When Do Epidural Steroid Injections Work for Back Pain?

February 2, 2010
by: Sylvia Marten

For many back pain sufferers, surgery is scheduled only after all other options have been exhausted. One non-surgical approach to pain relief is epidural steroid injections. While intended only for temporary pain relief, a steroid injection coupled with therapeutic exercise theoretically may allow patients to postpone or even avoid surgery altogether.

Epidural steroid injections are most often used to treat low back and leg pain associated with sciatica: pain caused by a pinched nerve in the low back that radiates down the leg. Sciatica can result from a number of conditions, including a herniated disc, degenerative disc disease or spinal stenosis.

Reader Experiences with Epidural Steroid Injections

Many Spine-health readers have had epidural steroid injections and have shared their results with us.

• There were many people who did experience relief, if only temporarily.
• In several instances, readers noted having injections in an effort to reduce the pain until their scheduled surgery.
• There was also indication that a series of 3-4 shots provided the most relief, while anything more than that went unnoticed, or even made pain worse.

• A select few were awarded complete relief and have been able to return to normal activities.
• For as many who have had success, there were just as many readers who experienced little to no relief from epidural steroid injections.
• There has been some controversy regarding the imaging techniques used during the procedure. Physicians using fluoroscopy and radiographic contrast often have much better success rates pinpointing the exact location of the injury, allowing them to guide the injection needle more accurately.
• The most common reader complaints were centered on the side effects associated with steroids. Many reported significant weight gain and bloating, swelling of the face, feet and ankles, and headache and nausea. Another concern for some readers, especially those with diabetes, was the rise in blood sugar associated with steroids.

There is no conclusive evidence that epidural steroid injections work better for one condition than another; success rates are different for each individual. For those looking to postpone surgery, injections may provide enough temporary relief. The most important thing is to find a doctor that you trust, and who will adequately answer any questions you may have regarding your condition or the injection procedure.

Additional Information on Epidural Steroid Injections

For more information on epidural steroid injections, see:

• Epidural Steroid Injections for Back Pain and Leg Pain Video
• Use of epidural steroid injections for radicular lumbosacral pain – American Academy of Neurology.