Johns Hopkins Health Alert
Steroid Injections for Back Pain
This Health Alert is intended for readers interested in learning about the prevention, diagnosis, and management of back pain.
For older people, chronic conditions such as degenerative changes of the spinal bones and disks, vertebral compression fractures, spinal stenosis (narrowing of the spinal column), and spinal deformities are the most common sources of back pain. Recently many of us are turning to steroid injections to ease our back pain, according to a recent study in the journal SPINE.
In most cases, back pain resolves quickly, regardless of the type of treatment. In fact, about 90% of cases improve on their own. Fewer than 5% of people with back pain have a major medical problem that requires either intensive care or surgery. But if you experience severe back pain that doesn't improve after a couple of days of bed rest, or if your back pain is recurring or is accompanied by pain, numbness, or tingling that radiates into the buttocks or legs, it is important to see a doctor.
Now data reported in the journal SPINE (Volume 32, page 1754) suggests that older people with back pain are receiving steroid injections for a growing number of conditions, despite limited evidence about how well the steroid injections actually work and limited agreement on when they should be used.
A look at Medicare claims for steroid injections from 1994 through 2001 showed a 271% increase in steroid injections into the lower back (epidural) and a 231% increase in injections into facet joints (small stabilizing joints located between and behind adjacent vertebrae). The majority of the steroid injections were given to treat conditions for which there is little documented evidence of benefit. Women were 1.5 times more likely than men to receive an epidural steroid injection.
Posted in Back Pain on May 8, 2009
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The problem is that the steroid injections help with the pain in the short term but do nothing to correct the problem. Frequent or continued steroid injections also can negatively affect your health in other ways.
Posted by: michaelgtx | May 9, 2009 9:44 AM
The injections I recieved over a 1 1/2yr period for shoulder pain before and after surgery from my Pain Specialist were the best thing that could have happened for me. After 1yr I had no more shoulder pain, and was able to return to work with some restriction. I also recieved 2 injecttions for and my chronic/daily headaches that have never come back. It has been 3 years since my last injection and my last pain pill. They were worth every dime spent. When other Doctor's were tired of listening to my complaints and tired of prescribing pain meds that were often not helpful, I found a Pain Specialist that listened and knew exactly how to treat my pain. I'm an RN. This Doctor explained the pro's and con's, was prudent in his care and treatment of my problems. I would recommend steriod injections given by a qualified professional Pain Specialist to anyone who has chronic neck, shoulder, back pain, or chronic headaches.
Posted by: formerpainpatient | May 11, 2009 8:54 AM
"despite limited evidence about how well the steroid injections actually work" What does this mean? Has the efficacy been studied and the results ambiguous, or is there simply a paucity of research? I can't tell you how many times an MD has mistaken lack of research for lack of truth. Doctors need to listen to their patients' experiences, and patients need to trust their instincts. For me, steriod gave me back my life. I was completely bedridden before, and now I am a productive, and happy, member of society. Not all conditions can be corrected, by the way. Sometimes you just need a good pain management doctor. One who will listen.
Posted by: Teresa080 | May 16, 2009 7:38 AM
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I read your article. The following are incorrect in my opinion.
Women use it more..(back injections)....I use it, am female and it works. I am staving off back surgery #3 and it makes me able to function and walk!
Crunching numbers and making statements about whether it is effective and that it is being done for $$ offends me.
You did not contact all of us who have been treated....instead you, again in my opinion, made a statement that may influence people in need of alternative treatments not to seek it.
If you have ever had serious back problems you would be able to speak from actual experience not the fact crunching you did in this article.
I have lost confidence in the information and opinions from this site and that is a shame as I originally felt JOHN HOPKINS knew what it was talking about. No I do not have the same opinion.
Mary E. Bryce
Posted by: boatcat | May 8, 2009 11:41 AM