Many people had to face acute pain in the back. This type of pain paralyzes the movement, makes the person freeze in one position and do not move. Lower back pain, for example, stands first among diseases that can lead a person to disability, according to World Health Organization statistics. At the same time, the maximum burden of the dorsal part is on the lumbar vertebrae, which are the largest and most powerful. Therefore, according to medical statistics, about 85% of the cases of pain in the back are associated with the pain of the lumbar region of the musculoskeletal system. Steroid injection in back (or steroid pills) are often used to relieve this condition.
Causes of Pain in Back
It should be noted that severe back pain can occur due to many causes:
- getting injuries (for example, stretching muscles, fractures);
- exacerbation of many diseases of the musculoskeletal system (scoliosis, osteochondrosis of the lumbosacral section, radiculitis, protrusion, intervertebral hernia, etc.);
- Various inflammatory processes, such as rheumatoid arthritis and Reiter’s syndrome;
- Tumors or infectious diseases affecting the spine and intervertebral disks (tuberculosis, brucellosis, epidural abscess).
Medications Used to Treat Pain in Back Effectively
If the pain in the back is observed only once, it will be enough to take the drug with analgesic effect of weak action. But in the case of constant pain syndrome, doctors prescribe a comprehensive treatment that has several directions: painkillers and non-steroidal anti-inflammatory drugs, as well as medications aimed at eliminating the root cause of back pain and achieving auxiliary effects.
An important role in especially difficult cases of removal and treatment of back pain is played by corticosteroid medications. These are the most powerful drugs that have an anti-inflammatory, as well as anesthetic, nature of treatment. At the same time, the main advantage of these drugs is a powerful anti-inflammatory effect, which exceeds the action of even non-steroidal drugs. In addition, removing inflammation, they also help to eliminate and pain in the back.
Corticosteroids are a group of natural steroid hormones (which are called “corticosteroid hormones”), produced solely by the adrenal glands of a person, as the body’s response to an inflammatory process.
It should also be noted that as early as 1949, scientists found a way to artificially synthesize these hormones and injected them in elevated doses to the patient to relieve the inflammatory process (read more on history of steroids). Practical use of synthetic corticosteroids in medical practice has been shown that they possess absolutely the same properties as natural steroids.
The Use of Corticosteroids for Back Pain
To date, modern medicine identifies several types of corticosteroid therapy: limiting therapy and intense therapy.
Limiting therapy is used for long, chronic processes and as a rule, prescribe tableted forms for several months or even years. With intensive therapy (in the case of acute, life-threatening pathology) drugs are administered intravenously to achieve a quick effect.
Depending on the type of therapy, drugs for back pain are most often used in two forms: oral and injectable. Thus, corticosteroids can be produced both in the form of tablets and in the form of injections for the introduction of the drug into the body.
The Use of Oral Steroids for Back Pain
The oral method of administration means the taking of tablets that are quickly and completely absorbed into the small intestine when ingested, reaching a maximum concentration in the blood after 30-90 minutes. While taking food at the same time as taking the drug, the absorption process slows down, but the degree of their effect isn’t influenced by the food.
Dosage of oral steroids for back pain should be prescribed by a doctor. According to medical indications, the tablet preparation should be taken from 6 am (the first dose) but not later than 14 pm. Such administration conditions are necessary to mimic the physiological absorption of glucocorticoids into the blood when they are produced by the adrenal cortex. In some cases, at high doses and depending on the severity of the disease, the initial dose is distributed by the doctor for 3-4 doses for a uniform intake within a day. Tablets should be taken with food or immediately after eating, washing down with a small amount of water.
Depending on the cause of inflammation, there are many types of corticosteroid drugs in the form of tablets. The most famous of them are: prednisolone, methylprednisolone, triamcinolone, dexamethasone, cortisone, and others.
Features of Steroid Injection in Back
When injectable way of administration is used, corticosteroids are injected into the body intramuscularly near the place of pain or intravenously. The time of manifestation of the effect of drugs administered intramuscularly or intravenously depends on the characteristics of the drug and varies on average from 1-2 to 24 hours. In especially severe back pain, injections into the epidural space (the area between the hard shell of the spinal cord and the periosteum of the vertebrae) are also used to relieve pain and eliminate the inflammatory process.
Once ingested, corticosteroids bind to proteins and undergo structural changes in the liver. They are excreted by the kidneys. If the function of this organ is not deteriorated, dosage adjustment of the injected drug is not required. Thus, corticosteroid injections bring temporary but significant relief of back pain.
The effectiveness of this method of administration varies from patient to patient, but, as a rule, after 1-2 injections, clinical improvement occurs to some extent. It is the rate of achievement of the therapeutic effect that is the main reason for the popularity of this particular method of using these drugs.
The most common injectable corticosteroids are prednisolone, hydrocortisone, betamethasone, and others.
But it should be remembered that injections of corticosteroids do not have a therapeutic effect in diseases of the musculoskeletal system, they do not strengthen the bone tissue and restore normal blood circulation and they should be used only to achieve a single effect – reducing the inflammatory response of the body to a disease in the back. Thus, the use of injections of corticosteroids is possible only in the complex treatment of diseases of the musculoskeletal system or for the urgent removal of the inflammatory process in order to gain time for the diagnosis and the appointment of the appropriate treatment.
However, some doctors prescribe courses of prolonged administration of corticosteroids, if the improvement with local administration of the drug is minimal or absent altogether. They prescribe injections of corticosteroids with some periodicity and a break-off.
At the same time, the manufacturers of these medications warn that prolonged and uncontrolled use of injectable corticosteroids (for several weeks or even months) reduces their overall effectiveness and further abrupt cancellation inevitably leads to severe exacerbation of the disease (manifestation of the so-called withdrawal syndrome) because corticosteroids suppress the function of the adrenal cortex. Therefore, with rapid or sudden cancellation of the drug, adrenal insufficiency may develop. The unified scheme for the abolition of corticosteroids is not present. The mode of cancellation and reduction of dose depends on the duration of the previous course of treatment. It is difficult to eliminate by other means. Such a regimen should be appointed exclusively by the attending physician.
In this regard, many experts recommend that when achieving a clinical effect with corticosteroid therapy, a patient should switch to less active drugs to maintain this result.
Possible Side Effects of Steroid Shot for Back Pain & Contraindications
In the treatment with corticosteroids, the risk of side effects is especially high in two cases: withdrawal of drugs and the long-term use of these drugs in doses exceeding recommended ones. In such cases, there may be: the manifestation of infectious diseases (because corticosteroids affect the immune system), ulcer diseases, circulatory disorders, steroid myopathies, mental disorders, cataracts, aseptic necrosis of bones, growth and developmental disorders. In addition, it should be remembered that corticosteroids have a hormonal nature, and therefore, uncontrolled use of them can lead to hormonal failures, as well as serious diseases of the endocrine system.
The use of steroid shot for back pain (or steroid pills) is contraindicated for pregnant women, for patients with congenital diseases of the spine, postoperative operations on the spine, circulatory disorders and blood clotting disorders, and if there is any infection at the intended injection site.
Where to Buy Steroid Pack for Back Pain?
If you want to buy steroid pack for back pain, you can use the services of online pharmacies or go to the usual brick-and-mortar pharmacy. It should be noted that corticosteroids are RX medications, that is, they are available only on prescription. If you see that some online pharmacy sells corticosteroids without a prescription, it is possible that this is a fake pharmacy. Remember, almost all corticosteroids are prescription medications. There are a few over-the-counter (OTC) steroids (corticosteroids).
Read more about steroids for pain here.