Why are epidural steroid injections for back pain limited to only a few a year?

Answers from Richard H. Rho, M.D.

Epidural steroid injections are usually limited to just a few a year because there's a chance these drugs might weaken your spinal bones and nearby muscles. This isn't caused by the needle — it's a possible side effect of steroids.

Steroid injections can also cause other side effects, including skin thinning, loss of color in the skin, facial flushing, insomnia, moodiness and high blood sugar. The risk of side effects increases with the number of steroid injections you receive.

Epidural steroid injections contain drugs that mimic the effects of the hormones cortisone and hydrocortisone. When injected near irritated nerves in your spine, these drugs may temporarily reduce inflammation and help relieve pain.

But steroid injections also disrupt your body's natural hormone balance. Delaying repeat injections allows your body to return to its normal balance.

It's important to carefully weigh the potential risks and benefits of long-term epidural steroid injections. If you're in pain between epidural steroid injections, you might ask your doctor about other treatment options for back pain.


Richard H. Rho, M.D.

Jan. 26, 2016