In this study, 160 consecutive, eligible patients with sciatica who had unilateral symptoms of 1 to 6 months duration, and who never underwent surgery were randomized for a double‐blinded injection with methylprednisolone bupivacaine combination or saline. Objective and self‐reported outcome parameters and costs were recorded at baseline, at 2 and 4 weeks, at 3 and 6 months, and at 1 year. Recovery was better in the steroid group at 2 weeks for leg pain, straight leg raising, lumbar flexion, and patient satisfaction. Back pain was significantly lower in the saline group at 3 and 6 months. Sick leave and medical costs were similar for both treatments, except for cost of therapy visits and drugs at 4 weeks, which were in favor of the steroid injection. By 1 year, 18 patients in the steroid group and 15 in the saline group underwent surgery. Conclude improvement during the follow‐up was found in both the methylprednisolone and saline groups. The combination of methylprednisolone and bupivacaine seems to have a short‐term effect, but at 3 and 6 months, the steroid group seems to experience a “re‐bound” phenomenon.
Pain Practice – Wiley
Published: Jan 1, 2001
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