As noted in a new article from the May 19, 2015 issue of JAMA, oral steroid tapers are commonly used to treat acute sciatica due to a herniated disc.  The study performed a randomized clinical trial evaluating the use of a short course of an oral steroid taper for acute sciatica pain with a confirmed disc herniation on MRI reported modestly improved function and no improvement in pain in prednisone treated group compared to placebo at the end of one year. Â
Oral steroid tapers such as the prednisone taper used in the study are commonly used medications in patients with an acute episode of sciatica (also known as a pinched nerve) to help reduce the inflammatory component of the a pinched nerve in the short term.  Such medications are not meant to be a long term cure all treatment for acute sciatica.  Rather, they should be an a potential tool in a treating physician’s treatment regimen to be used on a case by case basis.
Furthermore, the utility of analyzing the benefit of the medication to 52 weeks is unclear.  A case of sciatica that lasts for a year no longer fits the definition of acute sciatica and can carry a different prognosis from a clinical standpoint, even with surgical intervention.  Use of a short medication taper would not be expected to change the outcome in these chronic cases.