Spinal injections may not aid lower back pain

Steroid or etanercept injections cost about $500 to $700 each, Cohen said. The biggest concern with etanercept is immune system side effects, he added, while steroids can cause stomach problems and alter blood sugar levels.

Between one and six patients in each group had side effects related to the injections, including worsening pain, a rash or infection, but none were serious.

It’s possible that patients treated with regular saline got some relief because the injection washed out the spine and increased blood flow to nerve roots, researchers said.

In the end, whether or not patients’ sciatica pain improves may be more up to their own behavior than what type of injections they get, if any, Cohen added.

Sciatica facts

- Sciatica is nerve pain from irritation of the sciatic nerve.
- The sciatic nerve is the largest nerve in the body.
- Sciatica pain is typically felt from the low back to behind the thigh and radiating down below the knee.
- Treatments for sciatica depend on the underlying cause and the severity of the pain.

What is sciatica?

Sciatica is pain in the lower extremity resulting from irritation of the sciatic nerve. The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and radiating down below the knee. The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb. The pain of sciatica is sometimes referred to as sciatic nerve pain.

“The treatment that has the strongest evidence behind it is actually exercise programs,” he said - as well as losing weight, for people who are too heavy.

“It’s kind of a long, slow process. People have to have realistic expectations.”

SOURCE: Annals of Internal Medicine, online April 16, 2012

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