Many people have to face acute and unbearable pain in the back. This type of pain occasionally paralyzes normal movement and flexibility, making the sufferer freeze in one position. Ongoing back pain can render people effectively disabled for periods of time.
Lower back pain stands first among diseases that can lead a person to a disability, according to World Health Organization (WHO) statistics. The maximum burden of the dorsal part is on the lumbar vertebrae, which are the largest and most powerful. According to medical statistics, about 85% of back pain cases are linked to the musculoskeletal system’s lumbar region.
Steroid injections in the back (or steroid pills) are often used to relieve these conditions. Drugs are sometimes administered as an epidural is, in extreme cases concerned with compression of the sciatic nerve.
Causes of Pain in Back
Many causes can lead to severe back pain:
- Injuries (overstretched muscles, fractures)
- Exacerbation of musculoskeletal system issues (scoliosis, osteochondrosis of the lumbosacral section, radiculitis, protrusion, intervertebral hernia, sciatica)
- Various inflammatory processes, such as rheumatoid arthritis and Reiter’s syndrome
- Tumors or infectious diseases affecting the spine and intervertebral disks (tuberculosis, brucellosis, epidural abscesses)
- Kidney related health problems or stones
- Spinal curvatures
- Female reproductive conditions (ovarian cysts, uterine fibroids, endometriosis)
- Leaking aortic aneurysm
- Issues with the pelvis and/or the sacroiliac joint
In many of these, back pain is an indication of the root cause, not a condition in and of itself.
Medications Used to Treat Pain in the Back Effectively
It’s no joke, pain in the back can be a real pain in the backside. While we all have differing pain thresholds, it’s fair to state that most people find back pain enervating. Adult men will even crawl on the floor, sniveling for relief. Lucky for sufferers, there are many medicines which can alleviate the pain, if not address the underlying causes.
If the pain in the back is observed only once, it will be enough to take a drug with a relatively weak analgesic effect (NSAI such as Ibuprofen, Panadol, Ketoprofen).
But in the case of chronic and ongoings pain, with accompanying signs and syndromes, doctors prescribe a comprehensive treatment plan that is multi-pronged: painkillers and non-steroidal anti-inflammatory drugs, as well as medications aimed at eliminating the root cause of back pain and achieving the desired auxiliary effects.
An important role in difficult cases of back pain is played by corticosteroid medications. They can aid with both removal and treatment. These powerful drugs have an anti-inflammatory and anesthetic nature. The main advantage is the potent anti-inflammatory effect, which exceeds the action of non-steroidal drugs. By removing inflammation, they also help to eliminate those shocking and debilitating back pains.
Corticosteroids are a group of natural steroid hormones (aptly named corticosteroid hormones) which are produced by an individual’s adrenal gland as the body’s natural response to inflammatory processes.
We should also note that as early as 1949 scientists found a way to artificially synthesize these hormones and injected them in elevated doses to the patient (read more on history of steroids). The practical use of synthetic corticosteroids in biomedicine has shown that they possess the same properties as natural steroids.
You may have been prescribed corticosteroids without even knowing that’s what they were. Recognizable brands include Celestone, Prednisone, Intensol, Orapred, Prelone, Medrol, Depo-Medrol, Solu-Medrol and Kenalog.
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 conditions and involves prescriptions for tablets forms for several months or even years in the worst case scenarios. With intensive therapy (in the case of acute, life-threatening pathology) drugs are administered intravenously to achieve a quick effect.
Depending on the therapy, drugs for back pain are mostly in one or two forms: oral and injectable. Corticosteroids come in both versions.
The Use of Oral Steroids for Back Pain
An oral method of administration means the tabs or capsules are quickly and completely absorbed into the small intestine when ingested, reaching a maximum concentration in the blood after 30 to 90 minutes. While taking food at the same time as taking the drug, the absorption process does slow down, but the degree of their effect isn’t influenced the food.
