Medicalization of sciatica and its treatment

Abstract

Sciatica is a common back problem with a generally positive natural course. This interview study was performed to gain increased insight into ambivalent and reluctant medicalization on the interactional level regarding the perceptions of Dutch patients and physicians about sciatica and its treatment options as a case study. While the concept of medicalization was introduced decades ago, nuanced perspectives on medicalization on the interactional level—ambivalent and reluctant medicalization—were added recently. Interviews were conducted with 10 patients and 22 clinicians and analyzed using these perspectives. The findings show that patients and clinicians share the problem definition of sciatica, which is stated to be the essence of medicalization. They differ from each other regarding the preferred course of action after diagnosis. Ambivalent and reluctant medicalization both highlight that medicalization in practice is often an uncertain and contested process, with medical intervention as a compromise result. In this case, the problem was not in the diagnosis but in reaching a treatment compromise, considering how much discomfort due to sciatica a patient could handle.