Comorbid subjective health complaints in patients with sciatica: A prospective study including comparison with the general population Lars Grøvle a, ⁎ , Anne J. Haugen a , Camilla M. Ihlebaek b,c , Anne Keller d , Bård Natvig e,f , Jens I. Brox g , Margreth Grotle e,h a Department of Rheumatology, Østfold Hospital Trust, Fredrikstad, Norway b Research group of nature, health and quality of life, IHA, Norwegian University of Life sciences, Aas, Norway c Research group of stress, health and rehabilitation, Uni health, Uni Research, Bergen, Norway d Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevaal, Norway e National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway f Department of General Practice and Community Medicine, ASAM, University of Oslo, Oslo, Norway g Section for Back Surgery and Physical Medicine and Rehabilitation, Orthopaedic Department, Oslo University Hospital, Rikshospitalet, Norway h FORMI (Communication Unit for Musculoskeletal Disorders), Oslo University Hospital, Ullevaal, Norway Received 6 July 2010; received in revised form 30 October 2010; accepted 9 November 2010 Abstract Objective: Chronic nonspecific low back pain is accompanied by high rates of comorbid mental and physical conditions. The aims of this study were to investigate if patients with specific back pain, that is, sciatica caused by lumbar herniation, report higher rates of subjective health complaints (SHCs) than the general population and if there is an association between change in sciatica symptoms and change in SHCs over a 12-month period. Methods: A multicenter cohort study of 466 sciatica patients was conducted with follow-up at 3 months and 1 year. Comorbid SHCs were measured by 27 items of the SHC inventory. Odds ratios (ORs) for each SHC were calculated with comparison to a general population sample (n=928) by logistic regression. The SHC number was calculated by summing all complaints present. Results: At baseline, the ORs for reporting SHCs for the sciatica patients were significantly elevated in 15 of the 27 items with a mean (S.D.) SHC number of 7.5 (4.4), compared to 5.2 (4.4) in the general population (Pb.01). Among those who during the 1- year follow-up period fully recovered from their sciatica, the SHC number was reduced to normal levels. Among those with persisting or worsening sciatica, the number increased to a level almost double that of the general population. Conclusion: Compared to the general population, the prevalence of subjective health complaints in sciatica is increased. During follow-up, the number of health complaints increased in patients with persisting or worsening sciatica. © 2010 Elsevier Inc. All rights reserved. Keywords: Sciatica; Pain; Psychological stress Introduction There is a large body of evidence showing chronic low back pain (CLBP) to be comorbid with other mental and physical conditions [1–5]. It is not known whether the increased comorbidity is a cause, an effect, or just a concomitant of CLBP. In this study, the term comorbidity is defined as coexisting ailments to an index disease [6]. Many of the coexisting conditions seen in CLBP represent subjective health complaints (SHCs) such as headaches, muscular pain, dyspnea, gastrointestinal discomfort, anxiety, and sadness [5,7], and several are referred to as unexplained, functional, or somatization symptoms [8–10]. Most research has focused either on patients with nonspecific CLBP or has not distinguished between patients with specific and nonspecific back pain. This distinction may be important because the mechanisms underlying comorbidity might Journal of Psychosomatic Research 70 (2011) 548 – 556 ⁎ Corresponding author. Department of Rheumatology, Sykehuset Østfold, 1603 Fredrikstad, Norway. Tel.: + 47 91814029. E-mail address: lars.grovle@so-hf.no (L. Grøvle). 0022-3999/10/$ – see front matter © 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.jpsychores.2010.11.008