A drug sometimes prescribed for use in spondylitis (FDA-approved for spondylitis of inflammatory bowel disease) and rheumatoid arthritis to help ease pain and inflammation may also double as a potential sciatica treatment. Remicade works by reducing the level of a chemical in the body called tumor necrosis factor alpha, which is key in the inflammatory process that occurs in a variety of conditions (like spondylitis) and is increasingly believed to play a role in sciatica. This study is the first to evaluate a TNF-a medication for treatment in sciatica patients.

Sciatica can be caused by normal wear and tear on the body, but it can also be caused by any sudden pressure on the disc that supports the spine, like a herniated disc. Symptoms include leg pain, weakness, numbness, or a burning or tingling sensation that travels down the leg.

Study Participants
10 people who had sciatica caused by a herniated disc were given an intravenous (I.V.) dose of Remicade over two hours.

Findings

• One hour after infusion, leg pain had reduced by 50%.
  
• Two weeks after treatment, 60% of patients were free of pain, compared to 16% of those who had received the placebo.
  
• Benefits continued for at least three months.
  
• Within one month after treatment, all the patients who received Remicade were able to return to work, yet 38% of the placebo group remained on disability leave.
  
• None of the patients who received Remicade had to undergo surgery for sciatica, compared with 15% of the placebo group.

"These results are very promising for patients suffering from severe sciatica, for whom surgery is the only treatment option," says researcher Jaro Karppinen, MD, of Oulu University Hospital in Oulu, Finland. "While more research is needed, these findings indicate that Remicade may provide a potential new alternative to help fulfill this unmet medical need."

Results demonstrate that Remicade effectively reduced leg pain caused by severe sciatica and allowed many study participants to return to normal activities. Researchers say the findings need to be confirmed by a randomized, controlled trial to look at the long-term safety of using Remicade for sciatica treatment before it can be adopted for general use.

The study appears in a recent issue of the journal Spine.