Observational multicentric study on chronic sciatic pain: clinical data from 44 Italian centers

OBJECTIVE: To provide informa- tion on the clinical presentation of sciatic neu- ropathy and its management in a real-world set- ting, and to analyze the effects of a multimodal approach based on the association of physical and pharmacological therapy. PATIENTS AND METHODS: A multicentric ob- servational prospective study was conducted in 44 Italian tertiary centers specialized in Physical Medicine and Rehabilitation, Orthopedics, Neu- rology, Neurosurgery, and Rheumatology. To de- velop a shared management of LPB with sciat- ica, a dedicated clinical record was proposed to collect data about diagnosis, treatment, and outcomes. Pain, disability, and quality of life were recorded trough validated questionnaires at baseline and after a two-month follow-up. RESULTS: 394 patients (age, mean ± SD 55.7 ± 14.1 years, 57.1% females) with chronic LBP and sciatica were enrolled in the study. The charac- teristics of the selected group showed a certain variability in the clinical presentation. At base- line, patients received several different thera- peutic options among physical, pharmacolog- ical and neurotrophic treatments. A subgroup of 312 patients was treated with a combination of neurotrophic agents containing alpha-lipoic acid (ALA). After a two-month follow-up, a gen- eral improvement in both perceived pain and functional disabilities was observed. A signi - cant improvement (p < 0.001) in the Pain Numer- ic Rating Scale (NRS), Roland e Morris Disability Questionnaire (RMDQ) and Brief Pain Inventory (BPI) Italian short version was observed. CONCLUSIONS: Sciatic neuropathy is a multi- faceted condition managed by means of a wide spectrum of therapeutic options. The results of this study suggest that a multimodal approach based on the association of ALA with physical and pharmacological therapies can be bene - cial in the treatment of LBP with sciatica.