Sciatica Patients Research Articles

Acupuncture Modulation of Chronic Neuropathic Pain and Its Association With Brain Functional Properties

Chronic neuropathic pain has been one of the prominent causes of disability, and acupuncture has shown promise in treatment. The present study aimed to characterize acupuncture modulation of chronic neuropathic pain and explore the related functional brain changes. Sixty chronic sciatica patients were divided into acupuncture- or sham acupuncture groups and received 10 sessions of treatment during 4 weeks. The visual analog scale for leg pain, oswestry disability index (ODI), and resting-state functional magnetic resonance images were assessed at baseline and after treatment. Then, fractional amplitudes of low-frequency fluctuations (fALFF) and support vector regression analyses were performed. Compared with sham acupuncture, acupuncture significantly improved symptoms, including visual analog scale for leg pain and ODI. In addition, acupuncture exhibited increased fALFF of the right superior parietal lobule (SPL) and right postcentral gyrus. Furthermore, the actual 4-week ODI values were positively correlated with the support vector regression-predicted values based on the right SPL fALFF and baseline clinical measurements. These results indicate that the spontaneous neural activity of the right SPL and right postcentral gyrus may be involved in the modulation of acupuncture in chronic neuropathic pain. In addition, the spontaneous neural activity of the right SPL might be used as the predictor of response to acupuncture therapy. PerspectiveThis clinical neuroimaging study elucidated the neural basis of acupuncture in chronic sciatica. Neurological indicators and clinical measurements could be used as potential predictors of acupuncture response. This study combines neuroimaging and artificial intelligence techniques to highlight the potential of acupuncture for the treatment of chronic neuropathic pain. Trial registration numberChinese Clinical Trial Registry, ChiCTR2100044585, http://www.chictr.org.cn.

Causal association between circulating inflammatory markers and sciatica development: a Mendelian randomization study.

This research explores the causal association between circulating inflammatory markers and the development of sciatica, a common and debilitating condition. While previous studies have indicated that inflammation may be a factor in sciatica, but a thorough genetic investigation to determine a cause-and-effect relationship has not yet been carried out. Gaining insight into these interactions may uncover novel treatment targets. We utilized data from the OpenGWAS database, incorporating a large European cohort of 484,598 individuals, including 4,549 sciatica patients. Our study focused on 91 distinct circulating inflammatory markers. Genetic variations were employed as instrumental variables (IVs) for these markers. The analysis was conducted using inverse variance weighting (IVW) as the primary method, supplemented by weighted median-based estimation. Validation of the findings was conducted by sensitivity studies, utilizing the R software for statistical computations. The analysis revealed that 52 out of the 91 inflammatory markers studied showed a significant causal association with the risk of developing sciatica. Key markers like CCL2, monocyte chemotactic protein-4, and protein S100-A12 demonstrated a positive correlation. In addition, there was no heterogeneity or horizontal pleiotropy in these results. Interestingly, a reverse Mendelian randomization analysis also indicated potential causative effects of sciatica on certain inflammatory markers, notably Fms-related tyrosine kinase 3 ligands. The study provides robust evidence linking specific circulating inflammatory markers with the risk of sciatica, highlighting the role of inflammation in its pathogenesis. These findings could inform future research into targeted treatments and enhance our understanding of the biological mechanisms underlying sciatica.

Prevalence of priformis syndrome in sciatica patients: Predictability of specific tests and radiological findings for diagnosis.

The traditional approach for diagnosing piriformis syndrome (PS) is to rule out other causes of sciatica. This approach may lead to unnecessary radiological examinations and a waste of time. In contrast to the traditional approach, we aimed to first exclude PS and determine its prevalence by injecting patients with priformis tenderness. This observational cross-sectional study included patients diagnosed with PS who had sciatica and tenderness on palpation of the priformis muscle and whose pain was reduced by at least 50% with local injection. Age, sex, pain duration, presence of tenderness in the piriformis muscle, Freiberg test, PACE sign, FADIR, Visual Analog Scale (VAS) score, Douleur Neuropathique 4 Questions (DN4) score, and radiological findings were compared between patients who responded and those who did not respond to the priformis injection. A total of 110 patients with sciatica were evaluated, of whom 66 with tenderness on palpation of the primiformis muscle underwent local injection. In 27 of the 66 patients (40.9%), a decrease in the NRS score of >50% was observed after injection, and PS was diagnosed. There were no statistically significant differences in age, sex, pain duration, Pace, FADIR test positivity, radiological findings, NRS, and DN4 scores, but Freiberg test positivity was statistically higher in patients diagnosed with PS. PS is more common than is thought to be a cause of sciatica. A positive Freiberg test is predictive for the diagnosis of PS, but it should be confirmed by tenderness of the priformis muscle and local injection. Many pathologies can be detected incidentally radiographically in PS; however, they are not predictive of the diagnosis.

