Epidural Corticosteroid Injections for Sciatica: An Abridged Cochrane Systematic Review and Meta-Analysis
Conclusion. 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. Level of Evidence: 1
WEDNESDAY, Oct. 7, 2020 -- For patients with acute back pain with sciatica, those receiving early physical therapy (EPT) have improvements in the Oswestry Disability Index (OSW) score, starting after four weeks, according to a study published online...
People with recent-onset back pain with sciatica who receive four weeks of physical therapy experience less disability over the next year than those who receive only usual care, a small trial suggests.Reuters Health Information
CONCLUSION: Referral from primary care to physical therapy for recent-onset sciatica improved disability and other outcomes compared with UC. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality. PMID: 33017565 [PubMed - as supplied by publisher]
This study is significant in that it cannot only be a basis for safety-related evidence of complementary alternative medicine, which has been lacking, but it also gives clear evidence on the effectiveness and validity of treatment effects such as accompaniment of stenosis, sex, age, and type of disc herniation.
CONCLUSIONS: This updated Cochrane Review included 32 trials to evaluate the efficacy of NSAIDs in people with acute LBP. The quality of the evidence ranged from high to very low, thus further research is (very) likely to have an important impact on our confidence in the estimates of effect, and may change the estimates. NSAIDs seemed slightly more effective than placebo for short-term pain reduction (moderate certainty), disability (high certainty), and global improvement (low certainty), but the magnitude of the effects is small and probably not clinically relevant. There was no clear difference in short-term pain reduct...
Abstract BACKGROUND: Lumbosacral radicular pain (commonly called sciatica) is a syndrome involving patients who report radiating leg pain. Epidural corticosteroid injections deliver a corticosteroid dose into the epidural space, with the aim of reducing the local inflammatory process and, consequently, relieving the symptoms of lumbosacral radicular pain. This Cochrane Review is an update of a review published in Annals of Internal Medicine in 2012. Some placebo-controlled trials have been published recently, which highlights the importance of updating the previous review. OBJECTIVES: To investigate the effic...
Conclusions: HRQOL metrics can accurately predict patient satisfaction with symptoms at 3 months, 2 years, and 4 years after surgical intervention for a lumbar disk herniation. Absolute outcome scores were somewhat more predictive than change scores.
Conclusion: This proposed systematic review will evaluate the effectiveness and safety of acupuncture for LDH. Registration: PROSPERO (registration number CRD42019148272).
ConclusionModerate-level evidence supports clinically relevant immediate improvement in leg pain and disability following lumbar discectomy with accompanying improvements in back pain.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
ConclusionsUsing a strict diagnosis of sciatica, this work identified four clusters of patients primarily differentiated by back and leg pain severity. Patients with severe back and leg pain had the most severe profile at baseline and follow‐up irrespective of intervention. This simple classification system may be useful when considering prognosis and management with sciatica patients.This article is protected by copyright. All rights reserved.