BMJ 23 Jun 2007 Vol 334

Sciatica is a clinical diagnosis which is usually easy to make but hard to manage. This worthy Dutch review can find no evidence that any form of analgesia works, and claims that CT is as good as MRI at detecting disc herniation – though this finding in itself is not diagnostic, because it can be found in up to a third of asymptomatic people. It is a rotten condition which can trap people in a cycle of pain – for a Harvard Prof of Medicine’s experience see chapter 5 of The Anatomy of Hope by Jerome Groopman.