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Epidural steroid injections: Why limited dosing?

By Mayo Clinic staff

Original Article:  http://www.mayoclinic.com/health/epidural-steroid-injections/AN01892
  • With Mayo Clinic anesthesiologist and pain specialist

    Richard H. Rho, M.D.

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Question

Epidural steroid injections: Why limited dosing?

Why are epidural steroid injections for back pain limited to only a few a year?

Answer

from Richard H. Rho, M.D.

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. This is not caused by the needle, but it is a possible side effect of steroids. The risk of these side effects increases with the number of steroid injections you receive.

Epidural steroid injections contain drugs that mimic the effects of the hormones cortisone and hydrocortisone. When injected near irritated nerves in your spine, these drugs may temporarily reduce inflammation and help relieve pain. But steroid injections also disrupt your body's natural hormone balance. Delaying repeat injections allows your body to return to its normal balance.

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
Back pain relief: Ergonomic chair or fitness ball?
References
  1. Nieman LK. Pharmacologic use of glucocorticoids. http://www.uptodate.com/home. Accessed Jan. 4, 2013.
  2. Chou R. Subacute and chronic low back pain: Nonsurgical interventional treatment. http://www.uptodate.com/home. Accessed Jan. 4, 2013.
  3. Friedrich JM, et al. Lumbar epidural steroid injections: Indications, contraindications, risks and benefits. Current Sports Medicine Reports. 2010;9:43.
  4. AskMayoExpert. Spinal injections. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
AN01892 March 9, 2013

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