The Efficacy of Oral Steroids in the Treatment of Acute Sciatica
Status:
Completed
Trial end date:
2004-04-01
Target enrollment:
Participant gender:
Summary
Sciatica (lumbosacral radiculopathy) is a common diagnosis in primary care, occurring in
approximately one percent of all patients with acute low back pain. (1, 2) Traditional
treatment generally involves pain control (acetominophen, NSAID's, or narcotics), activity as
tolerated, and time. (1, 3-8 ) The general consensus is that fifty percent of patients with
sciatica recover within six weeks, and that ninety percent are better in twelve weeks.(4, 8)
Those patients with intractable pain or progressive neurologic symptoms usually receive
epidural steroid injections and, if necessary, decompressive laminectomy or discectomy. (2,
8, 9)
Low back pain and sciatica result in tremendous losses to our society in terms of decreased
productivity and cost of treatment. (1, 12) Oral steroids are inexpensive and relatively safe
medications that, if effective in reducing the pain and disability associated with sciatica,
could improve the quality of patients' lives, and result in significant cost savings to
society at large. We hypothesize that the use of oral steroids to treat acute sciatica will
speed patients' recovery as measured by: changes in physical findings, rates of return to
work and activities of daily living, pain and disability assessment scores, and decreases in
the use of narcotic and non-steroidal anti-inflammatory drugs (NSAID's), and in the need for
epidural injection or surgical intervention.