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Although sciatica is usually caused by a mechanical abnormality, pathophysiologic considerations provide a sound rationale for local corticosteroid therapy. There is evidence that this treatment should be started early to prevent persistent nerve-root pain due to peripheral and central sensitization. In this Viewpoint, Dr Valat discusses the use of epidural corticosteroid injections in early sciatica.
Chronic low back pain is a common condition that has significant economic consequences for patients and their communities. In this Technology Insight, the author discusses the imaging methods available for the diagnosis of low back pain, and highlights the need for the development of a noninvasive, low-risk technique.
There is increasing insight into the impact of ankylosing spondylitis on employment and the costs of illness associated with this disease. Standardization of cost-effectiveness studies will improve the quality and comparability of these costs. This Review summarizes the literature on work participation, costs of illness and cost-effectiveness of treatment in patients with ankylosing spondylitis.