Treating Sciatica with Steroids


A common practice in medicine is treating sciatica with steroids, it is common enough that it is likely you or someone you know has been given a dose of oral steroids to treat sciatica. It is our long held belief that the medical community treats spine and spine related issues all wrong because they mostly treat the pain instead of the cause of the pain. The purpose of oral steroids such as prednisone is to act as a strong anti-inflammatory which should reduce the inflammation in a painful joint and thus eliminate pain. The problem with this is the inflammation is a symptom of whatever is causing the pain. The pain may be better but whatever caused the pain may still be there. If you feel better, (and don’t get me wrong it is great if you do feel better,) you still have the problem that whatever caused the pain is still there. This isn’t the only other issue with oral steroids, a recent paper discovered a big problem with using oral steroids to treat sciatica and back pain.

This paper was published in the Journal of the American Medical Association on May 19, 2015. The authors looked to determine if oral prednisone is more effective than placebo in improving function and pain among patients with acute sciatica. Between 2008 and 2013 they followed 269 patients with acute sciatica with low back pain and lumbar disc herniation as seen on MRI. They were given either a tapering dose of oral prednisone, a constant dose or oral prednisone, or a placebo. The authors examined the patients at the end of the treatment period of 3 weeks then again at one year. Ultimately the authors found that oral prednisone was no better than placebo for reducing pain and only moderately better in improving function. This means that oral steroids have no effect on pain, and little effect on improving function in cases of acute back pain and sciatica with disc herniation. 

What is really egregious about this, in a separate article about this study that included a interview with a spine surgeon, the surgeon mentioned that studies like this probably won’t keep physicians from proscribing oral steroids. He basically says the risk is negligible and patients are desperate for some treatment so physicians give this anyway despite it being nothing more than a placebo. Talk about a waste of healthcare dollars, they know it doesn’t work but buy it anyway because you will think you get better after you take it. Lets go back to my first point, even if it did work, oral steroids don’t treat the cause of the pain the inflammation is causing. Oral Steroids don’t work, the medical profession knows it so a better treatment is necessary.

What does treat the cause is care such as ours. The best evidence in spine care today points that the key issue is a loss of the normal curves in the spine and overall posture. It is in the medical literature, rehab literature, geriatric literature, and yes chiropractic literature; posture matters. If you have been suffering with back pain and sciatica and oral steroids is what you been given it is time for something better. Give us a call today and we can get you on the road to a real recovery.

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Posted in Back Pain, Healthcare Policy and Politics

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