Cochrane · systematic review · CD012450
Systemic corticosteroids for radicular and non‐radicular low back pain
Chou, R, Pinto, RZ, Fu, R, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Back and NeckAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
17
current version
GRADE rated
14
No studies
3
Included studies
NR
No studies 3 · 17.6%Ungraded 0 · 0%Very low 1 · 5.9%Low 7 · 41.2%Moderate 6 · 35.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Systemic corticosteroids compared with placebo for radicular low back pain (not due to spinal stenosis)
Population: people with radicular low back pain (not due to spinal stenosis)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (continuous) Standardized to 0–10 scale Systemic corticosteroids vs placebo | no estimate extracted | 5 studies · 430 participants | Moderate Downgraded: risk of bias |
Pain (dichotomous) Pain improved (definitions varied)c Systemic corticosteroids vs placebo | RR 1.21 [0.88, 1.66] | 2 studies · 345 participants | Moderate Downgraded: imprecision |
Function (continuous) SMD (scales varied) Systemic corticosteroids vs placebo | no estimate extracted | 4 studies · 364 participants | Low Downgraded: risk of bias, imprecision |
Function (dichotomous) Function improved (definitions varied)f Systemic corticosteroids vs placebo | RR 1.52 [1.22, 1.91] | 3 studies · 403 participants | Moderate Downgraded: indirectness |
Participants who underwent surgery Underwent surgery Systemic corticosteroids vs placebo | RR 1 [0.68, 1.47] | 5 studies · 442 participants | Moderate Downgraded: imprecision |
Participants who experienced a serious adverse event Adverse event requiring hospitalization or resulting in death Systemic corticosteroids vs placebo | RR 0.74 [0.13, 4.33] | 2 studies · 267 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Participants with hyperglycemia "Transient hyperglycemia" or blood sugar increase ≥ 50 mg/dL Systemic corticosteroids vs placebo | RR 1.07 [0.47, 2.47] | 2 studies · 151 participants | Low Downgraded: risk of bias, imprecision |
Systemic corticosteroids compared with placebo for non‐radicular low back pain
Population: people with non‐radicular low back pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (continuous) Standardized to 0–10 scale Systemic corticosteroids vs placebo | no estimate extracted | 1 study · 86 participants | Low Downgraded: imprecision, inconsistency |
Pain (dichotomous) No pain in last 24 hours Systemic corticosteroids vs placebo | RR 0.95 [0.66, 1.39] | 1 study · 86 participants | Low Downgraded: imprecision, inconsistency |
Function (continuous) RDQ‐18 (scale 0–18) Systemic corticosteroids vs placebo | no estimate extracted | 1 study · 86 participants | Low Downgraded: imprecision, inconsistency |
Function (dichotomous) RDQ‐18 = 0 Systemic corticosteroids vs placebo | RR 1.05 [0.82, 1.33] | 1 study · 86 participants | Low Downgraded: imprecision, inconsistency |
Participants who underwent surgery Systemic corticosteroids vs placebo | no estimate extracted | NR | No studies |
Participants who experienced a serious adverse event Systemic corticosteroids vs placebo | no estimate extracted | NR | No studies |
Participants who experienced any adverse event Adverse event regardless of severity Systemic corticosteroids vs placebo | RR 0.45 [0.23, 0.88] | 1 study · 86 participants | Low |
Systemic corticosteroids compared with placebo for spinal stenosis
Population: people with spinal stenosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (continuous) Standardized to 0–10 scale Systemic corticosteroids vs placebo | no estimate extracted | 2 studies · 154 participants | Moderate Downgraded: imprecision |
Function (continuous) RDQ‐18 (scale 0–18) Systemic corticosteroids vs placebo | no estimate extracted | 2 studies · 154 participants | Moderate Downgraded: imprecision |
Participants who experienced any adverse event Systemic corticosteroids vs placebo | no estimate extracted | NR | No studies |