Epidural Steroid Shot May Offer Modest Benefit in Sciatica
(HealthDay News) – For adults with lumbosacral radiculopathy, epidural steroid injections may be beneficial for short-term pain relief and improvements in functional capacity.
Stephen P. Cohen, MD, from the Johns Hopkins School of Medicine in Baltimore, and colleagues compared epidural steroids, etanercept, and saline for 84 patients with lumbosacral radiculopathy of less than six months in duration. Pain and function were assessed for patients who were randomly allocated to receive two epidural injections of steroids, etanercept, or saline, mixed with bupivacaine, two weeks apart.
The researchers found that the epidural steroid group had nonsignificantly greater reductions in leg pain one month following the second injection compared with those who received etanercept (mean between-group difference, −1.01; P=0.21) or saline (mean between-group difference, −1.26; P=0.11). Smaller between-group nonsignificant differences for back pain were observed for steroids versus etanercept and saline (mean differences, −0.92 [P=0.18] and −0.52 [P=0.44], respectively). For functional capacity, etanercept was significantly worse than steroids (mean difference, −16.16; P=0.002) or saline (mean difference, 10.29; P=0.04). Fifty percent or greater leg pain relief and a positive global perceived effect at one month was experienced by significantly more patients treated with steroids (75%) versus etanercept (42%) or saline (50%) (P=0.09).
"Epidural steroid injections may provide modest short-term pain relief for some adults with lumbosacral radiculopathy, but larger studies with longer follow-up are needed to confirm their benefits," the authors write.