No Efficacy of Dexamethasone Injections for Acute Sciatica: A Double-Blind Randomized Study Versus Saline.
Eur J PainSep 1, 2026
Yves Maugars, Christelle Volteau, Simon Korner et al.
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In 30 seconds
The DEXHIA study, a double-blind randomized controlled trial, evaluated the efficacy of ultrasound-guided caudal dexamethasone injections versus saline in 106 adults with acute sciatica due to lumbar disc herniation. The primary outcome, change in the Oswestry Disability Index at 3 weeks, showed no significant difference between groups (mean change: -9.5 vs -13.8; p=0.18), indicating no clinical benefit from dexamethasone.
Key findings
- No significant difference in ODI change at 3 weeks between DEXA and PLACEBO groups (mean change: -9.5 vs -13.8; p=0.18).
- No significant differences in secondary outcomes, including pain and quality of life, at any follow-up time point.
- Injection-related adverse events were more frequent in the DEXA group, though mild and transient.
Why it matters
These findings challenge the common practice of using corticosteroid injections for acute sciatica, suggesting that clinicians should reconsider the efficacy of this treatment approach in their practice.