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Steroids relieve sciatica
Steroids relieve sciatica
Steroids, such as cortisone, frequently bring relief to patients suffering from sciatica according to a report presented to the American Academy of Orthopaedic Surgeons.
J Ted Hartman, MD, Lubbock, Tex, chairman of the Department of Orthopaedic Surgery, Texas Tech University School of Medicine, said results obtained with cortisone have been better or equal in many instances to those achieved by surgery or the injection of the enzyme chymopapain. In a study a t Cook County Hospital, Chicago, 30 patients received cortisone by injection into the low back just outside the epidural. Twenty-seven patients had complete relief, two were improved, and one patient received no relief. Relief from pain lasted for several months for most patients with some reporting relief for as long as two years. lntrathecal injections of the sciatic nerve were given to 37 patients, 26 of whom claimed complete relief, 7 were improved and 4 had no benefit. Both types of injections were given to 16 patients who did not have sufficient relief following the original injections. Fourteen of this group were completely relieved, one was improved, and one had no relief.
Dr Hartman pointed out that surgery to relieve a slipped disc causing sciatica is a major procedure requiring a long recuperative period. lack of relief may affect only one-fourth to one-half of the patients. It would be advantageous, therefore, to take the nonsurgical approach. There are two possible nonsurgical approaches-one aims to remove the cause mechanism while the other attempts to modify the response to that mechanism. Chemonucleolysis, the first approach, is a procedure whereby chymopapain is injected into the involved disc to relieve the pressure on the nerve. It is advocated by Lyman Smith, MD, who provided relief in 83% of his patients. However, not every surgeon has been able to duplicate these results according to Dr Hartman. He states that the procedure, although simple in the hands of an expert, still requires u general anesthesia. Allergic hypersensitivity has occurred in 1% to 2% of the patients. The second approach has involved a mixture of cortisone and local anesthesia as a means of relieving pain without affecting the slipped disc. Which of these two agents brings the relief has not been determined. The Cook County Hospital study evaluated the effectiveness of steroids alone.
AORN Journal, July 1974, Vol 20, N o 1
105
Steroids, such as cortisone, frequently bring relief to patients suffering from sciatica according to a report presented to the American Academy of Orthopaedic Surgeons.
J Ted Hartman, MD, Lubbock, Tex, chairman of the Department of Orthopaedic Surgery, Texas Tech University School of Medicine, said results obtained with cortisone have been better or equal in many instances to those achieved by surgery or the injection of the enzyme chymopapain. In a study a t Cook County Hospital, Chicago, 30 patients received cortisone by injection into the low back just outside the epidural. Twenty-seven patients had complete relief, two were improved, and one patient received no relief. Relief from pain lasted for several months for most patients with some reporting relief for as long as two years. lntrathecal injections of the sciatic nerve were given to 37 patients, 26 of whom claimed complete relief, 7 were improved and 4 had no benefit. Both types of injections were given to 16 patients who did not have sufficient relief following the original injections. Fourteen of this group were completely relieved, one was improved, and one had no relief.
Dr Hartman pointed out that surgery to relieve a slipped disc causing sciatica is a major procedure requiring a long recuperative period. lack of relief may affect only one-fourth to one-half of the patients. It would be advantageous, therefore, to take the nonsurgical approach. There are two possible nonsurgical approaches-one aims to remove the cause mechanism while the other attempts to modify the response to that mechanism. Chemonucleolysis, the first approach, is a procedure whereby chymopapain is injected into the involved disc to relieve the pressure on the nerve. It is advocated by Lyman Smith, MD, who provided relief in 83% of his patients. However, not every surgeon has been able to duplicate these results according to Dr Hartman. He states that the procedure, although simple in the hands of an expert, still requires u general anesthesia. Allergic hypersensitivity has occurred in 1% to 2% of the patients. The second approach has involved a mixture of cortisone and local anesthesia as a means of relieving pain without affecting the slipped disc. Which of these two agents brings the relief has not been determined. The Cook County Hospital study evaluated the effectiveness of steroids alone.
AORN Journal, July 1974, Vol 20, N o 1
105