Dexamethasone in the management of symptoms due to herniated lumbar disc

One hundred consecutive patients with radicular pain due to myelographically proven herniated lumbar intervertebral discs were treated with initially high but tapering doses of intramuscular dexamethasone for seven days. All patients had reflief of pain within 24-48 hours. Bed rest was eliminated as a significant factor in the improvement. Nine patients required surgery at the end of the hospital treatment period. Another 11 required surgery during the follow-up of 15 months. Review of work status and recurrent pain during the follow-up indicates that the non-surgically treated patients in this series fared better. It is concluded that nerve root inflammation is the immediate cause of radicular symptoms in case of ruptured lumbar disc and that treatment with dexamethasone gives prompt relief of pain and may avoid the need for surgery in most cases.