Effects of Neurodynamics Along With Conventional Exercises on Sciatica Patients: A Single-Blinded Randomized Clinical Trial.

Introduction Sciatica refers to a pain that travels along the course of the sciatic nerve. Patients also often experience paresthesia along with the pain in thighs, which may further radiate to the legs. Most commonly, compression of the lumbosacral nerve root is the cause of this syndrome. Neurodynamics and conventional exercises are considered effective treatment procedures for sciatica. This study aims to find out the efficacy of neurodynamics along with conventional exercises and conventional exercises alone. Methods A total of 58 patients with sciatica aged between 30 and 60 years of both genders were included in the study and randomly divided into a neurodynamic group (n=29) and a conventional group (n=29). Pre-test data were collected before the interventions, and post-test data were collected on the 14th day. The 101 numeric pain rating scale (NPRS) was used to measure data of sciatic pain, the patient-specific functional scale (PSFS) was used to measure the health-related quality of life (HRQL), and a surface electromyography (EMG) biofeedback instrument was used to measure the peak and average muscle activation of the biceps femoris muscle. Results The pre-post data analysis of the neurodynamics and conventional group showed significant (p<0.05) improvement in 101 NPRS, PSFS, and peak EMG values. Insignificant (p>0.05) improvements were seen in average EMG values in the conventional group, and significant (p<0.05) improvement were seen in the neurodynamic group. Between-group analysis showed insignificant (p>0.05) differences in 101 NPRS as well as peak and average EMG values and showed significant (p<0.05) differences in PSFS values. Conclusion Neurodynamics with conventional exercises can help in reducing pain, improving muscle activation of the biceps femoris, and elevating the HRQL of the patient.

Clinical Characteristics of Sciatica in Patients with Piriformis Syndrome Improved by Decompression Surgery

Objective: To clearly identify the symptoms of sciatica in patients with piriformis syndrome, we retrospectively reviewed patients whose symptoms significantly improved over long-term postoperative follow-up. Methods: Among patients who underwent sciatic nerve decompression for piriformis syndrome over the past 3 years, the preoperative sciatic pain symptoms of 32 patients whose symptoms were confirmed to have improved by more than 50% during more than 1 year of follow-up were analyzed. To identify the characteristics of sciatic pain in piriformis syndrome, we investigated pain when sitting, pain when resting, pain when standing or walking, and pain when resting at night. In addition, the distribution of sciatic pain in the lower back, buttocks, lower extremities, and feet was investigated. Results: The most common symptom was pain when sitting, which was present in 25 patients (81%). Pain characteristically occurred even at rest, occurring in 62.5% of patients while lying down at night and in 53.1% of patients during daytime rest. Sciatic pain from piriformis syndrome was most commonly distributed in the buttock (90.6%) and also present in the lower back (37.5%). Pain was present in the posterior thigh in 23 patients (71.9%), in the calf in 68.8% of patients, and in the foot in 50% of patients. Conclusion: Buttock pain exacerbated by sitting was the most common pattern of pain in patients with piriformis syndrome. However, the sciatic pain of this disease was also found to be characterized by pain that persisted even at rest.

Plant-Derived Medicines for Sciatica: A Comprehensive Review

Sciatica commonly refers to radicular leg pain which is mainly caused by lumbar disc herniation (LDH) and affects the daily functional ability of many patients in the world. However, according to the side effects and short-term benefits of its treatments, new therapeutic agents such as natural products are needed. The aim of this study was to comprehensively review the effectiveness of plant-derived products for the treatment of sciatica. Electronic databases, including Medline (via PubMed), Scopus, and Web of Science, were searched from inception to 17 August 2023 for this comprehensive review. English language papers reporting preclinical and clinical evaluations of the effectiveness of herbal products, including medicinal plants, multi-component herbal preparations, and phytochemicals on sciatica, radicular pain, or LDH, were included. Studies on neuropathic pain due to reasons other than sciatica, radicular pain, or LDH were excluded. From a total of 5666 papers identified in the primary search, 16 (including 4 clinical and 12 preclinical studies) were finally included. Most of the plant-derived treatments mentioned in this review belonged to the polyphenol family or contained high concentrations of various polyphenols. From the results obtained, polyphenols relieved sciatica by reducing inflammation and oxidative stress, mainly through the inhibition of mitogen-activated protein kinases pathways. In conclusion, plant-derived medicines have the potential to improve the quality of life and functional ability of sciatica patients by relieving symptoms. However, further preclinical and clinical studies are suggested to prove the safety and efficacy of such herbal medicines for sciatica.

