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Chiropractic Research Review

Leg Pain May Indicate Severity of Back Pain

Patients with sciatica may suffer significantly more disability than patients with lower-back pain alone. For this reason, evidence of nerve root irritation should be taken into account in the assessment of patients with low-back pain.

Four hundred twenty-eight patients were studied to determine a method of categorizing patients with low-back pain, by combining patient reports of radiating leg pain with the results of straight-leg-raising tests.

Results demonstrated that this method worked well in identifying patients with different levels of low-back-pain intensity. Patients were placed into four groups: 1) report of low-back pain alone; 2) report of low-back pain radiating into the thigh; 3) report of low-back pain radiating below the knee with negative straight-leg-raising tests; and 4) report of low-back pain radiating below the knee with positive straight-leg-raising tests.

The method also seemed to correspond well with differences in health-related quality of life scores and disability days which were assessed during the course of the study.

The study method of categorizing patients with low-back pain appears to be a practical approach to characterizing low-back pain. It may be important for future research to develop a case-mix adjustment for low-back pain based on factors that determine both the pain intensity and the extent of radiating leg pain.

Selim AJ, Ren XS, et al. The importance of radiating leg pain in assessing health outcomes among patients with low back pain. Results from the Veterans Health Study. Spine, Feb. 1998;23(4), pp470-74.

Chiropractic Research Review

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