Steroid Injections: Your Questions Answered
The pain management experts at The Spine and Pain Institute of New York present information about steroid injections and drugs used to manage pain.
Does a steroid injection mask the problem? To a degree, yes. The steroid injection decreases the inflammatory component of pain and simultaneously contributes to the healing of the disc. The injection helps control pain while you recover.
Does a steroid injection hurt? Possibly. However, the needles are so small that pain is minimal. Most patients who undergo an injection with anesthesia open their eyes after the procedure and do not realize the procedure was performed. Muscle spasm or pain after an injection is possible, but unlikely. Do not let the fear of an injection stop you from receiving treatment.
Are steroids bad for me? Potentially. Anytime a foreign substance is introduced into the body there is the chance of side effects. Most of the negative connotations about steroids are associated with chronic use. Steroids are often prescribed for chronic inflammatory conditions such as rheumatoid arthritis, severe asthma, lupus, and psoriasis.
In pain management only a small dose of a steroid is injected where it needs to be placed for long-acting relief. Side effects are usually minimal and self-limiting. Common side effects include possible facial flushing and menstrual irregularity. Other side effects are associated with long-term or chronic steroid use.
My doctor gave a steroid dose pack and it barely helped. Will the injection work? The goal of the injection is to use a very small amount of medication and deliver it to the pain source — to locally control your pain.
Steroid dose packs involve taking a higher steroid dose orally for one week. As the medication dissolves from the stomach and into your blood stream, only a small about of the steroid reaches the area where the disc is herniated. The rest of the steroid is dispersed throughout your body. Oral steroids are less effective and associated with more side effects as they are systemic.
Wouldn't it be easier to surgically cut the disc out? While surgery is effective in treatment leg pain associated with a herniated disc, surgery is not a first line treatment. Rather, in many patients, a spinal injection provides effective pain relief. Surgery may be considered if the pain is unrelenting and severe despite injections or other nonsurgical treatment. In my opinion, injections are an important, conservative and nonoperative step to take before any type of surgery.
How many injections do I need? As few as possible. Patient responses vary and depend on the cause and location of nerve impingement, degree of inflammation, and chronicity. The goal is to eliminate the pain using the least amount of medication/injections as possible. If you do not have pain, you do not need an injection.
Treatment of Spine Pain
If you are interested in learning about the cause and treatment of your pain problem, please contact our pain management experts at The Spine and Pain Institute of New York in Manhattan, New York and Staten Island, New York. We would be happy to make an appointment for a consultation and provide additional information about other treatment options.