In a recent randomized controlled trial conducted in two Dutch hospitals, transforaminal epidural corticosteroid injections (containing Methylprednisolone and Levobupivacaine) effectively mitigated leg pain in sciatica-affected patients. Researchers explored the effectiveness of steroid injections in patients suffering from acute sciatica lasting less than 8 weeks.

The study involved 141 subjects who were randomly assigned to three groups:

(a) Intervention 1: Received usual care along with transforaminal epidural steroid injections  containing 1 ml of 40 mg/ml Methylprednisolone and 1 ml of 0.5% Levobupivacaine

(b) Intervention 2: Received usual care along with transforaminal epidural injection consisting of 1 ml of 0.5% Levobupivacaine and 1 ml NaCl 0.9%

(c) Control group: Received usual care, including oral pain relievers without or with physiotherapy.

The co-primary outcomes, including back pain and leg pain intensity, physical functioning, and recovery, were estimated over a six-month follow-up period. The results indicated no profound differences in co-primary outcomes between groups, except for leg pain, which showed a vital drop in the intervention 1 group when compared to the control group. While secondary outcomes revealed some fundamental differences in surgery and treatment satisfaction, these were witnessed only when comparing the intervention 2 group with the control group.

Post hoc analyses revealed a profound improvement in leg pain (50% reduction) for the  intervention 1 group compared to the control group at 3 months. Additionally, both intervention groups reported reduced opioid usage. The researchers concluded that transforaminal epidural steroid injections had a statistically significant effect on leg pain for those dealing with acute sciatica as opposed to usual care. However, no differences were noted in co-primary outcomes. Despite this, transforaminal epidural injections appeared to be linked with reduced opioid usage, prompting the need for further exploration into their potential benefits.