Steroids help reduce inflammation that can cause severe back pain, but steroids aren’t long-term solutions. They come with a number of potential side effects and health risks.

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Back pain can limit your mobility and diminish your quality of life. When certain spinal conditions, such as a bulging disk, cause back pain, a doctor may suggest steroid injections to relieve your pain.

Steroids, specifically corticosteroids, tend to provide short-term relief and are usually recommended after other treatments have been tried.

In this article, you’ll learn what conditions may be treated with steroids, how these powerful medications work, as well as their possible side effects and complications.

Steroids work by reducing the inflammation that may cause your back pain. The body’s immune system triggers an inflammatory response when there’s illness or injury.

Inflammation is often part of the healing process. But chronic inflammation can also put pressure on nerves, which, in turn, causes pain that may linger until the inflammation is brought under control.

Steroids work by reducing levels of prostaglandins and other chemicals in the body that are part of the inflammatory process.

Steroids are sometimes recommended to treat acute back pain that results from an injury. The fast-acting nature of steroids can reduce pain and inflammation while the injury heals.

Other back conditions that may be treated with steroids include:

Steroids are also sometimes used to treat spinal stenosis, a condition in which the space inside the vertebrae narrows and puts pressure on the spinal cord and nerves. But a 2022 analysis of 13 clinical trials suggests that, while steroids may be helpful for some conditions, they’re not particularly effective for relieving spinal stenosis pain.

Steroids for back pain include oral tablets and injectable medications.

One of the most common oral steroids is prednisone (Deltasone), which is also taken for conditions ranging from asthma to various autoimmune disorders, such as lupus and multiple sclerosis.

Other oral steroids sometimes prescribed for back pain include methylprednisolone (Medrol) and dexamethasone (Maxidex, Ozurdex, DexPak).

An injectable form of dexamethasone (Decadron) is also used to treat back pain. Other injectable steroids commonly used to treat back pain include:

The choice of which steroid to use depends on several factors, including your previous reaction to a particular steroid and the region of the spine to be injected.

Oral and injectable steroids share some common side effects, such as insomnia. Most potential side effects of steroids are specific to the type of medication used.

Because oral steroids affect the entire body, some common side effects include:

  • changes in your heart rate (faster, slower, irregular)
  • elevated blood pressure
  • leg swelling
  • mood shifts
  • weight gain

Receiving steroid injections can lead to minor pain at the injection site and a temporary increase in back pain. You may also experience some flushing of your skin and a brief increase in your blood sugar levels. These side effects tend to disappear after a few days.

One of the main concerns with steroid injections for back pain is that the steroids can weaken the bones of the spine and the surrounding muscles. The National Institutes of Health notes that the general guideline is to limit spinal injections to no more than 3–4 per year.

Individuals rarely experience heavy bleeding or infection at the injection site. Allergic reactions to steroid injections are also uncommon.

Serious complications related to oral steroids are also uncommon, but there are some potential risks. A 2017 study suggests that short-term use of oral steroids may increase the risk of fractures and upper respiratory tract infections.

Oral steroids are taken daily but should only be used for 1–2 weeks. It can take several days before they provide significant relief. Steroid use is usually tapered. For example, you may take 6 tablets the first day, and then 6 the next day, and then 5, and so on until there are no more tablets left.

Injectable steroids are much more concentrated. After receiving one injection, you may not need one for a few months or longer.

Before receiving an injection of steroids, you’ll receive a local anesthetic to numb the injection site. You’ll lie face down, and you may have an X-ray taken of your spine to confirm the location of the injection.

After you receive your shot, you should be able to sit up and walk around. Before going home, you may be observed in the doctor’s office for 10 or 20 minutes to check for any adverse reactions.

A 2022 study suggests that steroids may be most effective for short-term back pain relief and delaying surgery, but there still isn’t enough data to show that there are many long-term benefits.

The best use of steroids for back pain may be as part of a combination of treatments that include heat and cold packs, physical therapy, and complementary treatments, such as massage or acupuncture.

Surgery is usually considered a last resort, though, in cases of severe spinal conditions, it may be necessary.

How quickly do steroids help back pain?

You should begin to experience back pain relief within 2–3 days after starting oral steroids.

Injectable steroids also may begin to work within a couple of days, though the pain may temporarily increase the first day or so after the injection. The timeline for steroids to work also depends on what’s causing your back pain.

What is the most common steroid for pain?

Prednisone is one of the most common oral steroids for back pain. Among the most common injectable steroids are dexamethasone and betamethasone.

What is the biggest side effect of prednisone?

Weight gain is an especially common side effect of prednisone, but mood shifts and changes in your heart rate are also common.

Steroids are generally well-tolerated medications that can provide short-term and fast-acting relief for various types of back pain, but they aren’t meant to be used regularly for a long time or as substitutes for more lasting treatments, such as physical therapy.

If you experience back pain, get an accurate diagnosis of your condition and discuss your treatment options with a healthcare team. Steroids may be a helpful piece of the puzzle in relieving your back pain and restoring your mobility and quality of life.