The review addressed a clear question and was supported by reproducible eligibility criteria. Attempts to identify relevant studies were made by searching electronic databases and checking references, but it was unclear whether there were any language or publication restrictions. It was also unclear whether appropriate methods (such as independent duplicate processes) were used throughout the review to reduce the possibility of reviewer error or bias.
Trial quality was not formally assessed, making it difficult to evaluate the reliability of the results. Sufficient trial details were provided, except that the dose was absent for two trials, and appropriate methods were used to synthesise the data and assess heterogeneity. The author's conclusions seem contradictory, since the reference to pain improvement appears to relate to the addition of steroids assessed at three months. The possible clinical meaning, and relevance, of the pain improvement estimate was not discussed.
The limited evidence, the lack of a formal quality assessment, and the contradictory conclusions, mean that the reliability of the author's conclusions is unclear.