Almost everyone has suffered from back pain, whether from that “brief” attempt to shoot hoops with your son or from just bending over to tie your shoes. Often there is shooting pain associated with this. The most common cause of this pain is a herniated disc. If the pain becomes chronic, it can be debilitating.

One treatment for this type of pain has been epidural injections. This is where a small amount of steroid is injected into the space next to the spinal canal or the epidural space. The steroid, which reduces inflammation, is felt to reduce long term pain. A recent study however casts doubt on how much pain relief these injections actually offer.

In fact, the study showed that a similar amount of pain relief was achieved at one month simply with saline or salt injections. What does this mean?

Steroid- or for that matter- any injections into the area near the spine carry serious risks. These include infection, infarction or death of vital nerve cells and direct injury to the cord. While these complications are rare, they are serious. The question becomes whether the treatment is worse than the disease.

I believe that chronic back sufferers should try nonnarcotic medications, and the occasional narcotic for relief. Chronic pain medications are no picnic either and should be avoided if at all possible. Weight loss will help as this will lessen the load for the overworked spine. Stopping smoking helps as this will reduce the risk of osteoporosis and arthritis. Stretching, something which might appear novel to many, might reduce muscle spasm and thus tension on the spine. Physical therapy can provide exercises to prevent and treat injuries.  Acupuncture works for some and has very little downside. Similarly, who in his right mind would refuse a back massage? I have found that jacuzzi jets work just fine ( unpublished data).

In short, there are many ways to prevent and treat back pain. Epidural injections should be reserved only for back pain which is severe and unrelenting despite multiple attempts at reducing the pain. Talk with your doctor-who knows? Maybe she could prescribe a massage?

In short, consider other, less invasive options before doing epidural injections.