Epidural Steroids, Etanercept, or Saline Injections for Subacute Sciatica?

Treatments for lumbosacral radiculopathy remain suboptimal, and data to support using the most common invasive intervention, epidural steroid injections, have been conflicting. In this double-blind U.S. study, 84 people with lumbosacral radiculopathy who had not responded to conservative therapy and had evidence of corresponding abnormalities on magnetic resonance imaging were randomized to receive two epidural injections (2 weeks apart) of methylprednisolone (60 mg), etanercept (4 mg), or saline. Etanercept was studied because experimental evidence suggested that cytokine inhibitors can have favorable effects on injured nerve roots. All patients also received bupivacaine. The primary outcome was leg pain, rated on a 0-to-10–point scale.

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