How It Works
Corticosteroids may be given orally or
injected into the spinal canal (epidural) or near a spinal nerve to treat
herniated disc symptoms. These medicines may help
reduce swelling and
inflammation in the area surrounding the herniated
disc and may help relieve pressure on the
Why It Is Used
Epidural and spinal nerve
corticosteroids can be used for people with symptoms of nerve root compression
and inflammation if their symptoms have not improved after several weeks of
nonsurgical treatment. Sometimes corticosteroid injections are used sooner
to treat acute disc herniations that are causing severe symptoms.
Corticosteroids may be used to
delay or even eliminate the need for surgery for some people who have severe
pain caused by a herniated disc.
How Well It Works
There is evidence that
corticosteroid injections can help you feel better. There is also evidence that
the injections do not help any more than a
placebo.1 Research continues
on both oral and injected corticosteroids. Oral corticosteroids have not been
shown to help relieve symptoms of herniated discs. But some doctors use them
because they are safe and simple for short-term use, and they seem to help some
Corticosteroid treatment does not provide long-term pain
relief by itself. But if corticosteroids can help calm down the acute
inflammation, the body's normal healing process may lead to long-term
Mild side effects may include:
Headache, sometimes severe. This usually lasts
no more than 1 to 2 days.
- Increased back or
Rare but serious side effects may include:
- Infectious and noninfectious inflammation of
spinal nerves or other tissues.
- Degeneration or damage to soft
tissue from multiple injections.
- Damage to nerve roots.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
An imaging test, such as
magnetic resonance imaging (MRI),
computerized tomography (CT scan), or myelogram is usually
done before a corticosteroid injection to find the exact location of the
herniated disc and nearby nerve roots.
Although some doctors prefer to use two to three
epidural corticosteroid injections, others will prescribe only one, repeating
the treatment only if symptoms recur and if the first injection was
Repeated use of corticosteroid injections or pills may
cause serious side effects.
Despite a lack of solid research
supporting the practice, corticosteroid injections are commonly prescribed to
treat herniated disc symptoms that haven't responded to a few weeks of
treatment with other methods.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Jordan J, et al. (2009). Herniated lumbar disc, search
date July 2008. Online version of Clinical Evidence: http://www.clinicalevidence.com.