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Oral Steroids Offer Little Benefit To Patients With Sciatica

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New research reveals that people suffering with acute sciatica, a painful condition of the lower back and leg, see no significant improvement in pain when they take oral steroids.

The study, published in the medical journal JAMA, demonstrated that a short course of oral steroids resulted in a modest improvement in function but had little effect on pain or subsequent need for surgery.

The research team, led by Dr. Harley Goldberg of the Kaiser Permanente Northern California Spine Care Program in San Jose, California, signed up 269 adults with sciatica for three months or less, a herniated disk, and a certain minimum measure on a disability index. Patients received either a tapering 15-day course of an oral steroid (prednisone) or matching placebo.

Results showed that there was a small, statistically significant improvement in function at both three weeks and 52 weeks among the prednisone-treated group but no difference in lower extremity pain scores. They also reported small but inconsistent improvements on several secondary outcomes in the active treatment group compared with the placebo group, and said that this may have been due to chance.

“An important rationale for using oral steroids is the potential to decrease the need for more invasive interventions,” the authors pointed out. However, in this trial there was no significant difference between the two groups in the likelihood of undergoing spine surgery at 52-week follow-up.

Most patients got better with or without treatment with oral steroids, the study showed.

http://media.jamanetwork.com/news-item/oral-steroids-for-herniated-disk-results-in-modest-improvement-in-function-no-improvement-in-pain/

http://www.medscape.com/viewarticle/845050

http://well.blogs.nytimes.com/2015/05/25/oral-steroids-may-be-ineffective-against-sciatica-back-pain/?_r=0

http://jama.jamanetwork.com/article.aspx?articleid=2293294