Researchers published in the Annals of Internal Medicine about patients suffering from lower back and leg pain due to nerve damage, a condition also referred to as sciatica.

The study looked at 81 sciatica patients who were placed in one of three different treatment groups.  In one group they were given two spinal injections of the steroid Prednisone, two weeks apart; in group two they got a drug called Enbrel, a disease modulating drug; and the third group got Saline, normal sterile salt water.

Researchers checked-in one month later and they found that the patients’ back and leg pain was reduced by a similar amount regardless of what treatment group they had been placed.

This tells us as primary care doctors and for our patients that these spinal injections are not magic pills for people with ongoing back pain.  We do wonder about the saline injections…  Are they washing out something or increasing blood flow to nerve roots, or is this just the placebo effect of getting something injected? We fear it is likely the latter.  Still saline is a much safer and less expensive than any of the other drugs.  Steroid injections, such as Enbrel, are more expensive and have more side effects, including suppression of the immune system.  Until we see better research, we are hesitant to advise most patients with this condition to rush to have injections.

We do know that physical and exercise therapy are helpful and that’s what we recommend most of the time.

• Sciatica
• Prednisone
• Etanercept Injection (Enbrel)