Commonly used sciatica treatments not significantly better than placebo

According to an article published in the April 17 issue of Annals of Internal Medicine, injections with steroids or Etanercept are not significantly better than placebo for treating patients suffering from moderate sciatica.

Low back pain is the most common reason people see a doctor, the report noted. Approximately half of all cases of low back pain are neuropathic, meaning they are caused by nerve compression, inflammation and/or injury. Identifying the source of back pain is important because classification informs treatment.

Physicians commonly use steroid injections to treat lumbosacral radiculopathy, or compressed nerves in the back, but steroids can have dangerous effects, the article stated. Etanercept injections have been considered to be another option for treatment for low back pain.

Researchers conducted a randomized trial of 84 adults to evaluate whether epidural steroids, etanercept, or saline better improved pain and function in patients suffering from lumbosacral radiculopathy for less than six months. Participants received either two steroid injections, two etanercept injections, or two injections of saline (all mixed with bupivacaine) separated by two weeks.

One month after the second injection, patients were asked to report leg pain and function. Leg pain was reduced more with steroids than etanercept or saline, but differences were modest and not statistically significant. Differences in back pain and function associated with steroids versus saline also were not statistically significant.

The researchers said larger trials of longer duration are needed to establish benefits of epidural steroids for lumbosacral radiculopathy.

Photo attributed to Kaudris via Creative Commons license.

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