Oral Steroids for Acute Sciatica Due to Herniated Lumbar Disk

[ Music ] >> The JAMA Network >> Catherine Dolf: Every day, thousands of people head to their doctor's office looking for relief from a very common problem

>> And so if you have any discomfort you tell me >> Catherine Dolf: It's called sciatica >> Acute sciatica is often disabling, extremely painful condition felt on the leg It's usually caused by a ruptured disc in the lumbar area >> We've begun looking at what are other ways to decrease the pain and improve the function more easily for patients with sciatica

>> Catherine Dolf: There are limited options for treating this painful condition One of the most common approaches is to prescribe the oral steroid medication called prednisone >> But it's never been studied to see if, in fact, it makes a difference >> Catherine Dolf: Doctors Harley Goldberg and Andrew Avins from Kaiser Permanente Northern California and coauthors, studied 269 patients with sciatica All patients underwent an MRI to confirm that they had a herniated disc

Two thirds were given oral prednisone and the other third got a placebo Patients were assessed for pain and overall function after three weeks and again at one year >> People got no better with the prednisone than they did with the placebo That is to say, they both got better equally There was actually a little bit of improved functional capacity for people that took prednisone

>> Catherine Dolf: The study appears in JAMA, Journal of the American Medical Association >> We also found that patients who took steroids had more side effects than patients who took the placebo But most of those side effects were fairly mild and transient in nature >> Catherine Dolf: The authors say these results provide important evidence about the relative risks and benefits of steroid therapy >> We now have guidance

We have information And we can provide for our patients true, meaningful, and informed discussions about the relative benefits and risks of this kind of therapy for this kind of condition >> Catherine Dolf: The JAMA Report [ Music ]

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