The most common procedure to treat back and neck pain may not be the best. Epidural steroid injections are frequently given to those who suffer severe pain caused by damaged spinal nerves. But a new review finds that injecting a simple saline solution into the spinal cord can work just as well — and spare you from side effects.
Epidural steroids have become the gold standard for treating nerve-related back pain because, frankly, they work, where anti-inflammatory drugs such as Advil and physical therapy often fail. Numerous studies also show that epidurals even provide more relief than steroids injected into the muscle. "Epidural steroid shots stop irritated nerves from sending pain signals, reduce inflammation, break up scar tissue, increase blood flow to nerve roots, and wash out inflammatory molecules released from degenerative discs," says lead researcher Dr. Steven P. Cohen, professor of anesthesiology and critical care medicine at Johns Hopkins School of Medicine and Walter Reed National Military Medical Center.
The problem is that taking steroids too often can weaken your immune system, give you ulcers, or even trigger further joint and muscle pain, says Cohen. Furthermore, they only provide short-term pain relief, usually lasting just one to three months. Looking for a safer alternative to steroids, Cohen and his team combed reams of research to determine whether injecting any liquid into the spinal cord would yield similar results. Sure enough, studies showed that injections of saline provided just as much pain relief as steroids.
The bottom line: The next time your doctor suggests an epidural steroid, ask for a lower dose watered down with or replaced entirely by an injection of saline solution. "These accomplish the same thing as steroids because they’re both injections," Cohen says. "They wash out inflammatory molecules that sensitize nerves, break up scar tissue, and stop irritated and inflamed nerves from transmitting pain signals."