A new study appearing in the May 19 edition of JAMA examines the benefit to patients with sciatica from a short course of oral steroids. The study found no significant difference compared to placebo in measures of pain improvement and only modest improvement in overall function. Oral steroids are used by many primary care physicians and have been included in some clinical guidelines; however, no adequate clinical trials of oral steroids for radiculopathy have been conducted to date, according to background information in the article.
In patients with sciatica that does not resolve quickly, common treatment includes invasive procedures such as epidural steroid injections (ESI) and surgery. Oral administration of steroid medication can be delivered quickly by primary care providers, carries less risk, and would be much less expensive than an ESI. However, in this study of 269 adults with radicular pain of 3 months or less who were randomly assigned to a tapered course of prednisone or placebo, no difference was recorded in lower extremity pain scores between the 2 groups.
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