingling/numbness: Yes, n (%) | 241 (64.8) | 40 (70.2) | 1.28 (0.70, 2.34) | |
| Cough/sneeze positive: Yes, n (%) | 97 (26.1) | 20 (35.1) | 1.53 (0.85, 2.77) | |
| Block 5 | ||||
| Abnormal myotomal strength: Yes, n (%) | 82 (22.0) | 20 (35.1) | 1.91 (1.05, 3.47) | |
| Reflex, n (%) | ||||
| Normal | 282 (75.8) | 41 (71.9) | ||
| Slightly reduced | 28 (7.5) | 2 (3.5) | 0.49 (0.11, 2.14) | |
| Absent | 46 (12.4) | 11 (19.3) | 1.64 (0.79, 3.43) | |
| Significantly reduced | 16 (4.3) | 3 (5.3) | 1.29 (0.36, 4.62) | |
| Sensation (Pin Prick), n (%) | ||||
| Normal | 190 (51.1) | 20 (35.1) | ||
| Reduced sensation | 142 (38.2) | 26 (45.6) | 1.74 (0.93, 3.24) | 1.59 (0.84–3.00) |
| Loss of sensation | 40 (10.8) | 11 (19.3) | 2.61 (1.16, 5.88) | 2.41 (1.05–5.53) |
| Neural test: any positive: Yes, n (%) | 272 (73.1) | 40 (70.2) | 0.87 (0.47, 1.60) | |
*Evidence of interference with ability to do work/home activities if > 6 (NRS 0–10) on single question on work interference or ‘yes’ response on the RMDQ item
a Univariable association between each variable and referral to secondary care, variables with p < 0.05 are bolded
b Multivariable model was fitted in two stages: (1) within each block: block 1 only had one variable; block 2 had 9 variables, however, variables within this block were all highly correlated with each other and could not be included in the same multivariable model, current leg pain was chosen on clinical grounds to be the only variable progressed to multivariable model; block 3 had two variables but one was not significant when adjusted within the block and was dropped; block 4 had 3 variables, none were significant when adjusted for each other within the block; block 5 had 4 variables, only one was significant when adjusted within the block; (2) overall adjusted model comprising all variables significant in the adjusted models within blocks: the following variables were entered in the initial overall multivariable model: impaired performance at work or cannot do jobs around the house, intensity of current leg pain, pain self-efficacy, and sensation. Pain self-efficacy was not significant and was dropped from the final model