Function Restored More Than Pain Eased With Steroids For Sciatica
A short course of oral steroids provided modest improvement in function and no significant improvement in pain for patients with acute radiculopathy (sciatica), a study published in JAMA has shown.
Oral steroids are given for anti-inflammatory activity and can carry less risk than invasive epidural steroid injections. Though they are used by many clinicians and are included in some guidelines, no appropriately powered study of oral steroids for radiculopathy has been performed.
Researchers from the Kaiser Permanente Northern California Spine Care Program in San Jose, CA randomized 269 adults with radicular pain for ≤3 months, a herniated disk, and a certain minimum measure on the Oswestry Disability Index (ODI), to a tapering 15-day course of prednisone or placebo.
Study data showed a small, statistically significant improvement in function from baseline ODI at both Week 3 and Week 52 in the prednisone-treatment group. However, there no was no difference in lower extremity pain scores. Some secondary endpoints showed small but inconsistent improvements in the prednisone-treatment groups vs. the placebo group.
No significant difference between the two groups was seen in the likelihood of undergoing spine surgery at 52-week follow-up, the researchers concluded.