A Comparative Effectiveness Randomised Placebo Controlled Pilot Trial of the Management of Acute Lumbar Radicular Pain

Inclusion Criteria: * Leg pain of any description with clinical findings consistent with single level radiculopathy * Minimum symptom duration \> 72hrs * Maximum symptom duration \< 3 weeks to ensure symptom duration at randomisation is ≤ 4 weeks * No previous episode of same level radicular pain in the previous 6 months * Pain intensity at \>30 on the Oswestry Disability Index (ODI) * Imaging (MRI and/or CT) indicating herniated disc or foraminal stenosis or both, concordant with the level indicated by history and physical examination Exclusion Criteria: * Previous transforaminal epidural steroids at any level in the last 12 months * Previous oral steroids in the last 12 months * Any lumbar surgery at same level, or above or below the level at any time * Previous lumbar surgery at any other level to that in (iii) within the last 12 months * Pregnancy, or lactation/breastfeeding * Direct indication for neurosurgery (e.g. cauda equina syndrome, or progressive motor loss i.e. less than or equal to 3/5 power) * Inability to read or understand English * Any serious medical or psychiatric condition that may interfere with participation or outcome assessment such as: need for uninterrupted anti-coagulation, spinal fracture, active infection or metastatic disease suspected, active cancer, poorly controlled diabetes, or patients with diabetes on any insulin, uncontrolled hypertension (systolic blood pressure \>180 or diastolic blood pressure \>110 within 30 days of randomization d…