"The differences aren't huge, averaging about one point on a 10-point pain scale," he said. "There weren't any clear benefits from epidural etanercept."
Importantly, people got better no matter which intervention they received, Chou added.
"I think it underscores our previous (APS) recommendation to consider epidural steroids as a potential option for patients who are looking for short-term pain relief, but to be very clear to patients that these benefits do not appear to last and they have a good chance of improving without the injection," Chou said. "I think a lot of doctors (and patients) think that epidural steroid injections are much more effective (and longer lasting) than the evidence shows that they really are."
Even though etanercept didn't work great in this study, researchers say it should continue to be studied for use with sciatica. People in the study got a low dose of the drug, 4 milligrams (mgs), whereas people who receive it for rheumatoid arthritis receive 25 mgs or 50 mgs. It's possible a higher dose would work better, Cohen said.
The bottom line is that better treatments for sciatica are sorely needed, Cohen said.
Epidural injections of steroids can cause complications, including paralysis and death.
Recommendations limit the number of injections people can get in a year to decrease other side effects, including ulcers, immune-system suppression, wound-healing interference and raising blood sugar levels in diabetics, Cohen said.
The U.S. National Library of Medicine has more on sciatica.
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