- With Mayo Clinic anesthesiologist
David P. Martin, M.D., Ph.D.
read biographyclose windowBiography of
David P. Martin, M.D., Ph.D.
David P. Martin, M.D.
Dr. David Martin is board certified in anesthesiology by the American Board of Anesthesiology with advanced certification in pain medicine. He is a consultant in the Department of Anesthesiology at Mayo Clinic, Rochester, Minn., and an associate professor of anesthesiology at College of Medicine, Mayo Clinic. Dr. Martin, a Cincinnati native, received his M.D. degree, and has a Ph.D. in neuroscience, from Washington University School of Medicine in St. Louis.
He has been with Mayo Clinic since 1993. Dr. Martin, who chaired Mayo Clinic's Division of Pain Medicine in the Department of Anesthesiology from 1999 to 2001, is a member of the International Association for the Study of Pain, the American Pain Society, the American Society of Anesthesiologists, the Minnesota Society of Anesthesiologists and other professional groups. He has been published widely in the medical literature on pain management and related topics.
Causes (1)
- Tarlov cysts: A cause of low back pain?
Treatments and drugs (3)
- Disk replacement: An effective treatment for low back pain?
- Epidural steroid injections for back pain: Why limited dosing?
- Myofascial release therapy: Can it relieve back pain?
Lifestyle and home remedies (1)
- Back pain relief: Ergonomic chair or fitness ball?
Alternative medicine (3)
- Inversion therapy: Can it relieve back pain?
- Acupuncture for back pain?
- Prolotherapy: An effective treatment for low back pain?
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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 questionMyofascial release therapy: Can it relieve back pain?
- Hurdle MF (expert opinion). Mayo Clinic, Rochester, Minn. June 15, 2010.
- Friedrich JM, et al. Lumbar epidural steroid injections: Indications, contraindications, risks and benefits. Current Sports Medicine Reports. 2010;9:43.
- Chou R. Subacute and chronic low back pain: Nonsurgical interventional treatment. http://www.uptodate.com/home/index.html. Accessed June 4, 2010.
- Martin DM (expert opinion). Mayo Clinic, Rochester, Minn. June 15, 2010.
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