How Effective Is Cortisone for Sciatica?

Cortisone for sciatica can provide temporary relief from persistent nerve pain caused by a compressed or injured sciatic nerve. Treatment can include injections directly into the area around the nerve, as well as oral medications for patients to take. As part of the overall treatment program, the patient might need to take other medications as well, and could need physical therapy, rest, and other measures to address the pain and irritation. Patients may respond very differently to treatments, and thus something that works for some people may not be effective in others.
Historically, there were some concerns about using cortisone for sciatica because of the high doses involved. Advocates were worried that taking high doses in the long term could expose people to a high risk of side effects and complications. Changes in prescribing practices have resulted in much lower dosages, reducing risks for patients while retaining the benefits that caused practitioners to recommend cortisone for sciatica in the first place. Patients who are unsure of the appropriateness of the dosage can ask for more information from their doctors.

In direct injection form, cortisone for sciatica can suppress immune responses to reduce inflammation. This should make the patient feel more comfortable, because the sciatic nerve and surrounding tissue will not be as swollen. Cutting back on swelling can reduce the pressure that causes the nerve pain, alleviating the symptoms. The injections may last several weeks or months, depending on each individual case.

Oral medications can be taken as a maintenance drug to keep inflammation down. Higher doses may be required because the drugs aren’t delivered directly to the site, and the patient can be at a higher risk of side effects. Whether such medications are appropriate can depend on patient history, the doctor’s experience, and the specifics of the case. If the patient does need to stop taking oral cortisone, it may be necessary to slowly taper off the dosage to avoid complications.

Patients who choose to use cortisone for sciatica may be able to delay surgery to treat the condition. In some cases, controlling the inflammation and keeping the patient comfortable eliminates the need for surgery altogether. The outcome of treatment can depend on what is causing the problem, the patient’s general level of health, and how early the patient started receiving treatment. People who receive care early may be able to prevent the long-term damage that eventually leads to a need for surgery.
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Discussion Comments
My first cortisone injection was very effective and relieved my sciatica symptoms. But the second and third injections were not as effective. I still had some pain relief, but not as much as I had with the first injection.
Does anyone know why this is? I don't think I'm going to go for any more rounds because it feels like it's going to be less and less effective.
@SarahGen-- I would have said the same thing three days after my cortisone injection too. Cortisone takes time to work, sometimes a week, sometimes two or three. But once it starts working, it relieves pain and lasts for months.
I continued to have severe pain for a week after my cortisone injection. But after the second week, the pain disappeared and it hasn't come back. It's been almost six months!
When I experienced pain relief, I didn't even think of the cortisone because like you, I expected results right away. But when I went for a check-up with my doctor, he said that it's the cortisone kicking in. I have no idea why doctors forget to tell us that it takes a while for cortisone to work from the beginning, but that's how it is.
I had a cortisone injection for my sciatica three days ago. I'm disappointed because so far, it has done nothing. My back still hurts, I have numbness and tingling in my leg and I can barely walk.
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