Corticosteroid injections can reduce inflammation and can be effective when delivered directly into the painful area. Unfortunately, the injection does not make a herniated disc smaller; it only works on the spinal nerves by flushing away the proteins that cause swelling.
The steroids usually begin working within 1 to 3 days. In some cases, you might need up to a week to feel the benefits. Many people get several months of improvement of pain and function from the injections.
Corticosteroids. If other medications do not relieve your back or neck pain, your doctor may recommend corticosteroids taken by mouth. Steroids work to reduce inflammation in the area near the herniated disc, taking pressure off an affected nerve and relieving pain.
An epidural injection is especially helpful if degenerative disc disease results in a herniated disc or if bone growths develop and press painfully on nerve roots or the spinal cord.
Yes. Epidural steroid injections have been used for years and are considered one of the safest options for pain management in the lower back. However, as with all minimally invasive procedures, there are small but extremely rare risks involved.
The Downsides
According to the National Institutes of Health, the side effects from cortisone shots include: Dizziness or headaches. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. Fatigue and trouble sleeping.
After the shots, your pain may get worse before it gets better. Serious side effects from an epidural steroid injection are rare. But they can include stroke, paralysis, or loss of vision.
Treatments for a bulging disk will depend on its severity and location. Doctors may recommend anti-inflammatory medications to help with pain and reduce inflammation. For people with severe pain, steroid injections may be a suitable short-term solution. If the disk ruptures, bed rest may be necessary.
The pain from a herniated disc usually is worse when you are active and gets better when you are resting. Coughing, sneezing, sitting, driving, and bending forward may make the pain worse. The pain gets worse when you make these movements because there is more pressure on the nerve.
Skip movements that involve significant axial loading on the lower back, such as squats and leg presses. Avoid toe-touches, sit-ups, and yoga poses that worsen the pain and lead to significant bending of the back.
When one (or several) injections fail to fix your problem, often the next recommended step is surgery. The majority of the people we work with are seeking pain relief for their back, knee, neck or shoulder WITHOUT the need for surgery and other procedures.
Most disc bulges resolve in 6-8 weeks, but it can take longer depending on the size of the bulge (i.e. if the bulge is hitting the nerve behind it like described above).
Generally, if the first shot doesn't work, we may inject the same area again after 6-8 weeks. However, if a second shot doesn't work, we don't recommend a third shot. But, you can have multiple cortisone shots in different parts of your body.
In the majority of cases, both a bulging and herniated disc will heal with only conservative (nonsurgical) treatment, especially if you take things a little easier. That doesn't mean that patients should become couch potatoes – that can actually make things worse and prolong recovery time.
“Many people who have pain from a bulging disc will get pain relief with a few days of rest and some anti-inflammatories. Traction, physical therapy, and epidural steroid injections can be beneficial as well.”
Herniated discs are considered more severe than bulging discs because they put significant pressure on nearby nerves, which can cause intense pain, inflammation and difficulties with movement.
Your doctor might recommend surgery as an option for your herniated disc if: Your symptoms have lasted at least 6 weeks and make it hard to do your normal activities, and other treatments haven't helped. You need to get better quickly because of your job or to get back to your other activities as soon as possible.
Living with a herniated disc
Most people who have a herniated disc are better in about 4 weeks. Sometimes it takes longer. If you still have pain or numbness after 4 to 6 weeks, or if you feel worse, talk with your doctor. Sometimes it takes surgery to relieve pain.
What are the consequences of not treating a herniated disc? Herniated discs are serious health problems. Because you're dealing with a spinal injury, you could be at risk for permanent paralysis or long-term chronic pain if you leave your herniated disc untreated.
What Is the Difference Between Steroid and Cortisone Injections? Many people are curious about what differentiates a steroid injection from a cortisone shot. When discussing steroid and cortisone injections for orthopedic related conditions, the two terms are referring to the same injection product.
When should steroid injections not be used? Steroids should not be injected when there is an infection in the area to be injected or elsewhere in the body. If a joint is already severely destroyed, injections are not likely to help. Before a joint is injected with a steroid, joint fluid may be removed for testing.
There's concern that repeated cortisone shots might damage the cartilage within a joint. So doctors typically limit the number of cortisone shots into a joint. In general, you shouldn't get cortisone injections more often than every six weeks and usually not more than three or four times a year.