Oral steroids ineffective in acute sciatica pain, according to new study

Use of oral steroids in acute sciatica caused by a herniated lumbar disk gave no significant improvement in pain, according to a study published in the JAMA.

Acute sciatica is most frequently associated with a herniated disk in the lower spine, and occurs to more than one in 10 people in their lives. Oral steroids are used by many physicians and have been included in some clinical guidelines, but no large-scale clinical trials of this therapy in sciatica have been conducted before.

Researchers at the Kaiser Permanente Northern California Spine Centers conducted a randomized, double-blind, placebo-controlled clinical trial from 2008 to 2013 in 269 adults with radicular pain persisting three months or less. Study participants were given either a tapering 15-day course of oral prednisone or a placebo. The prednisone-treated group showed a small but greater likelihood of achieving at least a 50% improvement in function at three weeks and at 52 weeks, but there was no statistically significant difference between groups in changes in pain at either three- or 52-week time points. The researchers found that oral steroids did not reduce the likelihood of undergoing surgery in the year following steroid treatment. They also found no evidence for substantial improvements in other measures of quality of life.