Epidural steroid injections are an effective treatment for certain types of severe, chronic back pain. Yet, like everything else in this universe, there is simply no free lunch: Steroids have some nasty side effects including increasing the risks for infections and bone fractures. A recent published study reviewed 43 other published reports about epidural steroid injections and confirmed that, yes these injections do work. However, they also found that injecting nonsteroids-even saline (a placebo) worked just as well.

Could it be that distention of the epidural space ( located right next to the spinal cord) quieted the nerves down and thus lowered the pain? Possibly or other unknown mechanisms could be at work.

For those who are at high risks for steroid related complications, perhaps saline epidural injections should be considered. And don’t forget that there are other ways to treat chronic back pain without jabbing a needle into your back:

Try gentle stretches (such as my preferred Yoga-Yoga lite). Massage and acupuncture are worth a try as well. Physical therapists can teach you effective and safe exercises.  Medications such as Ibuprofen work by reducing the pain and inflammation. Even biofeedback might do the trick.

Just as with any treatment, too much of a good thing is not so good. Epidural injections cannot and should not be given too often as they increase the risk for bony fractures, ligament and tendon ruptures and of course infections. Talk with your doctor about some of these other choices before you consider epidural injections.