Using Steroids to Treat Back Pain: A Guide

Medically Reviewed By Philip Ngo, PharmD

Back pain is a major cause of acute and chronic pain. Steroids are often used for back pain because they are widely available and generally not expensive. Steroids may help with some types of back pain. Steroids for back pain include corticosteroids. These are different from anabolic steroids that athletes may use for performance enhancement.

The effectiveness of steroids for back pain depends on the cause of the pain and the underlying structures affected.

Read on to learn more about how steroids treat back pain.

How do steroids work for treating back pain?

a person has a steroid pill and a glass of water
Simone Wave/Stocksy United

Steroids for back pain are anti-inflammatory. The steroid binds to receptors in the cells that block the production of inflammatory proteins and enzymes.

If inflammation is putting pressure on a nerve, steroids may help take the pressure off the nerve and relieve the pain.

These steroids are different from the steroids athletes may use for performance enhancement.

Types and examples of steroids for back pain

Steroids for back pain may be oral or injectable.

Oral steroids

Oral steroids come in pill and liquid forms. Oral steroids require the body to absorb and process the medication via the bloodstream. This is called “systemic” use and means that side effects may impact Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source multiple organ systems.

Examples include prednisone, methylprednisolone, and dexamethasone.

Injectable steroids

Injectable steroids go directly to the site of the inflammation. A physician injects them into the area of the pain, usually the epidural space in the spine. Injectable steroids may be less likely to cause significant side effects.

Who can take steroids for back pain?

Steroids are safe to use for many people, especially in the short term. Long-term or high doses of steroids are likely to cause side effects. Some of these may be serious. Up to 90% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of people taking steroids for longer than 60 days may experience adverse effects.

People with some conditions should not take steroids or should limit their use of steroids. These conditions include:

Back conditions that steroids can treat

Doctors may prescribe steroids for back pain from conditions such as:

Dosing guidelines

Steroids should be used Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for the shortest possible time at the lowest effective dose. Your doctor will assess you for conditions that might make steroids less safe for you.

Side effects

Steroids have a variety of potential side effects, some of which may be serious. Roughly 90% Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of people taking steroids for longer than 60 days experience side effects. These include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

Even with short-term use, corticosteroid use can lead Trusted Source BMJ Peer reviewed journal Go to source to an increase in serious side effects such as:

  • fractures
  • venous thromboembolism
  • sepsis

Addison’s crisis

The adrenal glands produce essential hormones, including cortisol. Steroids can slow Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source or stop the production of these hormones because they replace the natural production of corticosteroids. This means that suddenly stopping steroids can cause a condition known as Addison’s crisis.

Addison’s crisis is an emergency. It can progress rapidly and, if untreated, may be fatal.

Symptoms of Addison’s crisis include:

If you take steroids, you should carry a card with you indicating that you are on these medications. Report unusual symptoms to your doctor immediately.

Never stop taking steroids abruptly. Ask your physician for instructions to taper your withdrawal from steroids.

Are steroids effective for back pain?

Steroids may help treat low back pain or radiating leg pain caused by pressure on a nerve. Steroids probably will not decrease the potential need for surgery.

A U.S. Department of Veteran’s Affairs analysis shows that there is no convincing evidence that steroids are effective for back pain. The analysis suggests that steroids do not decrease pain or disability to any significant degree. In addition, the analysis states that any benefit does not outweigh the risks of taking steroids.

Another analysis suggests that epidural steroid injections repeated within 3 months offer a cumulative benefit.

Are steroids safe?

Steroids have many side effects, and many of the side effects may be serious Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . Therefore, doctors prescribe them cautiously. Take steroids exactly as prescribed, and take the smallest effective dose for the shortest possible time.

Follow your doctor’s instructions carefully. Be certain that you understand how to take these medications, how to stop them, and what to watch for.

Steroids can make some health conditions worse. Keep all appointments for monitoring, lab work, and weight management.

Steroids may interact with some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDS).

Other frequently asked questions

Here are questions people also ask about steroids and back pain.

What is the fastest way to relieve back pain?

The fastest way to relieve back pain depends Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source on the cause, severity, and duration of the pain.

Conservative treatments include massage, gentle heat, and physical therapy. Tai chi and yoga may help strengthen and support the area.

Over-the-counter medications such as Tylenol and ibuprofen may help. Nonsteroid medications such as muscle relaxants, anticonvulsants, and opioids may also help.

Does inflammation return after prednisone?

Steroids like prednisone decrease inflammation but do not treat the underlying condition causing the inflammation. This means that inflammation can return after taking a course of steroids if the underlying cause is still present.

Summary

Steroids for back pain may help somewhat with the pain, but they can also produce side effects. Some side effects can be serious.

Your doctor will take your overall health into account and weigh the risks and benefits of steroid use carefully. Keep all appointments for medical care and labs. Carry a wallet card indicating that you use steroids.

Never stop taking steroids suddenly.

Since steroids are unlikely to treat the underlying cause of your pain, consider ways to strengthen and support the affected area. Take all medications exactly as prescribed and know the signs that indicate side effects.

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Medical Reviewer: Philip Ngo, PharmD
Last Review Date: 2023 Jan 31
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