Effectiveness of Oral Prednisone in Improving Physical Functioning and Decreasing Pain in People With Sciatica

Inclusion Criteria: * Seeks care at a Kaiser Permanente clinic spine care specialist at the San Jose, Redwood City, or Roseville site * Complains of low back pain and functionally incapacitating leg pain extending below the knee with a nerve root distribution * Score of at least 20 on the modified Oswestry Disability Index * Appears, in the opinion of the study physician, to be very likely to have a herniated lumbar disc * MRI study confirms a herniated disc consistent with the signs and symptoms Exclusion Criteria: * Onset of sciatica symptoms occurred more than 3 months before study entry * Cauda equina syndrome * Active cancer * Acute spinal fracture * Currently taking oral steroids * Diabetes mellitus and taking insulin or glycohemoglobin greater than 10% * Systolic blood pressure greater than 180 mm Hg or diastolic blood pressure greater than 110 mm Hg * Pregnant or breastfeeding * Active peptic ulcer disease * History of intolerance to steroid therapy * Bleeding diathesis or anticoagulant therapy * Ongoing litigation or workers compensation claim for low back pain or sciatica * Underwent previous lumbar surgery * Received epidural steroid injection (ESI) within the 12 months before study entry * Unable to read or speak English * Progressive or severe motor loss