Prednisone Therapy to Manage Pain & Improve Function in Patients with Acute Lumbar Radiculopathy
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on November 12th, 2025
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Acute lumbar radiculopathy is a common condition that will affect around 10% of the population at least once throughout their lifetime. Spontaneous recovery can happen, but the affected person can experience significant pain and disability. More invasive treatment such as disketomy or epidural steroid injections can be utilized, but they are associated with significant challenges. With funding from the US National Institutes of Health, a study was conducted to examine the usage of oral steroids to manage lumbar radiculopathy.
The study was performed in California, and it included 269 participants with an average age of 46 years old who had been diagnosed with herniated disk confirmed by MRI. On average, patients in the study had experienced pain for around 30 days. Assessment with the Oswestry Disability Index score found the cohort has a mean baseline score of 51.1, indicating severe disability with the pain affecting daily life activities. When asked to rate their pain on a scale of 1 to 10, with 10 being the most severe, the cohort had an average subjective score of 6.7.
The patients were randomly assigned to be treated orally with either placebo or prednisone. For the first 5 days, the patients received 3 pills containing 20-mg of prednisone each, with the dose reduced to only 1 dose for the next 5 days. Throughout the study, the patients were restricted from taking non-steroidal anti-inflammatory drugs. Follow-up after 3 weeks found that oral prednisone resulted in significantly more funcitonal improvement, with their Oswestry Disability Index score reduced to 31.1, significantly more than the 37.5 average reported by the control group.However, there was no significant difference in pain alleviation. Participants treated with prednisone reported a frequency of insomnia, increased appetite, and indigestion. The researchers concluded that prednisone might reduce the need for invasive epidural steroid injection, but further assessment after 52 weeks found that prednisone did not reduce the need for surgery.
The study was performed in California, and it included 269 participants with an average age of 46 years old who had been diagnosed with herniated disk confirmed by MRI. On average, patients in the study had experienced pain for around 30 days. Assessment with the Oswestry Disability Index score found the cohort has a mean baseline score of 51.1, indicating severe disability with the pain affecting daily life activities. When asked to rate their pain on a scale of 1 to 10, with 10 being the most severe, the cohort had an average subjective score of 6.7.
The patients were randomly assigned to be treated orally with either placebo or prednisone. For the first 5 days, the patients received 3 pills containing 20-mg of prednisone each, with the dose reduced to only 1 dose for the next 5 days. Throughout the study, the patients were restricted from taking non-steroidal anti-inflammatory drugs. Follow-up after 3 weeks found that oral prednisone resulted in significantly more funcitonal improvement, with their Oswestry Disability Index score reduced to 31.1, significantly more than the 37.5 average reported by the control group.However, there was no significant difference in pain alleviation. Participants treated with prednisone reported a frequency of insomnia, increased appetite, and indigestion. The researchers concluded that prednisone might reduce the need for invasive epidural steroid injection, but further assessment after 52 weeks found that prednisone did not reduce the need for surgery.