Leisure-time physical activity and sciatica: A systematic review and meta-analysis

Abstract

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, I² = 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, I² = 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, I² = 0%, 4 studies, N = 10,046], or 1-3 times/week (PR = 1.34, CI 1.02-1.77, I² = 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.

Figure 1

A meta-analysis of four cross sectional and four case control studies on the association of leisure time physical activity at least once a week vs. no such activity with lumbar radicular pain or sciatica. The size of the gray shaded area indicates the weight of each study. Horizontal lines show the 95% confidence intervals (CI). PR, prevalence ratio; OR, odds ratio.

Figure 2

A meta-analysis of nine prospective cohort studies on the association of leisure time physical activity at least once a week vs. no such activity with lumbar radicular pain or sciatica. The size of the gray shaded area indicates the weight of each study. Horizontal lines show the 95% confidence intervals (CI). RR, risk ratio.

Figure 3

A meta-analysis of six prospective cohort studies on the association of moderate level of leisure time physical activity vs. no leisure-time physical activity with lumbar radicular pain or sciatica. The size of the gray shaded area indicates the weight of each study. Horizontal lines show the 95% confidence intervals (CI). RR, risk ratio.

Figure 4

A meta-analysis of seven prospective cohort studies on the association of high level of leisure time physical activity vs. no leisure time physical activity with lumbar radicular pain or clinically verified sciatica. The size of the gray shaded area indicates the weight of each study. Horizontal lines show the 95% confidence intervals (CI). RR, risk ratio.