Rheumatology Advance Access originally published online on September 16, 2003
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Rheumatology 2004; 43: 119-121
© British Society for Rheumatology 2003; all rights reserved
Editorial |
TNF-
blockade for herniated intervertebral disc-induced sciatica: a way forward at last?
1University of Manchester Rheumatic Diseases Centre, Hope Hospital, Salford 2Laboratory Medicine Academic Group, University of Manchester, Manchester, UK
Correspondence to: R. G. Cooper, Rheumatic Diseases Centre, Hope Hospital, Salford M6 8HD, UK. E-mail: rcooper@fs1.ho.man.ac.uk
| The first 150 words of the full text of this article appear below. |
Following the recognition that diagnostic triage is fundamental to the delivery and organization of services for low back pain (LBP) patients [1, 2], physiotherapy-led LBP triage and treatment clinics have proliferated. Although such developments have improved the speed and accessibility of such services to LBP patients, they have also meant that many rheumatologists now rarely see LBP patients. This especially applies to those with suspected herniated intervertebral discs (HIDs), who would usually be triaged surgically. Although representing only a small portion of the spectrum of degenerative disc disease problems [3], HIDs are still a common cause of back and radicular pain, and the natural history dictates that symptoms gradually resolve spontaneously, with a good functional outcome in most cases [4]. However, in some patients back and especially sciatic symptoms fail to resolve sufficiently quickly, or at all, so prompting decompressive surgery. Despite radiologically
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