Q: Why don’t steroid injections always help my back pain?
A: The outcomes from epidural steroid injections are unpredictable. If I gave 100 people injections for back pain, I’d get 100 different responses.
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Epidural steroids bring weeks of pain relief to some people, months of relief to others, and forever-type relief to a fortunate few. Outcomes vary for almost as many reasons.
One thing pain management specialists address during the consultations and follow-up visits is your own response to previous treatment. If your last epidural steroid injection helped you for a year and a half, we might consider repeating it if your pain returns. If it helped you only for a day, we’d look at other options for you. There are often other options for “short responders.”
Steroids have both good and bad effects. Too-frequent exposure could put you at risk for:
- Decreased bone density.
- Thinning of the skin.
- Water retention.
- Immunosuppression.
- High blood sugar.
If you’ve been challenged with a short duration of benefit, or perhaps little to no benefit at all, I would recommend talking with your doctor about all the interventional tools available for your specific type of back pain, not just epidural steroid injections.
—Pain management specialist Robert B. Bolash, MD
