Evidence-based practice regarding the lumbosacral radicular syndrome

The lumbosacral radicular syndrome causes pain in the leg and disability, often resulting in utilisation of healthcare resources and absenteeism from work. In general practice this syndrome is the most frequently seen specific low-back disorder. The aim of the research described in this thesis was to establish general practitionersâ?T and neurosurgeonsâ?T current management of patients with a lumbosacral radicular syndrome compared with their guidelines, and to assess the (cost) effectiveness of physical therapy in addition to the general practitionerâ?Ts care, in patients with an acute lumbosacral radicular syndrome. In two surveyâ?Ts it was concluded that the majority of the general practitioners and neurosurgeons support the content of the guideline and based on their current management of patients, they largely adhere with the guideline. The conclusion of the randomised clinical trial, at 12-months follow-up, was that physical therapy in addition to the general practitionerâ?Ts care is more effective in the treatment of patients with acute lumbosacral radicular syndrome than the general practitionerâ?Ts care alone. Furthermore, there are indications that physical therapy is particularly effective in patients reporting severe disability at presentation. The economic evaluation alongside this trial showed that physical therapy provided no cost effective addition to care in general practice for patients with a lumbosacral radicular syndrome.