Systemic steroids for cervical radicular pain: A systematic review.

Area of Science:

• Neurology
• Pain Management
• Pharmacology

Background:

• Cervical radicular pain significantly impacts quality of life.
• Systemic steroids are used for inflammatory conditions, but their efficacy in cervical radicular pain is not well-established.
• Defining systemic steroids as oral or intramuscular administration, excluding epidural or intra-articular injections.

Purpose of the Study:

• To determine the effectiveness of systemic steroids for treating cervical radicular pain.
• To synthesize evidence from existing literature on systemic steroid treatment for this condition.

Main Methods:

• Searched PubMed and Ovid Medline databases up to February 11, 2022, using terms like "Steroid* and Cervical Radic*" and "Steroid* and Cervicobrachialgia".
• Included randomized controlled trials (RCTs) and other studies involving adult patients (≥18 years) with cervical radicular pain treated with systemic steroids.
• Extracted data on study design, participant characteristics, diagnostic criteria, treatment protocols, outcomes (Neck Disability Index, patient-reported pain), and follow-up.

Main Results:

• Seven studies were included. One RCT showed oral steroids significantly improved Neck Disability Index and pain scores compared to placebo.
• The same RCT indicated higher success rates with oral steroids (76%) versus placebo (30%).
• Another RCT suggested intramuscular steroids had worse outcomes than interlaminar epidural steroids at one week and one year.

Conclusions:

• Evidence for systemic steroids in cervical radicular pain is limited.
• Oral steroids represent a potentially viable conservative treatment option.
• Intramuscular steroids appear less effective than epidural steroid injections, necessitating further high-quality research.