Steroid injections have served as a go-to treatment for lower back pain for decades. During the procedure, anti-inflammatory medication is injected into the epidural space within the spine. Before deciding to receive these injections, there are a few things patients should know about them.
1. Questionable Effectiveness
In recent years, the effectiveness of steroid injections in managing back pain has been called into question. One of the larger studies – an analysis of 23 different studies – found that steroid injections reaped insignificant benefits over placebo injections for patients with sciatica, a condition characterized by irritation of the sciatic nerve that creates lower back and leg pain.
Researchers compared both short- and long-term benefits of steroid injections versus placebo for leg and back pain. On a 100-point scale, placebo reduced short-term leg pain by 3 points, compared to 9.4 points for steroid injections. Placebo reduced short-term disability by 1.2 points, compared to 5 points for steroid injections. While the steroid injections outperformed placebo, the overall benefits to sciatica patients weren’t significant. No significant differences between steroid and placebo injections were found for long-term measurements.
See more on this analysis at http://annals.org.
2. Osteoporosis Risk
A Henry Ford Hospital study analyzed 6,000 records of patients who received lower back pain treatment. Half of the patients had received at least one steroid injection, while the other half had received none. The researchers found that each injection came with a 29% increased risk of bone fracture. Since patients often receive multiple steroid injections for back pain a year, this is particularly important for patients to note. It’s especially relevant to women, who are predisposed to osteoporosis – brittle bone disease – due to hormonal changes their bodies undergo during menopause.
More on this study can be found at www.sciencedaily.com.
Steroid use can cause osteonecrosis, a condition wherein part of a bone is cut off from blood supply and dies. This can cause the bone to collapse, leading to joint deterioration and severe osteoarthritis.
4. Blood Sugar Spike
Diabetics should understand that steroid injections can cause a spike in blood glucose levels. A small study of 30 diabetics found epidural steroid injections to raise average blood sugar levels from 160 to 286, and this change lasted for 2 days. Learn more about the study at www.ncbi.nlm.nih.gov.
5. Immune System Problems
Steroids act on the immune system – both inflammatory chemicals and white blood cells. Their use, particularly long-term, can leave you more susceptible to infection because they suppress the immune system.
Knowing effectiveness rates and risks associated with various treatment options ensures that patients can do a thorough cost/benefit analysis. Make the right choice for back pain management by staying informed.