I had a steroid injection into my spine to help relieve severe sciatica. The insurance company denied the claim. They said that sciatica will get better on its own, and steroid injection is not needed. Can I fight this?

A recent review of the literature may offer some help. Surgeons from the University of Washington looked at many studies on the use of epidural steroid injections (ESIs) for low back pain.

They found that there's no strong evidence to support the use of ESI for back pain alone. Back pain that radiates (travels) down the leg is called sciatica. Sciatica is a sign that the spinal nerve is pinched or irritated. Back pain with sciatica may benefit from an ESI.

The natural history of back pain with or without sciatica is that the symptoms will improve and go away in most people during the first seven to eight weeks. Treatment may not speed up this healing process.

For that reason, some experts don't advise any treatment during that first eight weeks. Others suggest that early intervention could help keep the problem from becoming chronic.

ESI may give patients the temporary help they need with painful symptoms. ESI is a reasonable treatment choice for some patients to decrease their pain and speed up their return to work or function. This may help them avoid becoming a chronic pain patient. It can also prevent the need for surgery.