Steroid injections for low back pain

Low back pain is a common problem that can significantly impact daily life. For many, simple treatments will provide sufficient relief. However, if pain persists, steroid injections may be recommended as part of a pain management plan.

Dr Mohammed Qureshi, distinguished pain medicine specialist, provides an expert guide to everything you need to know about steroid injections, including the procedure, their safety, and what to expect from their results.

What are steroid injections, and how do they help with lower back pain?

Steroid injections, also known as epidural steroid injections, are a minimally invasive treatment option used to manage pain in the lower back.

Conditions such as herniated discs, sciatica, spinal stenosis, and degenerative disc disease can compress the spinal nerves, leading to inflammation in the lower back that causes pain. Steroid injections work by delivering corticosteroid medication into the area that surrounds the spinal nerves (called the epidural space), helping reduce inflammation in the affected area. This provides relief from pain.

It’s important to know that while steroid injections relieve pain, they don’t cure the underlying condition. Instead, steroid injections should be part of a wider treatment plan that may include physiotherapy, lifestyle changes, and, in some cases, surgery.

How are steroid injections for the lower back given?

Steroid injections are typically administered in an outpatient setting. During the procedure, you will be asked to lie on your stomach or side. The pain medicine specialist, will clean the area where the medication needs to be delivered and use a local anaesthetic to numb the skin and deeper tissues.

The specialist will use imaging guidance, such as X-rays or ultrasound, to identify the exact location of inflammation. Once the target area is identified, the specialist will carefully insert a thin needle into the epidural space, and the corticosteroid medication will then be injected.

The entire process usually takes 15 to 30 minutes, with most people experiencing only mild discomfort due to the local anaesthetic. You will be monitored for a short time after the procedure before being discharged. It’s recommended to arrange for someone to drive you home, as you might experience temporary numbness or slight weakness in your legs.

Are steroid injections for the lower back safe?

Steroid injections are generally considered safe when performed by a qualified and experienced specialist. However, as with any medical procedure, they come with potential risks and side effects.

Common side effects include temporary pain or soreness at the injection site, facial flushing, or a mild headache. Rare but serious complications include infection, bleeding, nerve damage, or a condition known as a spinal headache, which can occur if the needle accidentally punctures the membrane surrounding the spinal cord.

Before undergoing the procedure, you will need to inform your specialist of any medical conditions, allergies, or medications you are taking. Special precautions will be necessary for people with diabetes, as steroid injections can temporarily raise blood sugar levels.

How long do the effects of these steroid injections last?

The duration of relief from steroid injections will vary depending on each person, the underlying condition, and the severity of the inflammation. Some people will only notice a slight improvement, while others will experience significant pain relief for weeks or even months.

Your specialist will generally recommend a maximum of 3 injections per year to minimise the risk of complications associated with repeated corticosteroid use. Repeated injections should be spaced out by at least several months.

If pain persists or worsens despite the injections, other treatment options such as surgery may need to be considered. Procedures such as a laminectomy or spinal fusion can address structural issues causing nerve compression. Consulting a pain medicine specialist can help to develop a tailored plan for managing your lower back pain effectively.

If you would like to book an appointment with Dr Mohammed Qureshi, head on over to his Top Doctors profile today.