Q: My back and sciatic pain is getting worse. I've been told that I can get an epidural and it will help with the pain. Will it?
A: A recent review found that this procedure has little or no lasting benefit beyond a two to six week period following treatment. This study caught my attention as I also have bouts of significant of “sciatica” (pain in the lower back that radiates down the leg).
Back pain is horrendously common... yearly healthcare expenditure for lower back pain exceeded $90 billion in the late 90’s. I assume (like everything else) it's become a lot more expensive in this century. You and I are part of a very large group of people that has tried everything, including medical therapy, epidural steroid injections, analgesics, narcotics, and surgery (I haven’t done the last two yet). I thought I felt better with an epidural, but perhaps it was the combination of the subsequent stretching exercises I was doing and anti-inflammatory medications I was taking.The American Academy of Neurology's study, which was published in the journal Neurology, refutes my experience. Thirty-seven articles were found in the search for writing this paper, but only four met the criteria that allowed them to be analyzed and included in the study. The study looked at around 300 patients (which isn't many considering how many people have this problem and get injections for it). The conclusion: getting an epidural steroid injection led to an improvement in sciatic pain between two and six weeks after treatment, but it didn't relieve back pain more than placebo in the first 24 hours, three to six months, or one year after the injection.In summarizing the study's results, the writers did point out that their paper doesn’t negate the usefulness of epidurals for treatment of back pain. In fact, the American Academy of Orthopedic Surgeons and the National American Spine Society have approved this treatment for this condition. Potential complications are usually minor, but rarely meningitis and infections in the area of the epidural can occur. So if you opt for this treatment, make sure an expert performs the procedure.
Dr. Reichman’s bottom line: Sciatic pain is unfortunately way too common. I sympathize and commiserate with anyone who suffers from this.If other non invasive therapies don’t help and your doctor recommends an epidural, know that its affect will probably be short lived, but a two to six week reprieve may be worthwhile.
Dr. Judith Reichman, the TODAY show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of .
PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.