A doctor should prescribe the exact dosage of oral steroids for back pain. Thsi isn’t something you want to self prescribe on a wing and a prayer. According to medical indications, tablets should be taken from 6:00 am (the first dose) but not later than 14:00 pm. Such conditions are necessary to mimic the complex 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 into 3 to 4 times per day. This allows for a gradual intake. Take the tablets with meals or after eating, washing them down with water.
There are many corticosteroids, which are utilized in different cases, including:
- prednisolone (used for allergies, inflammatory conditions, autoimmune diseases, and cancers) methylprednisolone, triamcinolone, dexamethasone, cortisone, and others.
Features of Steroid Injection in Back
When injected, corticosteroids enter the body intramuscularly near the place of pain or intravenously. The time before the effect of the drugs kicks in depends on the characteristics of the drug and varies on average between just 1 or 2 to a full 24 hours.
With especially severe back pain, injections into the spine (the area between the hard shell of the spinal cord and the periosteum of the vertebrae) are used to cancel pain and hinder the inflammatory process.
Once ingested, corticosteroids bind to proteins and undergo structural changes in the liver. They are metabolized by the kidneys and ejected for the body in urine. If the function of this organ is not vulnerable, then dosage adjustments are not required. If the renal system is compromised, milder doses may be considered.
The effectiveness of this method varies from patient to patient, but after 1-2 injections, clinical improvement will occur to some extent. The high rate of achievement and therapeutic effect is the main reason injectable steroids are given to patients.
The most common injectable corticosteroids are prednisolone, hydrocortisone, betamethasone, and others.
But it should be remembered that injections of corticosteroids do not positively affect 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.
Injections of corticosteroids are applicable in the treatment of diseases of the musculoskeletal system when it comes to urgent removal of inflammation. Doing so gains time for diagnosis and the start of appropriate treatment, no matter how convoluted the case.
The above said, some doctors prescribe prolonged courses of corticosteroids. If improvement with a local administration of the drug is minimal or absent altogether, they may stipulate injections of corticosteroids with irregular or regular periodicity.
Manufacturers of these medications warn that extensive and uncontrolled use of injectable corticosteroids (for several weeks or even months) reduces their overall effectiveness. Furthermore, abrupt cancellation inevitably leads to severe exacerbation of the disease (withdrawal syndrome) because corticosteroids suppress the adrenal cortex’s function.
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 the dose depends on the duration of the previous course of treatment. It is difficult to eliminate by other means. The attending physician should appoint such a regimen.
In this regard, many experts recommend that after achieving the anticipated clinical effect with corticosteroid therapy, the patient in question should switch to less active drugs to maintain the results.
Possible Side Effects of Steroid Shot for Back Pain and Contraindications
In treatment with corticosteroids, the risk of side effects is especially high in two cases: withdrawal of the drugs and the long-term use of these drugs in doses excessive to that recommended.
In such cases, the following may manifest:
- The propagation of infectious diseases (because corticosteroids affect the immune system)
- Circulatory disorders
- Steroid myopathies
- Mental disorders or instability (depression, anxiety, addictive behaviors)
- Cataracts (intriguingly, the direct functioning of pathogenesis is unknown)
- Aseptic necrosis of bones
- Growth and developmental disorders
In addition, it should be remembered that corticosteroids have a hormonal nature, therefore, unbridled use can lead to hormonal failures, as well as serious endocrine system diseases.
The use of steroid shots 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 an infection at the intended injection site.
Where to Buy Steroids for Back Pain?
If you want to buy steroids for back pain and you have a valid in-date prescription, you can use the services of online pharmacies or go to your local usual brick and mortar pharmacy.
Heed that corticosteroids are RX medications, that is, they are available only on prescription. If you see an online chemist selling corticosteroids without a prescription, it’s possible that this is a fake pharmacy. Remember, almost all corticosteroids are prescription medications. There are just a few over-the-counter (OTC) steroids (corticosteroids) and most are creams and ointments.