by Annina Schmid and colleagues.
This report gives details of the plans of the FORECAST study and all of the methods that it will use. It was written before the FORECAST study had recruited people and so it does not give any results. Published in BMJ Open 2023;13:e072832. doi:10.1136/bmjopen-2023-072832.
The FORECAST study website can be found here.
Background
Sciatica is a condition that affects the small nerves in the back, but people with sciatica feel pain or symptoms in their leg. Most patients with sciatica will improve over time (e.g., with treatment or spontaneously), but some will develop persistent pain. Currently, we cannot predict who will improve and who will continue to have persistent pain.
Study aims and objectives
The FORECAST study aims to answer the following questions:
1. Are there differences in nerve function and structure in patients with sciatica?
2. Can we predict who will recover or who will continue to have persistent pain?
Study findings and conclusions
FORECAST aims to answer these questions by collecting very detailed information from people with early sciatica (through questionnaires, a detailed assessment, a skin biopsy, blood testing, and, for some participants, a specialist MRI to look at the health of the spinal nerves) and then following those people for a year through regular questionnaires to find out how their symptoms change over time.
People recruited to FORECAST will give information about their pain, how their sciatica feels, their lifestyle and social life and psychology. A blood sample will be used to look at markers of inflammation and health. Also, a clinically-trained researcher will make a series of measurements on each person to assess how their nerves are working and responding to different sensations. These measurements will look at heat, cold, vibration, light touch, pressure, sharpness and also how the pain sensation can be changeable.
This large amount of detailed information will be analysed to look for people who fit into different subgroups and to examine whether certain factors predict who will develop persistent pain.
Future directions for healthcare and research
The findings of the FORECAST study will show the different ways that sciatica affects people and how that can lead to worse pain. There will also be new information to help guide research into the development of new treatments.