Evaluation of body mass index, age and smoking as factors influencing the efficacy for treating acute sciatica pain with oral prednisone in female patients

Abstract

Acute sciatic pain affects about 12% of individuals who show up at emergency services in the United States of America and its main cause is lumbar disc herniation. Despite the benign evolution in most cases, with spontaneous remission in up to 90% of the patients in 6 weeks, acute sciatic pain is a factor of disability and dysfunction that causes huge expenses for public health and the economy. The initial first-line treatment, except in acute cases of Cauda Equina Syndrome, involves administration of painkillers, anti-inflammatories and relative rest. More symptomatic cases and refractories to clinical treatment are candidates for epidural infiltrations with corticosteroids and even surgical procedures. The administration of systemic corticosteroids per os, under the premise of reducing the inflammatory response associated with radiculopathy, is consolidated in medical practice. However, the results of this treatment, in literature, are contradictory. The aim of this project is to evaluate the influence of Body Mass Index, age and smoking in female patients on the efficacy of this kind of treatment. The hypothesis is that overweight or obesity, advanced age and smoking are important factors to predict an ineffective response to treatment due to intervertebral disc degeneration. For this purpose, a prospective cohort study will be conducted with patients undergoing a course of systemic corticosteroid therapy for 20 days.