Arthritis Drug Relieves Sciatica Pain

Remicade May Offer New Sciatica Treatment Option

From the WebMD Archives

April 23, 2003 -- A drug commonly used to ease the pain and inflammation of rheumatoid arthritis may also double as a potential sciatica treatment. A new study shows Remicade (infliximab) effectively reduced leg pain caused by severe sciatica and allowed many suffers to return to normal activities.

"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, in a news release. "While more research is needed, these findings indicate that infliximab may provide a potential new alternative to help fulfill this unmet medical need."

The study appears in the current issue of the journal Spine.

Researchers say it's the first time this class of drugs has been studied as a sciatica treatment. The condition can be caused by normal wear and tear on the body, but may also be caused by any sudden pressure on the disc that supports the spine, such as a herniated disc. Symptoms usually include leg pain, weakness, numbness, or a burning or tingling sensation that travels down the leg.

Remicade works by reducing the level of a chemical in the body called tumor necrosis factor alpha. Tumor necrosis factor alpha is a key factor in the inflammatory process that occurs in a variety of conditions and is increasingly thought to play a role in sciatica.

Remicade is currently approved by the FDA for use in treating rheumatoid arthritis and Crohn's disease.

In the study, 10 people who had sciatica caused by a herniated disc were given an intravenous dose of Remicade over two hours.

One hour after the infusion, leg pain had been reduced by 50%. Two weeks after treatment, 60% of the patients were free of pain, compared with only 16% of those who received a placebo infusion, and those benefits continued for at least three months.

The study also found that within one month after treatment, all of the patients who received Remicade were able to return to work while 38% of the placebo group remained on disability leave.


In addition, researchers say none of the patients who received the Remicade sciatica treatment had to undergo surgery for their condition, compared with 15% of the non-treated group.

In an editorial that accompanies the study, Bjorn Rydevik, MD, of Sahlgrenska University Hospital in Gothenberg, Sweden, says the results are impressive and "a new era may have been reached with new promising pharmocologic treatment methods for sciatica."

Although these results are promising, experts say the findings must first be confirmed by a randomized, controlled trial to look at the long-term safety of using Remicade for sciatica treatment before it can adopted for general use.

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SOURCES: Spine, April 15, 2003. News release, Orton Rehabilitation Clinic.
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