A qualitative exploration of patient experiences of medication for sciatica

Background: Sciatica is often a painful and disabling condition, with medication routinely the first line of management. It is important to describe patients experiences of taking medication for sciatica, the reasons for commencing and reasons for cessation, the effects of the medication in symptom management and any other potential positive or deleterious effects. Objectives: To describe patient experiences of medication for the relief of symptoms of sciatica. Study design: Qualitative analysis of data from a mixed-methods randomised controlled pilot study. Methods: A total of 46 semi-structured interviews were conducted with 33 consenting participants (19 female) recruited from 14 GP practices. A purposive sampling strategy ensured a range of age, severity of pain and disability. Interviews were recorded and transcribed verbatim prior to thematic analysis, which aimed to identify the important, interesting or divergent views within the data. Findings: Participant experiences of pain were often severe with significant disability and fear. The use of a combination of medications was common, including the use of opioids and other medication inconsistent with national (NICE) guidance. Most participants found medication ineffective and reported significant side-effects, often necessitating cessation of the drugs or the use of alternatives. Despite the regularity of participants stopping all medication for sciatica, their pain levels still significantly eased over the 6-month period of the study. Conclusions: The study highlighted a lack of perceived effectiveness for prescribed medication, often with concomitant side-effects. Clinicians should be cognisant of the fears that patients hold in terms of the cause and severity of sciatica, as well as fears of prescribed medication.