Anyone with back pain deserves lots of sympathy. People with spinal stenosis have less space in their backbones for the spinal cord to pass through. The pain this creates can make people desperate for relief. Should they consider steroid shots?
Q. I have stenosis in my spine, degenerative back disease and arthritis. Some days I can walk for awhile but most of the time walking and normal activities are very painful. I hate steroid shots. The benefit seems short lived and I worry about long-term side effects.
Are there any home remedies that might be helpful for the inflammation and pain that has interfered with my ability to get around?
Side Effects from Steroid Shots:
A. We understand your concern about steroid side effects. Doctors seem to think that when they inject a corticosteroid into the spine or a joint (hips, knees, elbows or shoulders) that it says put. We strongly suspect that corticosteroids migrate into the surrounding bone. This could increase the risk for weakening and osteoporosis, thereby increasing the underlying problems.
People with arthritis in a joint do not need to have the bone become weaker. An eminent expert in the field once told us that steroids “melt bone.” Although he did not mean that literally, we think he was not far off with his vivid description.
Other side effects of injected cortisone or other corticosteroids include:
INJECTABLE STEROID SIDE EFFECTS
- Fluid retention, edema, sodium retention
- Headache, dizziness
- Anxiety, nervousness, irritability, insomnia
- Increased blood pressure
- Increased blood sugar (glucose)
- Muscle weakness
- Loss of potassium
- Infection, immune system suppression
- Osteopenia, osteoporosis
Home Remedies That May Help:
When it comes to home remedies, there is not a lot that can ease the pressure on nerves caused by spinal stenosis or bony narrowing of the spinal column. A general anti-inflammatory regimen does make sense, however. Some of the remedies we generally recommend to ease inflammation include:
- Tart cherries
- Olive oil
- Vitamin D
- Gin-soaked raisins
- Certo & grape juice
- Apple cider vinegar, apple & grape juice
- Fish oil & green-lipped mussels
To learn more details about such non-drug approaches we suggest our book, Quick & Handy Home Remedies.
Other Research on Steroid Shots in the Spine:
A meta-analysis from Johns Hopkins suggests that injections of saline or local anesthetic may work about as well as corticosteroid injections (Bicket et al, Anesthesiology, Oct., 2013). The mere act of injecting fluid around the spinal column appears to accelerate healing.
These epidural injections were twice as effective at alleviating as intramuscular injections of steroids. It is encouraging to have evidence that this sort of prolotherapy can be effective without the damaging side effects of powerful corticosteroids. A more recent review suggests that steroid shots in the spine might have a very modest short-term effect on helping to delay or prevent back surgery (Bicket et al, Spine Journal, Feb. 1, 2015).
Prolotherapy for Other Joints:
Some People’s Pharmacy visitors have shared their experience with prolotherapy for joints.
“I can tell you from personal experience prolotherapy works. I had muscle and ligament pains that started from an injured knee. The pains in the knee got better, leaving me with just the muscle and ligament pain.
“After having the dextrose shots over a 3 week period, directly into the areas of pain, a month later, those pains are all but forgotten.”
But the procedure is not universally successful. (What in medicine is?)
“Prolotherapy treatment did not work for me at all. It was the last treatment I tried before going ahead with total knee replacement surgery. I had several injections directly into the pain area 4 to 5 weeks apart that did absolutely nothing for my knee pain. I previously had several knee injections of SYNVISC and SUPARTZ over the years that worked for a while and basically delayed the need for surgery. However, after a while these injections stop working also.
“I am not a big fan of surgery, but with my replaced knee I can ski and play tennis with no pain; however the recovery was not easy and required a lot of physical therapy. That’s the trade off, I guess. Anyway, these injections will not build up new knee cartilage.”
“People with corn allergy can have severe reactions to dextrose in shots, and every other form. I am allergic to corn, and have to avoid anything that contains dextrose.”
Nancy D noted:
“I am a licensed acupuncturist (13 yrs) and physical therapist. If “saline” helps why not just plain acupuncture? I have had success placing needles at the site of the pain AND adding gentle movement (based on Qigong) is an essential tool in relieving back pain. If movement isn’t happening, patients have a tendency to guard against moving that may cause pain. Releasing spasms can be a major part of releasing pain. Where there is movement (the right kind of movement), spasms have difficulty surviving.”
VFC offered this testimonial:
“I have had great success with trigger-point dry needling for my chronic low back & sciatic pain. Trigger-point dry needling is a technique similar to acupuncture except meridians & energy flow is not the target. An acupuncture needle is inserted into tight muscle knots, which interrupts the pain signal to the brain & releases Factor P, involved in neurotransmissions. My PT says when the needle twitches, he knows he has hit the right spot!
“He will often attach electrodes and do electric stimulation to these needles. That part feels good. It takes about a week for the full effect even though I do feel immediate pain reduction. I am really a needle-phobe, but after one has had chronic pain you get braver and it really doesn’t hurt so much that I am unwilling to repeat when necessary.Better than Percocet and epidural steroid injections, with none of the complications. I require a tune-up every 3 or 4 months but it is well worth it.”
“Prolotherapy has been a life saver for me. 19 years after having a very successful spinal fusion, my back began to hurt. Acupuncture did not help and I did not want a cortisone injection. Prolotherapy worked amazingly well. After about five years, I needed it again and it helped immensely. I have no pain in my back! After 6 months of unresolved pain, I then used it for a mildly torn rotator cuff and, again, it miraculously fixed my shoulder. I am a real believer in prolotherapy.”