Can you take prednisone for sciatica?

In this article:

• Does prednisone help sciatica?
• Timeline
• Dosage
• Side effects
• Bottom line

In this article

• Does prednisone help sciatica?
• Timeline
• Dosage
• Side effects
• Bottom line

Sciatica is a painful and sometimes debilitating condition characterized by chronic pain, numbness, or weakness along the sciatic nerve, which extends from the buttocks down the back of each leg. For some people, leg pain from sciatica can be severe. According to the Journal of the American Board of Family Medicine (JABFM), traditional sciatica treatment includes pain management with pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids and epidural steroid injections. But can oral steroid medications such as prednisone help?

Prednisone is an oral steroid medication used for various conditions that involve inflammation, including ulcerative colitis, psoriasis, and rheumatoid arthritis. It works by reducing the activity of the immune system to decrease swelling. While prednisone may be prescribed for sciatica in certain cases, it isn’t a common treatment for the condition. 

Does prednisone help sciatica?

Sciatica occurs when the sciatic nerve gets pinched. Many things can cause this, such as a herniated disc in the spine, obesity, poor posture, or in rare cases, a tumor. Regardless of the cause, treatment options typically include nonpharmacologic interventions, such as physical therapy and medications. Medications used to relieve sciatica pain include oral NSAIDs, such as Advil (ibuprofen) or Naprosyn (naproxen), opioids, muscle relaxants, nerve pain drugs, and either oral or injectable corticosteroid medications. 

Prednisone is an oral steroid, so it isn’t typically recommended as a first-line treatment for sciatica. In fact, according to the American College of Physicians (ACP), there is minimal evidence supporting the use of any medications other than Neurontin (gabapentin) for sciatica. However, there is some evidence that oral steroids may be helpful in certain situations. 

• In a 2015 randomized clinical trial, researchers found that a short course of oral prednisone (15 days) modestly improved the ability to function in people with sciatica due to a herniated disc. However, prednisone didn’t improve overall pain. 
• In a 2008 study, in comparison to those who took a placebo (sugar pill), people in the prednisone group had slightly quicker improvement in pain, mental well-being, and ability to function when prednisone was given within one week of the start of their sciatic pain. 

How long does it take for prednisone to work for sciatica?

Prednisone starts to work within a few hours of taking a dose, but the effects can take a few days to feel. Nevertheless, certain factors, including age, other health conditions, and other medications, may affect how quickly the drug works in the body. 

Fortunately, there is some evidence that the effects of prednisone can last even after stopping treatment. According to a 2015 study published in the Journal of the American Medical Association (JAMA), participants who took a short-term course of prednisone reported a modest improvement in function at three weeks and one year after stopping prednisone. 

Dosage of prednisone for sciatica

The dose of prednisone is highly individualized according to the severity of your condition. According to prednisone’s prescribing information, the initial dosage may vary from 5 mg to 60 mg per day, and in many situations, prednisone is only used for a short time. 

Because oral steroids aren’t traditionally used to treat sciatica, there isn’t a standard dosage of prednisone that’s recommended. According to the 2015 study in the Journal of the American Medical Association, participants took a 15-day course of prednisone that consisted of 5 days each of 60 mg, 40 mg, and 20 mg. In the 2008 study published in the Journal of the American Board of Family Medicine, participants took a 9-day course of prednisone of 3 days each of 60 mg, 40 mg, and 20 mg. If you and your healthcare provider decide that prednisone is appropriate for you, they will prescribe a treatment plan based on your condition and medical conditions. 

Prednisone side effects 

Because prednisone works by suppressing the immune system to reduce inflammation, it can cause a wide variety of side effects, especially if it’s taken in high doses or long term. For this reason, healthcare professionals typically try to prescribe it at the lowest effective dose for the shortest time needed.  

Prednisone affects nearly every system in the body. Some of the more common side effects include:

• Weight gain
• Fluid retention
• Changes in appetite
• Stomach pain
• Trouble sleeping
• Nausea and vomiting
• Facial puffiness
• Acne
• Mood swings
• Increased blood sugar
• Increased blood pressure

Prednisone may also cause serious side effects. These side effects are more likely to occur if you take prednisone for a long time, and they may require immediate medical attention.

• Stomach ulcers
• Kidney problems
• Eye problems, including glaucoma or cataracts
• Bone weakness 
• Infection
• Heart problems
• Severe allergic reactions

If you develop any signs or symptoms of these side effects, contact your medical provider right away. 

The bottom line

Sciatica treatment can include a combination of nonpharmacologic treatments, medications, and in some cases, surgery. While prednisone isn’t traditionally prescribed for sciatica, there is some research supporting its benefits in improving the ability to function. However, discussing with a primary care provider is important if the medication is right for you. Prednisone affects nearly all body systems, and it can cause several side effects. The recommended dosage is also highly individualized, depending on your condition. Your healthcare provider can guide you on how to safely take prednisone to improve your condition, and they can recommend other ways to relieve your sciatic pain.