Low Back Pain: Should I Try Epidural Steroid Shots?

If you've had back pain for more than 6 weeks and your pain is very bad, your doctor might recommend a shot (injection) of corticosteroid, or steroid medicine, into your spinal canal. This is called an epidural injection.

Steroid medicines reduce inflammation and swelling. This can relieve pressure on nerves and nerve roots. The medicine can't fix your back, but it may give you short-term relief from back and leg pain.

The medicine may be given as 1 shot or a series of up to 3 shots about a month apart. More than 3 shots in the same spot within 12 months isn't recommended.^{footnote 3}

For some people, the shots provide short-term relief from pain, especially pain that runs down the leg. But relief doesn't last very long. In most cases, the shots only last about 3 months.^{footnote 1} But that may be enough time for your back to heal so that pain doesn't return.

The shots may allow you to postpone or avoid surgery. But they may not improve how well you can do your daily activities over the long term.

If you don't have pain that spreads from your back down your leg, it's unlikely that epidural steroid shots will help at all. Epidural steroid shots are not recommended if you have general, or nonspecific, low back pain.^{footnote 2}

The most common problem is a severe headache that lasts for a few days. And your pain might get worse before it gets better.

Complications include infections or bleeding at the site of the injection.

Serious side effects from an epidural steroid injection are rare. But they can include stroke, paralysis, or loss of vision.

You may be able to relieve your symptoms by making lifestyle changes or trying other treatments, such as:

• Exercise. Aerobic exercise-especially riding a stationary bike-can help your symptoms.
• Medicines. Acetaminophen, such as Tylenol, and nonsteroidal anti-inflammatory drugs like ibuprofen (such as Advil or Motrin) and naproxen (such as Aleve) may help your pain. Be safe with medicines. Read and follow all instructions on the label.
• Healthy body weight. Getting to and staying at a healthy body weight may help your symptoms and keep the pain from getting worse.
• Physical therapy. This helps you learn stretching and strength exercises that may reduce pain and other symptoms.
• Cognitive-behavioral therapy for controlling pain and pain triggers. See a psychologist, a licensed counselor, or a clinical social worker who specializes in pain management skills.

Your doctor may recommend the shots if you've already tried other treatments for at least 6 weeks, and if you have pain that spreads down your leg.