The Mckenzie Methodwith Interferential Therapy on Acute Low Back Pain (Sciatica) Patients: A Randomised Controlled Clinical Trial

Purpose: To investigate the effect of McKenzie method withInterferential therapy (IFT)when compare to IFTalone on acute low back pain (Sciatica) patients in terms of relieving pain, increasing lumbar extension range of motion and speed of walking.Methods: Randomised controlled clinical trial,fifty seven patients were screened; forty sciatica patients agedfrom 30 to 60 years with no recent injury were selected through the special tests, after randomisation, the experimental group (n-15) was treated with the McKenzie method andInterferential therapy whereas control group (n-15) was treated with the Interferential therapy alone. The primary outcome was the relief of low back pain and increasing the lumbar extension range of motion. The secondary outcome was the speed of walking by measuring the stride length and cadence for 10 meters.Result: The study aimed to compare the pain, lumbar extension range of motion (ROM), stride length, and cadence of two different teams before and after physiotherapy. The experimental team had an average pain score of 7.70 VAS, a lumbar extension range of motion of -3.70 degrees, a stride length of 56.70 cms, and a cadence of 115.35 steps. In post-physiotherapy, the team had an average pain score of 2.20 VAS, a lumbar extension range of motion of 24.85 degrees, a stride length of 58.65 cms, and a cadence of 113.15 steps. The mean difference in pain, ROM, stride length, and cadence was statistically significant. The results suggest that physiotherapy can be a valuable tool for improving pain management and reducing back pain.Conclusion: McKenzie method with Interferential therapy showed greater relief of low back pain, increased lumbar extension range of motion, increased speed of walking in terms of step length and cadence than IFT alone.

Comparison of the Effectiveness of TENS and Low-Level Laser Therapy Applied to the Sciatic Nerve Region in Chronic Lumbar Radiculopathy.

Introduction: This study was carried out to assess and compare the efficacies of transcutaneous electrical nerve stimulation (TENS) and low-level laser therapy (LLLT) applied to sciatic Valleix points to reduce sciatica in patients with chronic lumbar radiculopathy. Methods: The study population consisted of 164 patients with chronic radicular pain caused by LDH. The remaining 75 patients were studied in three groups. TENS and hotpack were applied to the lower back region of all patients. In addition, group 1 (n=24), group 2 (n=25), and group 3 (n=26) received LLLT (4 J/cm2 for each point), TENS, and sham LLLT, respectively, on sciatic Valleix points five days a week, for three weeks (15 sessions). Outcomes were assessed at the beginning of the treatment, after completion of 3 weeks of treatment, and after three months (follow-up). Results: Post-treatment assessments indicated that all parameters investigated within the scope of the study improved in all three groups, except for the VAS leg pain (VASLP) score in group 3. Post-treatment VASLP and DN4 scores of group 1 were significantly superior to those of group 2 (P˂0.001). Follow-up assessments revealed an improvement only in the VASLP score and in group 1. The VASLP, DN-4, and ODI scores of groups 1 and 2 were significantly superior to those of group 3. There was no significant difference between the groups in the PSQI score and lumbar ROM value. Conclusion: Both LLLT and TENS were found to be effective in treating the sciatic nerve associated with lumbar disk herniation with radiculopathy. LLLT was found to be more effective than TENS in reducing leg and neuropathic pains. Follow-up assessments revealed that the only lasting effect of the treatments, which continued into the third month, was the improvement in leg pain.

Importance of Wet Cupping in Sciatica Patients: A Literature Review

Importance of Wet Cupping in Sciatica Patients: A Literature Review

Predictors of outcome in sciatica patients following an epidural steroid injection: the POiSE prospective observational cohort study protocol

IntroductionSciatica can be very painful and, in most cases, is due to pressure on a spinal nerve root from a disc herniation with associated inflammation. For some patients, the pain...

