Steroid Injections for Back Pain

Dr Shreedhar Archik

Steroid injections for back pain at a glance

• Steroid injections deliver corticosteroids that resemble the body’s anti-inflammatory hormone to specific areas in the back via a needle to decrease inflammation and provide pain relief.
• The three main types of steroid injections for the back are categorized by where the injection is made and include trigger point, facet joint and epidural.
• Steroid injections for back pain reduce the pain and increase mobility.

What are steroid injections for back pain ?

Steroid injections are a common, nonsurgical treatment for spine, back and neck pain. Steroids, short for corticosteroids, are synthetic drugs that resemble cortisol, an anti-inflammatory hormone that the adrenal gland produces naturally.  Steroids work by decreasing inflammation and reducing activity in the immune system, and are used to treat a variety of diseases and conditions, including spinal stenosis and sciatica.

Steroid injections are performed to help reduce the inflammation and pain associated with a compressed nerve.  Nerves can be compressed by a herniated disc, spinal stenosis or bone spurs.

Steroids are administered two ways.  They can be administered to the entire body system or injected into the entry point of the affected area.  There are three main types of steroid injections for back pain associated by their  location  :

• Epidural injections : A steroid that is injected into the spinal canal around the area that surrounds the spinal cord and nerve roots for relief of sciatica.

• Trigger point injections :  The steroid is injected into the area in the back that triggers or causes pain at that spot or extends to another area of the body such as the hip or leg.
• Facet joint injections : The steroid is injected into a facet joint, which is one of the points where a vertebra connects to another.

Benefits of steroid injections

Steroids work to reduce inflammation (heat, swelling, redness and pain).  As a result, patients suffering from neck, spine or back pain typically feel less pain, swelling and stiffness and are able to function better after receiving steroid injections.

Steroid injections are a first-time option for patients who suffer from sciatic and do not want to have surgery. Steroid injections can be added to a treatment plan that may already include pain medications, anti-inflammatory drugs, physical therapy, occupational therapy or supportive devices such as  canes or braces.  Whether one or more of those treatment methods are used depends on the nature of the problem.  They are used for long-term treatment of sciatic pain and are often repeated once or twice a year.

Steroid injection procedure

The patient will be given specific instructions prior to coming in for the injection and can usually continue on their normal medications with the exception of any blood thinners or anti-inflammatory medications.

• An intravenous (IV) line will be placed in one of the veins. Patients may be given medication to help them relax during the procedure.
• The patient will be placed on an X-ray machine over a bolster to help open up the spaces between the bones in the back. The X-ray is obtained to verify the proper level for the injection.
• The patient’s skin is cleaned and they are injected with a medication to numb the area.
• After the area is prepared and numb, the doctor will insert a needle through the skin and toward the spine.  Once the needle is in the proper space, a small amount of dye may be injected to verify the position of the needle on the X-ray.
• A mixture of numbing medication and steroids is injected into the epidural space.  The needle is removed and a bandage is placed over the site.

The injection is generally very quick and is administered in under 30 seconds. It is usually not painful because of the numbing medication used at the start. Many people have a mild tenderness in the days following the injection and it may help to apply ice to the affected area for 15 to 20 minutes at home.

Steroid injections are one of the most effective ways to decrease pain and improve function.  It’s important to keep in mind that not everyone gets the same level of relief from the injections.  Since the amount of steroid injected is usually small, injections may be repeated up to three times per year if necessary with no significant side effects.

Common side effects of steroid injections include :

• Insomnia
• Flushing
• Headache
• Muscle tensions
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Disclaimer: The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. The information is provided solely for educational purpose and should not be considered a substitute for medical advice.