Epidural Corticosteroid Injections may reduce Sciatica pain and disability

They evaluated 25 clinical trials (from 29 publications) and a total of 2470 participants from placebo-controlled randomized trials investigating epidural corticosteroid injections in patients with sciatica were included. The major outcome analyzed were leg pain intensity and disability. Adverse events, overall pain, and back pain intensity were also analyzed as a secondary outcome. Researchers grouped similar trials according to outcome measures and their respective follow-up time points and determined Short-term follow-up (>2 weeks but ≤3 months) as primary follow-up time point due to the expected mechanism of action of epidural corticosteroid injection.

At the end of the analysis, they found epidural corticosteroid injections were probably more effective than placebo in reducing short-term leg pain with the mean difference of −4.93 and for short-term disability, it was −4.18. They also found epidural corticosteroids were slightly more effective in reducing short-term overall pain when compared with placebo with a mean difference of −9.35. They observed minor adverse events (i.e., without hospitalization) after both the treatments. Limitation of the trial was the quality of evidence which was at best moderate mostly due to problems with trial design and inconsistency.

The authors concluded, "A review of 25 placebo-controlled trials provides moderate-quality evidence that epidural corticosteroid injections are effective, although the effects are small and short-term. There is uncertainty on safety due to very low-quality evidence".

For further information:

https://journals.lww.com/spinejournal/fulltext/2020/11010/epidural_corticosteroid_injections_for_sciatica_.13.aspx