Predisposition of sciatica in different socioeconomic classes: a brief clinical survey

Background: Sciatica became the accepted name for pain radiating from the lower back or buttock into the leg after being distinguished from arthritic hip pain in the 18th century. Several studies suggest strong connection of Socioeconomic status with sciatica. Accurate data on the incidence and prevalence of sciatica is still missing. The objective of this study was to observe a relationship of sciatica patients with their socioeconomic status. Methods: Sixty (60) diagnosed cases of sciatica selected randomly were interrogated and assessed according to the modified Kuppuswamy’s socioeconomic status (SES) scale. Results: It was found that 36.6% were belonging to upper-middle class of society, 35% from lower-middle class, 13.8% from upper-lower class, 8.6% from upper class and only 6.9% were belonging to lower socioeconomic class of society. Conclusions: The current study depicted that the sciatica is more common in middle socioeconomic class followed by upper and lower socioeconomic class respectively.

The McKenzie Method versus guideline-based advice in the treatment of sciatica: 24-month outcomes of a randomised clinical trial

Objective To compare the effectiveness of a McKenzie Method intervention in patients with sciatica with guideline-based patient education. Design Multi-centre, assessor-blinded, parallel-group, randomised trial Setting Two tertiary hospitals providing operative spinal care. Subjects Sciatica patients with magnetic resonance imaging-confirmed lumbar disc herniation compressing a nerve root. Interventions The McKenzie group received specific back exercises for seven visits combined with an educational book, and the Control group received a single session of self-management guidance according to usual practices. Main measures The primary outcome was the number of surgical operations. Secondary outcomes were pain measured using the Visual Analogue Scale, disability using the Oswestry Disability Index and health-related quality of life using a RAND-36 questionnaire at baseline and 24-month follow-up. Results Altogether 66 patients, mean age of 43 years, of which 50% were females with long-lasting sciatica, mean 16 weeks, were randomised to two groups. Nineteen patients (29%) had surgery. There was no significant difference in surgery rates between the groups. Back and leg pain decreased, and disability improved in both groups. Health-related quality of life improved in six dimensions out of eight in both groups. There were no significant between-group changes in the patient-reported outcomes at the follow-up. Conclusions Multiple sessions of McKenzie-based back exercises with a McKenzie-specific patient's educational book produced effects equal to guideline-based advice at long-term follow-up. However, the power of these results is diminished due to the small patient population and confounding factors.

Comparison of magnetic resonance imaging findings among sciatica patients classified as centralizers or non-centralizers

ABSTRACT Objective To compare if the degenerative findings from MRI differ between the sciatica patients classified as centralizers (CEN) and non-centralizers (Non-CEN) according to the McKenzie Method of mechanical diagnosis and therapy. Study Design A cross-sectional study. Methods Patients (N = 100) referred to a spine clinic of a single tertiary hospital for specialist consultation for sciatica. The McKenzie-based assessment was performed by the mechanical diagnosis and therapy-trained physiotherapists. Clinical data and prevalence of lumbar MRI findings were compared between the groups. Results There was no significant difference in leg pain intensity between the groups. The Non-CEN had significantly more intense back pain, mean 56 (SD 30) and were more disabled 44 (SD 15) compared to the CEN mean 41 (SD 25) and mean 31 (11), measured with a visual analogue scale (0–100), and the Oswestry Disability Index (0–100), respectively. The CEN had more severe degenerative findings on MRI than the Non-CEN: vertebral end-plate changes were 63% and 43%; mean Pfirrmann’s disc degeneration lumbar summary score was 12.8, and 10.6; and severity score of total damage was 12.0 and 10.1, respectively. There were differences neither in disc contour changes nor nerve root stenosis on MRI. Conclusions Sciatica patients classified as non-centralizers had significantly more severe back pain, and were significantly more disabled than centralizers, who instead had more severe degenerative findings on MRI. Thus, classification to non-centralizers by the McKenzie method seems not predict higher incidence of degenerative findings on MRI compared to centralizers.

NSAIDs in sciatica (NIS): study protocol for an investigator-initiated multicentre, randomized placebo-controlled trial of naproxen in patients with sciatica

BackgroundNonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to treat sciatica, despite insufficient evidence from placebo-controlled trials. NSAIDs may cause serious side effects; hence, there is a strong need to clarify their potential beneficial effects in patients with sciatica.MethodsThis is a multicentre, randomized, placebo-controlled, parallel-group superiority trial. Participants will be recruited among sciatica patients referred to outpatient clinics at hospitals in Norway who have radiating pain below the knee with a severity score of ≥ 4 on a 0–10 numeric rating scale and clinical signs of nerve root or spinal nerve involvement. The intervention consists of oral naproxen 500 mg or placebo twice daily for 10 days. Participants will report the outcomes and adverse events daily using an electronic case report form. The primary endpoint is change in leg pain intensity from baseline to day 10 based on daily observations. The secondary outcomes are back pain intensity, disability, sciatica symptom severity, rescue medication (paracetamol) consumption, opioid use, ability to work or study, 30% and 50% improvement in leg pain, and global perceived change of sciatica/back problem. The outcomes will be analysed using mixed effects models for repeated measurements. The total duration of follow-up is 12 (± 2) days.DiscussionThis trial aims to evaluate the benefits of naproxen, a non-selective NSAID, in patients with sciatica. No important differences in efficacy have been demonstrated between different NSAIDs in the management of musculoskeletal disorders; hence, the results of this trial will likely be applicable to other NSAIDs.Trial registrationClinicalTrials.gov NCT03347929. Registered on November 20, 2017.

Predictors of neuropathic pain and related functional disability in sciatica patients: a cross-sectional study

Purpose The aim of the present paper was to assess neuropathic pain and its predictors among patients with sciatica. In addition, we sought to investigate the predictors of functional disability in sciatica patients with neuropathic pain. Methods A cross-sectional study was carried out on a sample of 100 sciatica patients aged 18 years and older with a radiating pain from the lower back down to the leg below the knee. Information about socio-demographic characteristics, duration of symptoms, being treated or not, type of treatment, side of sciatica, presence of back pain, leg pain occurrence, leg pain intensity, functional disability and pain catastrophizing were collected. Results Of the total patients, 57% had neuropathic pain. Multivariable analysis showed that leg pain intensity was higher in the neuropathic pain group as compared to the non-neuropathic pain group. Also, patients with left sciatica were less likely to have neuropathic pain than patients with right sciatica. Patients with neuropathic pain having high levels of pain catastrophizing and being on bed rest for at least one week were at a higher risk of developing functional disability as compared to their counterparts. Conclusion Low levels of pain catastrophizing and less bed rest should be considered in interventions aimed at improving the functional ability for sciatica patients with neuropathic pain.

EFFECTIVENESS OF CUPPING THERAPY ON NERVE CONDUCTION VELOCITY IN SCIATICA-A RANDOMIZED CONTROL TRIAL.

BACKGROUND: Sciatica is a radiating pain that is caused due to the impingement in bony structures. Cupping is a simple application of quick, vigorous, rhythmical strokes to stimulate muscles and it's also helpful in the treatment of aches and pains associated with various disorders. AIM AND OBJECTIVES: AIM:To nd out the effectiveness of cupping therapy on nerve conduction velocity in sciatica. OBJECTIVES:To nd out the effect of cupping therapy on NCV in sciatica. To compare the experimental group to the control group. METHOD: Thirty patients were selected based on inclusion and exclusion criteria. The details of the treatment were explained to the subjects and written consent was taken from the patients. They were treated with cupping therapy for three alternative days/week, the patient was reassessed with NPRS and NCV after 4 weeks. RESULTS: The data was analyzed using SPSS version 22.0. A parametric test was used within the group analysis. A signicant improvement in pain and functional status of the nerve was found after 4 weeks. Greater statistically signicant improvement was seen in Group-A (p-value is 0.00) as compared to Group-B CONCLUSIONS: Cupping therapy is effective to reduce pain and improvement in functional status of nerves in Sciatica patients.

Comparative Clinical Study of Hijama bil shart (Wet Cupping) and Hijama bil nar (Fire Cupping) in Irq al- nasa’ (Sciatica)

Background: ‘Irq al nasa’ an Arabic term to which we call ‘Sciatica’ is clinically defined as the pain along with Sciatic nerve and its component nerve roots. Pain may vary from mild ache to severe burning or shooting, or tingling in nature. According to Unani literature, sciatica (Irq al-nasa') may be caused by accumulation of morbid matter or phlegm (Khilt balgham galeez) in the affected area. “Hijama” means “to suck” is a Unani regimental method of treatment, which helps to evacuate the morbid materials from the body and reassure the blood flow to the site of Hijama.&#x0D; Objective: This study aims to compare the efficacy and safety of hijama bil-shart (wet cupping) and hijama bil-nar (fire cupping) in the management of sciatica.&#x0D; Methods: In an open, randomized, controlled study out of 70 sciatica patients, 60 were randomly allocated in test and control group, 30 in each. The test group received wet cupping and control group were applied with fire cupping at 0th, 15th, 30th and 45th day.&#x0D; Results: While observation of visual analogue scale for pain, limb movement, straight leg raising test, deep tendon reflexes at ankle and knee joint, and stiffness along with Bragard’s sign, the intergroup comparison of pre and post treatment results showed wet cupping is more effective than fire cupping (p&lt;0.001).&#x0D; Conclusion: Hijama bil-shart (wet cupping) is more effective than hijama bil-nar (fire cupping) in managing sciatica. Both the therapies were generally well tolerated.&#x0D; Keywords: Cupping, Hijama, Sciatica, Unani.

