Steroid Injections for Back Pain
In some cases, a steroid (cortisone) injection can reduce back pain and nerve pain that travels into your buttocks and legs by reducing inflammation. Our spine specialists may prescribe a combination of medications, exercise, physical therapy, and steroid injections. This type of comprehensive treatment plan is the most effective way to reduce your back pain and improve your quality of life.
Types of Spinal Steroid Injections
There are many types of steroid injections we use for spine pain treatment:
- Epidural steroid injection—We inject the steroid into the epidural space, the area around your spinal nerves.
- Intradiscal injection—We inject a steroid, antibiotic, and anesthetic mixture into a specific disc. Discs are the shock absorbers between your spinal bones.
- Joint injection—We inject the steroid into a specific joint that’s suspected to cause pain.
You may have a spinal steroid injection to diagnose or treat back pain. Your provider may inject the steroid around a specific nerve to see if it relieves your symptoms. This approach helps us pinpoint the cause of back pain.
Who Is a Good Candidate for a Steroid Injection?
There are several reasons you may benefit from a steroid injection:
- You’ve tried other treatments, such as activity modifications, physical therapy, and medications, which haven’t relieved your symptoms.
- You’ve had back pain for six weeks or longer.
- Your pain reduces your ability to participate in your usual activities.
Pros & Cons of Steroid Injections for Back Pain
Steroid injections can successfully reduce back pain for many people. They’re minimally invasive and can improve your function and quality of life.
The main drawback of a steroid injection is that it might not relieve pain as well as you hope. We consider a steroid injection successful if it reduces your pain by at least 50% for three months or longer.
What to Expect During a Steroid Injection
Your spine specialist will give you specific instructions to prepare for a steroid injection. You may need to stop eating or drinking after midnight on the morning of the procedure. We may ask you to stop taking blood thinners and/or antiplatelet medications before an injection.
We will take you to a procedure suite after you check in on the day of your treatment. Your provider will perform the following steps:
- Sterilize the skin in the area being treated
- Numb the area with local anesthesia
- Use X-ray imaging to guide a needle to the precise area being treated
- Inject a mixture of steroid and numbing medicine
- Remove the needle, clean the area, and place a small bandage over it
The procedure can take up to 20 minutes. You go home the same day and rest.
After Your Steroid Injection
Most people with desk jobs return to work the next day. It’s important for the medication to stay where we injected it. You’ll need to avoid exercising for a couple of days.
Rarely, you may temporarily experience some increased back pain after the procedure. It takes several days for the steroids to start relieving your symptoms.
How Often Can You Get Steroid Injections in Your Back?
You should only get steroid injections 3–4 times per year at most. Your provider may recommend getting more injections over a short period if they’re diagnosing the cause of your pain.
Side Effects of Steroid Injections In Your Back
Some people experience minor side effects of steroid injections:
- Bruising in the treated area
- Dizziness or fainting immediately after the injection
- Headaches
- Infection or bleeding in the treated area
- Short-term increased blood sugar, especially in people with type 1 or type 2 diabetes
- Slightly elevated blood pressure
- Temporary numbness in the affected area
How Long Do Steroid Injections Last for Back Pain?
Our goal is for you to experience pain relief for at least three months after the injection. However, everyone responds differently to steroid injections. Your injection may last for more or less than three months.
How Long After Steroid Injections to Consider Back Surgery?
Steroid injections can successfully treat back pain for many years. Keep in mind that steroid injections may not relieve all your pain. However, they’ll often reduce your symptoms enough for you to participate in your usual activities. You may be a candidate for spine surgery if steroid injections no longer improve your function or relieve your back pain.
When to See a Spine Specialist
Talk to your primary care provider first If you’ve been experiencing the following types of back pain:
- Moderate to severe chronic back pain (lasting more than three months)
- Severe acute back pain (lasting less than three months) that prevents you from functioning
Your primary care provider will often start treatment that resolves your symptoms. They will refer you to a spine specialist if needed.
