Cortisone Steroid Injections for Sciatica

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If you have low back pain and sciatica, you may have tried many different treatments to find relief and to improve your ability to function. Your healthcare provider may prescribe medication, physical therapy, or spinal decompression to attempt to treat your problem.

Epidural steroid injections are another common way to non-surgically treat the low back and leg pain associated with sciatica. The medicine is usually a steroid that is injected into your spine near the inflamed lumbar nerve. This steroid helps to decrease pain and swelling around the nerve root, and thus, offer relief from sciatica.​

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Are Steroid Shots the Optimum Choice?

A study published in the Annals of Internal Medicine examined the effect of three different injections in the spine. The researchers randomized 84 patients with lumbar radiculopathy of fewer than 6 months duration into three groups. One group received injections of steroids, one group received etanercept (an arthritis medication with the trade name Enbrel), and the third group received normal saline injections. All participants received two injections spaced two weeks apart.

The main outcome measure in the study was leg pain one month after the second injection was administered.

The results indicate the there was more improvement in symptoms with the epidural steroids, but the improvement was not statistically significant when compared to etanercept or saline. That’s right–your healthcare provider could possibly inject salt water into your back to treat your lumbosacral radiculopathy, and this may help improve your pain level just as effectively as steroids. Of course, your healthcare provider would never do such a thing, but the thought is pretty interesting.

Bottom line: For a specific group of patients, injection of steroids into the spine can help with the pain associated with sciatica. The trick is identifying those people and identifying those patients who would not benefit from such a procedure.

What Should You Do?

Does this study mean that you should vow never to have an epidural steroid shot for your sciatica? No. Some people benefit from injections in their back when they have sciatica. If you have back pain or sciatica, you need to find the right treatment for your specific condition.

What does help low back pain and sciatica? Most studies indicate that exercise is some the best and safest treatments for lumbosacral radiculopathy. Which exercises are best? A visit to your physical therapist can help find the right exercises for you. Many people with back pain benefit from low back stretching like the McKenzie Exercise program. Some patients get relief from strengthening their core and hip muscles, and others require a combination of stretching and strengthening to help treat their back pain.

Exercises to try for back pain may include:

Be sure to check in with your healthcare provider before starting any treatment for your back pain or sciatica. He can guide you to the right treatment so you can get adequate relief from pain and can return to your normal level of activity.

The most important thing you can do for back pain is to work closely with your healthcare provider and your physical therapist to find the right combination of exercises (or injections and exercises) that can help improve your spinal motion and decrease or eliminate your pain.

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