Mark Johnson, D.O.
Evidence-Based Answers From The Family Physicians Inquires Network
Clinical Inquires
Short courses of systemic steroids are likely safe, but they are ineffective. A single dose of intramuscular (IM) or intravenous (FV) methylprednisolone doesn’t improve long-term pain scores in patients with low back pain and sciatica and produces conflicting effects on furiction. Oral prednisone (9-day taper) doesn’t improve pain or function in patients with back pain and sciatica. A single IM dose of methylprednisolone doesn’t improve pain scores or function in patients with back pain without sciatica (strength of recommendation: B, randomized controlled trials [RCTs]).
No trials of corticosteroids for back pain reported an increase in adverse outcomes, but studies were small, and only short-term (1 month) follow-up data are available.