Why are epidural steroid injections for back pain limited to only a few a year?

Dec 18, 2018 | Richard H. Rho, M.D. | @richardrho | Comments (23)

man balancing on a logOriginally posted via MayoClinic.Org

Epidural steroid injections are usually limited to just a few a year because there's a chance these drugs might weaken your spinal bones and nearby muscles. This isn't caused by the needle — it's a possible side effect of steroids.

Steroid injections can also cause other side effects, including skin thinning, loss of color in the skin, facial flushing, insomnia, moodiness and high blood sugar. The risk of side effects increases with the number of steroid injections you receive.

Epidural steroid injections contain drugs that mimic the effects of the hormones cortisone and hydrocortisone. When injected near irritated nerves in your spine, these drugs may temporarily reduce inflammation and help relieve pain.

But steroid injections also disrupt your body's natural hormone balance. Delaying repeat injections allows your body to return to its normal balance.

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.

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@sickofbeinsick1

I e had neck injections for years through different Dr’s. I wonder if that could have something to do w/ complete desiccation of C2 -3, 3 -4, 4 - 5…all the way down to T1 & 2?

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Steroids over time weaken bone that can lead to destruction, which is why they are limited. Unfortunately you may have developed that leading to your current state. I’ve never had injections and will not if I can help it.

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I have received epidural injections in my L4/L5 area during the past year. Initially, the injections would eliminate pain for four months. Recently, they eliminated/minimized pain for six weeks. What is my next step to minimize this pain?

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Hello Speedy,
My husband had steroid injections for his back that lasted about six months. Then his pain doctor did nerve ablation which has lasted over a year now. He was told the nerves will grow back and everyone has a different timeframe, but the ablation has helped him. He still has morning stiffness and some bad days but he also has many good days too.

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@speedy

I have received epidural injections in my L4/L5 area during the past year. Initially, the injections would eliminate pain for four months. Recently, they eliminated/minimized pain for six weeks. What is my next step to minimize this pain?

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You can only minimize pain for so long before you need further help than that provided by the steroid injections. But over time the medication causes bone destruction leading to surgery.

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@parrot53

Hello Speedy,
My husband had steroid injections for his back that lasted about six months. Then his pain doctor did nerve ablation which has lasted over a year now. He was told the nerves will grow back and everyone has a different timeframe, but the ablation has helped him. He still has morning stiffness and some bad days but he also has many good days too.

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I had a consultation at Mayo Spine Center last week. Two solutions were proposed.
1. A six-day dose pak of medroprednisone
2. An ablation that may have to be repeated at some point.
I'm on my third day of medropredisone and my back pain has reduced significantly.
I was pleased that two non-surgical options were proposed. Happy to hear the ablation was successful
Thanks

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@speedy

I had a consultation at Mayo Spine Center last week. Two solutions were proposed.
1. A six-day dose pak of medroprednisone
2. An ablation that may have to be repeated at some point.
I'm on my third day of medropredisone and my back pain has reduced significantly.
I was pleased that two non-surgical options were proposed. Happy to hear the ablation was successful
Thanks

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Glad to hear you found some relief. I hope this is the answer for you. Best of luck. It was good also to confirm that ablation was a good choice for us. Thanks for sharing.

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@speedy

I had a consultation at Mayo Spine Center last week. Two solutions were proposed.
1. A six-day dose pak of medroprednisone
2. An ablation that may have to be repeated at some point.
I'm on my third day of medropredisone and my back pain has reduced significantly.
I was pleased that two non-surgical options were proposed. Happy to hear the ablation was successful
Thanks

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Have had ablation in spine and shoulder but stop at surgery. With EDS my calcium doesn’t seat screws or do anything normal. N never heard of medroprednisone. Will look into it. Have started Humira and after three injections, there is significant reduction in pain but back is still screaming.
Thank you

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@jholland

Have had ablation in spine and shoulder but stop at surgery. With EDS my calcium doesn’t seat screws or do anything normal. N never heard of medroprednisone. Will look into it. Have started Humira and after three injections, there is significant reduction in pain but back is still screaming.
Thank you

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I'm in my fifth of six of
six days of methylprednisolone. After two days my back pain was down significantly. Since then it has increased. I'll wait another week to allow the steroid time to work. Fortunately, there are nonsurgical options available.

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@jholland

Have had ablation in spine and shoulder but stop at surgery. With EDS my calcium doesn’t seat screws or do anything normal. N never heard of medroprednisone. Will look into it. Have started Humira and after three injections, there is significant reduction in pain but back is still screaming.
Thank you

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Hello JHolland,
We were wondering how long ago you had your ablations. My husband’s pain doc says they may have to be repeated as nerves do grow back and everyone’s body has its own timetable for that.
Also is Humira a steroid based med?
Thanks.

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My ablation lasted from a few weeks to a few months. Insurance wouldn’t permit a second until a few months after the first so it wasn’t done again for a year. I was surprised that insurance picked up the Humira. Knew that inflammation was a problem but it is amazing as even my shoes are now too big. Still pain but feeling better and able to stand straight is overwhelming and I have a tendency to overdo. Search Humira for it’s chemical composition. Should know more but don’t, sorry.

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