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Steroids No Better for Sciatica Pain Than Placebo, Study Finds

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Steroids No Better for Sciatica Pain Than Placebo, Study Finds By Kathleen Doheny

HealthDay Reporter

TUESDAY, May 19, 2015 (HealthDay News) -- Doctors often prescribe steroid pills to ease the discomfort of sciatica -- back and leg pain usually caused by a herniated disk in the lower back.

But a new study finds steroids are no more effective than a placebo pill for the pain and provide only modest improvement in function.

Sciatica affects about one in 10 people in their lifetime, the researchers said. For this study, 269 people with sciatica were randomly assigned to take an oral steroid (prednisone) or a placebo (a dummy medication) for 15 days. The participants were followed for up to a year.

"When we compared the prednisone to placebo, there was a modest improvement in function," said study researcher Dr. Harley Goldberg, director of spine care services at Kaiser Permanente San Jose Medical Center in California. People reported they could go about their daily activities somewhat better than before.

However, "when we compared the pain [between the two groups], there was actually no difference," he said.

The finding "doesn't slam the door" on steroids as a treatment, Goldberg said. Rather, it provides information for patients and their doctors to discuss and decide together the best treatment option.

"Some people could still choose to use it," he added.

Usual treatments for herniated disk-related sciatica range from self-care, steroid pills and anti-inflammatory medicines, physical therapy, or epidural steroid injections, Goldberg said. When all else fails, surgery is an option, he explained.

This new study found that after a year, the likelihood of spine surgery was no less for those who took prednisone than for those who took a placebo, the researchers reported in the May 19 issue of the Journal of the American Medical Association.

The study results suggest that sometimes the best course is to let the body heal itself, said Dr. Nick Shamie, chief of orthopedic spine surgery at UCLA Medical Center, Santa Monica, who wasn't involved in the study.

"It is interesting that the pain was not as much improved as the physical function, and yet pain is what the patients come to your office for," Shamie added.
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