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Leisure‐time physical activity and sciatica: A systematic review and meta‐analysis
Author(s) -
Shiri R.,
FalahHassani K.,
ViikariJuntura E.,
Coggon D.
Publication year - 2016
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.885
Subject(s) - sciatica , medicine , meta analysis , physical therapy , lumbar , cohort study , cohort , low back pain , subgroup analysis , surgery , pathology , alternative medicine
Background and objective The role of leisure‐time physical activity in sciatica is uncertain. This study aimed to assess the association of leisure‐time physical activity with lumbar radicular pain and sciatica. Databases and data treatment Literature searches were conducted in PubMed, Embase, Web of Science, Scopus, Google Scholar and ResearchGate databases from 1964 through August 2015. A random‐effects meta‐analysis was performed, and heterogeneity and small‐study bias were assessed. Results Ten cohort ( N = 82,024 participants), four case–control ( N = 9350) and four cross‐sectional ( N = 10,046) studies qualified for meta‐analysis. In comparison with no regular physical activity, high level of physical activity (≥4 times/week) was inversely associated with new onset of lumbar radicular pain or sciatica in a meta‐analysis of prospective cohort studies [risk ratio (RR) = 0.88, 95% CI 0.78–0.99, I 2 = 0%, 7 studies, N = 78,065]. The association for moderate level of physical activity (1–3 times/week) was weaker (RR = 0.93, CI 0.82–1.05, I 2 = 0%, 6 studies, N = 69,049), and there was no association with physical activity for at least once/week (RR = 0.99, CI 0.86–1.13, 9 studies, N = 73,008). In contrast, a meta‐analysis of cross‐sectional studies showed a higher prevalence of lumbar radicular pain or sciatica in participants who exercised at least once/week [prevalence ratio (PR) = 1.29, CI 1.09–1.53, I 2 = 0%, 4 studies, N = 10,046], or 1–3 times/week (PR = 1.34, CI 1.02–1.77, I 2 = 0%, N = 7631) than among inactive participants. There was no evidence of small‐study bias. Conclusions This meta‐analysis suggests that moderate to high level of leisure physical activity may have a moderate protective effect against development of lumbar radicular pain. However, a large reduction in risk (>30%) seems unlikely. What does this review add Leisure‐time physical activity may reduce the risk of developing lumbar radicular pain.