Epidural steroid injections for back pain: Why limited dosing?

Why are epidural steroid injections for back pain limited to three a year? The pain relief usually wears off within six to eight weeks, but I have to wait eight to 10 weeks for another injection.

- Edward / Virginia

Answer

Epidural steroid injections can provide short-term relief of back pain. The number of epidural steroid injections is limited — often to no more than three in one year — to reduce the risk of potentially serious side effects. These side effects may include:

• Decreased bone density
• Thinning skin
• Weakened muscles
• Decreased production of naturally occurring steroids

Epidural steroid injections contain corticosteroids, which mimic the effects of the hormones cortisone and hydrocortisone. When prescribed in doses that exceed the natural levels of these hormones, corticosteroids reduce inflammation around the irritated nerves. This can help relieve pain, although only temporarily.

Research on the correct dose and frequency of epidural steroid injections is limited. And even then, the available data come mainly from studies in which participants received daily steroid injections for conditions other than back pain.

It's important to carefully weigh the potential risks and benefits of long-term epidural steroid injections. If you're in pain between epidural steroid injections, you might ask your doctor about other treatment options for back pain.

RELATED

• Prolotherapy: An effective treatment for low back pain?
• Disk replacement: An effective treatment for low back pain?
• Inversion therapy: Can it relieve back pain?
• Pulsed radiofrequency neurotomy: A cure for back pain?
• Myofascial release therapy: Can it relieve back pain?
• Bowen therapy: Effective for back pain?
• Noninvasive treatments
• Spinal fusion
• Complementary and alternative approaches
• Back pain guide
• Back pain
• Spinal injury: First aid
• Back surgery: When is it a good idea?
• Back pain: Will chiropractic treatment help?
• Acupuncture: Can it help?