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Prednisone for Sciatica No Better Than Placebo

But steroid was tied to small improvements in ability to perform daily activities

WEDNESDAY, May 20, 2015 (HealthDay News) -- Oral prednisone is no more effective than placebo for sciatica pain and provide only modest improvement in function, researchers report in the May 19 issue of the Journal of the American Medical Association.

The study, which ran from 2008 to 2013, included 269 people with sciatica who were randomly assigned to take a course of oral prednisone or a placebo for 15 days. The participants were followed for up to a year. All had a herniated disc, confirmed by magnetic resonance imaging. Half took a short, tapered course of steroids -- 20 milligrams three times a day for five days; then twice daily for five days; and once a day for five days -- for a total of 600 milligrams.

Patients reported on functioning ability and pain levels for up to a year. The steroid-treated group was more likely to report a small improvement in functioning, defined as 50 percent, at three weeks and at one year. But pain was similar for both groups at those time points. Side effects, such as insomnia, increased appetite, and nervousness, were twice as common at three weeks in the steroid group. Nearly half reported at least one side effect, compared to about one-quarter of the placebo group. After one year, however, both groups had reported a similar number of side effects, and the likelihood of spine surgery was no less for those who took prednisone than for those who took a placebo.

"When we compared the prednisone to placebo, there was a modest improvement in function," study author Harley Goldberg, D.O., director of spine care services at the Kaiser Permanente San Jose Medical Center in California, told HealthDay. 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," Goldberg said.

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