Ibuprofen With or Without Dexamethasone for Acute Radicular Low Back Pain.

This study compares two pain relief approaches for adults who come to the emergency department with acute sciatica (radicular low back pain) — pain that shoots from the lower back into the leg. It tests whether adding a short course of dexamethasone (a steroid) to ibuprofen provides better relief than ibuprofen alone. You may be eligible if: - You are between 18 and 70 years old - You are being treated in the ER for acute sciatica with pain radiating to the buttock or leg - Your pain started less than 2 weeks ago - Your pain is not from a direct trauma to your back in the last month - Your back pain significantly limits your function (score above 5 on a disability questionnaire) - You will be sent home from the ER (not admitted) You may NOT be eligible if: - You are pregnant - You use pain medications daily or near-daily (chronic pain syndrome) - You have a known allergy to the study medications - You take steroids regularly or have contraindications to ibuprofen (stomach ulcers, severe heart failure, kidney disease, blood thinners, or cirrhosis) - You cannot be reached for follow-up Talk to your doctor to see if this trial is right for you.