Try conservative measures first to control pain, and know the limits and risks of this therapy if you choose to try it.
Most people who suffer from back pain already know the drill: time heals this wound. Over weeks to months, the pain will calm down, and you will slowly return to your normal life. In the meantime, try to stay as active as possible and rely as much as possible on over-the-counter pain relievers.
But for some people, these conservative measures may not relieve the agony soon enough—especially if the problem is back pain caused by irritated spinal nerves. After a few weeks, just getting to the bathroom can be a challenge. At that point, you may be offered an injection of a steroid medication to calm the war zone in your lower back.
Even for nerve-related back pain, guidelines discourage hasty intervention with steroids. You would do less invasive, less aggressive things first.
However, if you choose this therapy, know its limits. The shots are almost always a temporary measure. In general, it's for symptom control, and not a definitive treatment.
Used appropriately, steroid injections can calm inflamed joints and tissues but do not speed healing or prevent future problems. Here are some of the most common targets for steroid injection therapy:
Epidural space. Epidural injections target the area around the spinal cord where nerve "roots" exit and extend to other parts of the body. The area near the nerve roots may be the source of low back pain, such as sciatica.
Tendons and bursae. Steroids are used for tendinitis—inflammation of a tendon, the tough, fibrous cord of tissue that connects muscle to bone. Steroids may also be used to calm down an inflamed bursa (bursitis). Bursae are cushioning pads of tissue that reduce friction between muscles and tendons as they move across bones and other joint structures.
Joints. Steroids are sometimes injected into a joint to calm inflammation related to arthritis. Common targets are the knee and the facet joints in the spine.
How long should you wait before considering injection therapy? It depends on the intensity of the pain and how long you can bear it before it starts to ease on its own. Most people experience substantial improvement in six to eight weeks.
How steroid shots work
Steroid injections contain various formulations of medications. A common combination is the numbing drug procaine hydrochloride—known to millions of dental patients as Novocain—mixed with the anti-inflammatory drug cortisone.
Once the injection finds its target, the numbing effect will start to wear off within hours. As the Novocain wears off, the pain may temporarily come back. Then 24 to 48 hours after the injection, you can begin to expect whatever benefit you're going to get.
What to expect
If the injection works, you'll certainly be grateful for the relief, but success is not guaranteed. In studies of large groups of back pain sufferers, the benefit is small to none on average. It's hard to predict what you, individually, will experience.
Steroid injections do not change the course of a chronic back pain condition. Months down the road, you will generally end up in the same condition as if you never got the shot. In the meantime, the shot could ease your discomfort.
For more information on epidural injections for back pain, contact Comprehensive Pain Management in Franklin, MA.
Source: Harvard Health