Sciatica is a common type of low back pain characterized by intense unilateral leg pain, tingling or numbness, and shooting pain that radiates below the knee.
Since symptoms of sciatica can be debilitating and persistent, patients are nearly four times more likely to have back surgery compared with those who have persistent low back pain only. Conservative treatment options often offer little relief, so more invasive procedures such as epidural corticosteroid injections have become increasingly popular.
Currently, there are no clear guidelines for treating sciatica with epidural corticosteroid injections. Researchers reviewed published studies to determine the efficacy of epidural corticosteroid injections for reducing pain and disability from sciatica, compared to placebo controls.
At short-term follow-up between two weeks and three months, 14 studies (n = 1,316 patients) showed that compared to placebo, corticosteroid injections offered significant relief from leg pain. Ten trials (n = 1,154) revealed a significant effect of epidural corticosteroid injections for reducing disability. Six trials (n = 723) showed that corticosteroid injections had no effect on back pain.
Follow up at one year or later showed no difference in leg pain, back pain, or disability for patients given epidural corticosteroid injections or placebo.