Do Oral Steroid Dose Packs Predict How Well Epidural Steroid Injections Will Work?

Inclusion Criteria: * 18 years and older * Diagnosed by participating physicians during the study enrollment period as having intervertebral disk herniation and persistent symptoms with or without some nonoperative treatment for at least 4 weeks * Radicular pain (below the knee for lower lumbar herniations, into the anterior thigh for upper lumbar herniations) * Evidence of nerve-root irritation with a positive nerve-root tension sign (straight leg raise-positive between 30° and 70°) or a corresponding neurologic deficit (asymmetrical depressed reflex, decreased sensation in a dermatomal distribution) * Undergone either MRI or CT scan showing disc herniation (protrusion, extrusion, or sequestered fragment) at a level and side corresponding to the clinical symptoms * Patients with multiple herniations can be included if only one of the herniations is considered symptomatic * Preenrollment nonprocedural care can include: education/counseling, physical therapy, chiropractic therapy, anti-inflammatory medications, opioid analgesics, adjuvant analgesics such as anticonvulsants and antidepressants Exclusion Criteria: * Prior lumbar surgery * Cauda equina syndrome * Vertebral fractures * Spine infection or tumor * Severe motor deficit * Inflammatory spondyloarthropathy * Pregnancy * Cardiac or pulmonary comorbid conditions contraindicating interventional procedures * Diabetes * Inability/unwillingness to have spinal injections