Why Not Get Epidural Steroids for Subacute Sciatica?

Because it is not the long-term answer

Ross Hauser, M.D.

A recent study from John Hopkins says “more patients treated with epidural steroids (75 percent) reported 50 percent or greater leg pain relief and felt better overall after one month compared to those who received saline (50 percent) or etanercept (42 percent). On a pain scale of 0 to 10, with 10 denoting the worst pain, those who received steroids reported, at one month, an average pain score of 2.1 compared with 3.6 in the etanercept group and 3.8 in the group injected with saline. Those in the steroid group also reported lower levels of disability (21 percent) than those in the saline group (29 percent) or etanercept group (38 percent).

After six months, however, slightly more patients in the saline (40 percent) and etanercept (38 percent) groups had a positive outcome than those in the steroid group (29 percent).” (1)

Saline better than steroid in the long-run?
Epidural steroid injections are one option commonly presented to people with neck pain, thoracic pain, and low back pain. The goal of this injection is pain relief through a reduction of inflammation and swelling in the epidural space. The injection consists of inserting a needle into the epidural space of the spine and injecting a long lasting steroid. Many health professionals agree that the results are temporary and have no long-lasting effect. Pain relief may last a few weeks to a few months and in some cases provide just enough pain relief to participate in physical therapy for recovery.

Prolotherapy for Back Pain
Temporary pain relief is not what pain patients should be seeking. Permanent healing and pain relief should be the goal. Maybe pain patients don’t believe there is a cure for their pain, so they seek as many pain relief options as possible. The problem is that many pain relief treatments include steroids and anti-inflammatory agents that can make the injury even worse. As the injury gets worse, a person is forced to look for stronger and more complex pain relief. It’s a vicious cycle.

Prolotherapy is the opposite of epidural steroid injections that contain steroids. Prolotherapy creates inflammation to bring blood flow and healing factors to the injured tissue. Any neck or back pain that is related to joint degeneration or ligament injury can be treated effectively with Prolotherapy.

At Lifeworks we do Prolozone. Prolozone is a newer form and prolotherapy and seems to work better. If you are having problems with chronic pain we can help.

Call Tamora for an appointment at 727 466 6789.

1. Cohen sP, White RL, Kurihara C, et al. Epidural Steroids, Etanercept, or Saline in Subacute Sciatica. Annals of Internal Medicine April 17, 2012 vol. 156 no. 8 551-559

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