Effectiveness of non-surgical interventions for patients with chronic sciatica: A systematic review with network meta-analysis.
The journal of pain May 13, 2025 Zhaochen Zhu, Tim Schouten, Rob Strijkers et al. 1 citation
A systematic review and network meta-analysis of 50 randomized controlled trials involving 4920 adults with chronic sciatica found very uncertain evidence regarding the effectiveness of non-surgical interventions. At short-term follow-up, spinal manipulative therapy, exercise combined with neural mobilization, and soft tissue anesthetic injections showed the largest reductions in leg pain intensity compared to placebo, but all were based on very low confidence evidence. Epidural magnesium injections improved physical function at short-term, and long-term improvements in physical function were seen with epidural steroid plus ketamine injections and epidural injections combined with physical therapy, again with very low confidence. No high-quality evidence confirms the superior effectiveness of any non-surgical intervention for chronic sciatica.