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Oral steroids are used commonly in patients with acute lumbar radiculopathy or sciatica, but strong evidence of benefit is lacking. In this study, researchers at a large California health system randomized 269 patients (mean age, 46) with acute sciatica, magnetic resonance imaging–confirmed disc herniation, and substantial functional impairment to a tapering course of oral prednisone (60 mg daily for 5 days, 40 mg daily for 5 days, and 20 mg daily for 5 days) or placebo. Patients with pain for >3 months, recent epidural or oral steroid use, or previous lumbar surgery were excluded. The 1-year rate of spine surgery was the same in both groups (about 10%).
In adjusted analyses, improvement in function was significantly greater in the prednison…
