• image.alt
  • With Mayo Clinic anesthesiologist

    David P. Martin, M.D., Ph.D.

    read biography

Free

E-Newsletters

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer

Question

Epidural steroid injections for back pain: Why limited dosing?

Why are epidural steroid injections for back pain limited to three a year? The pain relief usually wears off within six to eight weeks, but I have to wait eight to 10 weeks for another injection.

Answer

from David P. Martin, M.D., Ph.D.

Epidural steroid injections contain corticosteroids, which mimic the effects of the hormones cortisone and hydrocortisone. When prescribed in doses that exceed the natural levels of these hormones, corticosteroids reduce inflammation around the irritated nerves. This can help relieve pain, although only temporarily.

Epidural steroid injections are usually limited to just a few a year because there's a chance these drugs might weaken your spinal bones and nearby muscles. Steroid injections also suppress the body's natural hormone balance and can lead to adrenal insufficiency, a serious medical condition. Delaying repeat injections allows your body to return to its normal balance. The risk of these side effects may increase with the number of steroid injections you receive and the dose given in each injection.

It's important to carefully weigh the potential risks and benefits of long-term epidural steroid injections. If you're in pain between epidural steroid injections, you might ask your doctor about other treatment options for back pain.

Next question
Myofascial release therapy: Can it relieve back pain?
References
  1. Hurdle MF (expert opinion). Mayo Clinic, Rochester, Minn. June 15, 2010.
  2. Friedrich JM, et al. Lumbar epidural steroid injections: Indications, contraindications, risks and benefits. Current Sports Medicine Reports. 2010;9:43.
  3. Chou R. Subacute and chronic low back pain: Nonsurgical interventional treatment. http://www.uptodate.com/home/index.html. Accessed June 4, 2010.
  4. Martin DM (expert opinion). Mayo Clinic, Rochester, Minn. June 15, 2010.
AN01892 Aug. 20, 2010

© 1998-2012 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

Print Share Reprints

Advertisement


Text Size: smaller largerlarger