Identification of Immune-Related Biomarkers for Sciatica in Peripheral Blood

Objective: Sciatica pertains to neuropathic pain that has been associated with inflammatory response. We aimed to identify significant immune-related biomarkers for sciatica in peripheral blood. Methods: We utilized the GSE150408 expression profiling data from the Gene Expression Omnibus (GEO) database as the training dataset and extracted immune-related genes for further analysis. Differentially expressed immune-related genes (DEIRGs) between healthy controls and patients with sciatica were selected using the “limma” package and verified in clinical specimens by quantitative reverse transcription PCR (RT-qPCR). A diagnostic immune-related gene signature was established using the training model and random forest (RF), generalized linear model (GLM), and support vector machine (SVM) models. Sciatica patient subtypes were identified using the consensus clustering method. Results: Thirteen significant DEIRGs were acquired, of which five (CRP, EREG, FAM19A4, RLN1, and WFIKKN1) were selected to establish a diagnostic immune-related gene signature according to the most appropriate training model, namely, the RF model. A clinical application nomogram model was established based on the expression level of the five DEIRGs. The sciatica patients were divided into two subtypes (C1 and C2) according to the consensus clustering method. Conclusions: Our research established a diagnostic five immune-related gene signature to discriminate sciatica and identified two sciatica subtypes, which may be beneficial to the clinical diagnosis and treatment of sciatica.

Amplified Vasodilatation within the Referred Pain Zone of Trigger Points Is Characteristic of Gluteal Syndrome-A Type of Nociplastic Pain Mimicking Sciatica.

Gluteal syndrome (GS) mimicking sciatica is a new disease that has been recently recognized and included in the International Classification of Diseases, 11th Revision. The present study examines nociplastic pain involvement in GS and sciatica patients using a new Skorupska protocol (SP) test that provokes amplified vasodilatation in the area of expected muscle-referred pain. A positive test is confirmed if there is (i) a development of autonomic referred pain (AURP) and (ii) an increase in the delta of average temperature (Δ₸°) > 0.3 °C at the end of the stimulation and during the observation SP phases. Chronic GS (n = 20) and sciatica (n = 30) patients were examined. The SP test confirmed muscle-referred pain for (i) all GS patients with 90.6% positive thermograms (Δ₸° 0.6 ± 0.8 °C; maximum AURP 8.9 ± 13.6% (both p < 0.05)) and (ii) those sciatica (n = 8) patients who reported pain sensation during the test with 20.6% positive thermograms (Δ₸° 0.7 ± 0.7 °C; maximum AURP 15.1 ± 17.8% (both p < 0.05)). The remaining sciatica (n = 22) patients did not report pain during the test and presented a Δ₸° decrease and the AURP size below 1%. Conclusion: Amplified vasodilatation suggesting nociplastic pain involvement was confirmed for all GS and sciatica patients who reported painful sensations in the zone typical for gluteus minimus referred pain during the test.

The Automatization of a New Thermography Method Using Invasive Nociceptive Stimulation to Confirm an Autonomic Phenomenon within a Trigger Point Referred Pain Zone.

The trigger points (TrPs) related to chronic low back pain that mimic sciatica have been lately recognized and included in the International Classification of Diseases, 11th Revision. This study examined the MATLAB software utility for the objective stratification of low back pain patients using the Minimally Invasive Procedure (MIP). The two diagnostic MIP parameters were: average temperature (ΔTavr) and autonomic referred pain (AURP). Chronic sciatica patients with TrPs (n = 20) and without TrPs (n = 20) were examined using the MIP. A significant increase in both parameters was confirmed for the thigh ROI of the TrP-positive patients, with ΔTavr being the leading parameter (p = 0.016, Exp(β) = 2.603). A continued significance of both parameters was confirmed from 6′00″ to 15′30″ (p < 0.05). The maximum AURP value was confirmed at 13′30″ (p < 0.05) (TrPs(+) 20.4 ± 19.9% vs. TrPs(-) 3.77 ± 9.14%; p = 0.000; CI (0.347,0.348)).