Corticosteroid Injection for Low Back Pain: What It Is, How It Works, and What You Need to Know

Corticosteroid injections are a type of medication that is injected directly into a joint or tissue to reduce inflammation and pain. These injections are used to treat a variety of conditions, including low back pain, arthritis, bursitis, tendonitis, and other inflammatory condition.

What Are Corticosteroids?
Corticosteroids are a class of drugs that are similar to hormones naturally produced by the body’s adrenal gland. They are often used as anti-inflammatory drugs to reduce inflammation and swelling, and they can also help to suppress the immune system.

Corticosteroids can be administered in a variety of ways, including orally, topically, and intravenously. However, when corticosteroids are injected directly into a joint or tissue, they can provide more targeted and effective pain relief.

How Do Corticosteroid Injections Work?
When corticosteroids are injected directly into a joint or tissue, they work by reducing inflammation and swelling in the affected area. This can help to relieve pain and improve mobility.

Corticosteroids work by binding to specific receptors in cells, which then leads to a decrease in the production of inflammatory molecules, such as prostaglandins and leukotrienes. This decrease in inflammatory molecules helps to reduce inflammation and swelling, which can help to relieve pain.

Effectiveness of Corticosteroid Injections
Corticosteroid injections can be very effective at reducing inflammation and pain in some people. However, they are not always effective for everyone. The effectiveness of corticosteroid injections can depend on a variety of factors, including the type of condition being treated, the severity of the condition, and the individual’s response to the medication.

In some cases, corticosteroid injections may provide only temporary relief, and the pain may return after a few weeks or months. In other cases, corticosteroid injections may not provide any relief at all.

There are also some risks associated with corticosteroid injections, including infection, bleeding, and damage to surrounding tissues. Therefore, it is important to discuss the risks and benefits of corticosteroid injections with your healthcare provider before undergoing the procedure.

Corticosteroid and Low Back Pain

Corticosteroid injections are commonly used in the treatment of low back pain, particularly when the pain is caused by conditions such as herniated discs, spinal stenosis, or degenerative disc disease.

In the case of a herniated disc, the gel-like material inside the disc can leak out and put pressure on nearby nerves, causing pain, numbness, or weakness. With spinal stenosis, a narrowing of the spinal canal that can put pressure on the spinal cord or nerves. And finally with degenerative disc disease, which is a condition that can cause discs in the spine to break down over time, a corticosteroid injection can be used for all these to reduce inflammation around the affected area and the nerve roots, which can help to relieve pain and improve function and quality of life.

However, it’s important to note that while corticosteroid injections can be effective in treating low back pain caused by these conditions, they are NOT A CURE. It’s important to also address the underlying cause of the pain in order to see long term results. This cone be done through physiotherapy or other active treatments to prevent the pain from returning or worsening over time.

Additionally, corticosteroid injections should not be used as a first-line treatment for low back pain. They are typically reserved for cases where other treatments, such as physiotherapy, medication, or lifestyle changes, have not been effective. It’s important to discuss the risks and benefits of corticosteroid injections with your healthcare provider to determine if they are appropriate for your specific situation.

What To Do Post Injection

After receiving a corticosteroid injection, there are several things that can be done to help maximize its efficacy and ensure the best possible outcome. Here are some key steps to take:

1. Rest and avoid strenuous activity: It’s important to rest the affected area for at least 24 hours after receiving the injection. This means avoiding strenuous activity, such as heavy lifting, running, or high-impact exercise. This will help to reduce the risk of further inflammation and ensure that the medication has time to work.
2. Apply ice to the injection site: Applying ice to the injection site can help to reduce swelling and inflammation, which can improve the efficacy of the injection. Use a cold pack or a bag of ice wrapped in a towel, and apply it to the injection site for 20 minutes at a time, several times a day.
3. Take pain medication as directed: In some cases, your healthcare provider may recommend taking pain medication to help manage discomfort after the injection. It’s important to take any medication as directed and not exceed the recommended dose.
4. Attend physiotherapy: Depending on the underlying condition causing your low back pain, your healthcare provider may recommend attending physio after receiving the injection. Physiotherapy can help to strengthen the affected area, improve mobility, and prevent the pain from recurring.
5. Follow up with your healthcare provider: It’s important to follow up with your healthcare provider after receiving a corticosteroid injection to evaluate the effectiveness of the treatment and determine if further intervention is needed.

In addition to these steps, it’s important to continue practicing appropriate lifestyle modifications, good posture and taking care of your back after receiving the injection. This can help to prevent the pain from returning or worsening over time. This includes maintaining a healthy weight, avoiding prolonged sitting or standing, using proper lifting techniques, and engaging in regular exercise.

Risk Factors Post Injection

After receiving a corticosteroid injection, there are certain activities or behaviours that can increase the risk of the injection not working well and the pain returning. Here are some things to avoid:

1. Strenuous activity: As mentioned earlier, it’s important to rest the affected area for at least 24 hours after receiving the injection. For up to a week or two after the injection, strenuous activity, such as heavy lifting or high-impact exercise, can increase inflammation and reduce the efficacy of the injection. Slowly building back up capacity is key.
2. Applying heat: While applying ice to the injection site can help to reduce inflammation and improve the efficacy of the injection, applying heat can have the opposite effect. Heat can increase inflammation and reduce the effectiveness of the medication.
3. Ignoring new or worsening symptoms: If you experience new or worsening symptoms after receiving the injection, such as increased pain, numbness, or weakness, it’s important to contact your healthcare provider right away. These symptoms could indicate a complication, such as infection or nerve damage, that requires immediate attention.
4. Not addressing the underlying cause of the pain: While corticosteroid injections can be effective in treating low back pain, as we mentioned before, they are not a cure. It’s important to address the underlying cause of the pain or else symptoms will likely return or worsening over time.

In summary, corticosteroid are an effective tool to help initially reduce inflammation in an affected area but is not a long term fix.  Avoiding strenuous activity immediately after and addressing the underlying cause of the pain with your physiotherapist can help to ensure the best possible outcome after receiving a corticosteroid injection.