If you’ve read any of our work and subscribe to our point of view, you already know the answer to that question. For those of you who are just joining us, allow me to share my opinion of cortisone injections as a treatment for back pain and sciatica.
First, let’s go over some of the terminology to make sure we’re all on the same page. Cortisone injection, epidural, steroid injection, and epidural steroid injection are all essentially the same thing. The goal is to inject a chemical into the inflamed area and try to control the inflammation, delivering relief in the short term. When I say “short term,” I’m saying that some people feel better by the time they get home, or perhaps the next morning.
How is it that professional athletes can play hurt or beat themselves up on game day, and a week later they can do it again – and continue to do this week after week, year after year? The answer is simple: Science has learned how to trick the body into feeling better and working harder.
Sure, steroid injections can reduce localized inflammation, and that can help you feel better. It may even help you with your rehab. Studies have shown that roughly half of those who try steroid injections get some level of relief – at least, for a while.
Here is the bigger question: Are you willing to take those odds? Let’s see…You have a 50 percent chance that it won’t work at all, and a 50 percent chance of “some” relief for an undetermined amount of time. As you ponder that, I should add that steroid injections “HURT LIKE HELL!” This is a universally accepted fact. Now, I can imagine what you’re thinking – you’re in pain, you’ve tried everything else, and you’re at your wit’s end. You’re ready to do anything to get relief. Thank goodness you’re reading this, because I’m about to save your life.
Cortisone Shots: The Cash Cow
Steroid injection has been around since the early 1950s, and it remains a primary treatment for general practitioners all the way to orthopedic surgeons. Why? First of all, it offers the hope of quick relief. Second, it’s a Big Fat Cash Cow. Let’s do the math. Say you have sciatica, and you go to see Dr. Prick Butt and he says, “Not much I can do for you other than give you a steroid injection. Of course, it may take up to three of these to achieve the best results.” Three injections @ $150 per injection = $450. Now, taking into account that the average orthopedist probably sees at least 20 patients a day and works 180 days a year, that comes to 3,600 patients. If 20 percent of those patients get three steroid injections, that’s an annual income of $324,000 ($450 X 750 patients). That’s for 10 minutes of work per patient. And you wonder why things haven’t changed in more than 50 years.
If that weren’t bad enough, let me explain why these injections fail to deliver long-term relief. Steroid Injections are solely designed to treat the symptoms of your condition. Unfortunately, many doctors don’t take the time to help their patients find out what’s causing the pain. Were they not taught in med school to address the underlying issues, or is it simply that they don’t have the time to spend with each patient? I’ll let you drawn your own conclusions.
Meanwhile, let’s get back to why you’re still suffering. I believe it’s because most traditional treatments focus only on symptoms. We, as patients, are partly to blame for this. We demand that someone do something for us – and quick. Heaven forbid we take some responsibility for our own health and learn what we can do for ourselves. Relying totally on someone else to take care of our problems is a prescription for disaster.
You need to understand that 99 percent of back pain is the result of a physical problem, which means it requires a physical solution – regardless of the type or severity of the condition. No pill, injection, or massage can deliver lasting physical changes in – or for – your body.
What I’m trying to say is that you are going to have to do some work, in the form of targeted exercise. Yes, it may be uncomfortable at times, and you aren’t going to feel like doing it. And, yes, you’re going to get frustrated, and you may feel like quitting. That’s to be expected. But the alternative is to continue living with the pain. It’s your choice.
I don’t have space here to go into the specific types of exercises, but I can give you a formula that has brought unbelievable success to those who followed it.
Immediate steps to take
First, you must be willing to learn all you can about your condition, from symptoms to the various forms of treatments – even some that go back 2000 years. Next, you will have to find someone who is willing to treat both your symptoms and the underlying cause of your condition.
I strongly recommend that you take a proactive approach to your current situation. You are lucky that you do not have pain. It is such a shame that millions of people are suffering from conditions that could have been prevented or corrected years ago, if only they understood how muscle imbalances affect our bodies.
What do I mean by the underlying cause of your condition? I don’t care if you have a herniated disc or spinal stenosis, the two most fundamental factors responsible for the pain associated with your condition are the position of your pelvis and the curvature of your spine.
The next logical question is this: How did my pelvis and spine get out of proper alignment? The answer is that your muscles are out of balance with each other.
Muscle imbalances are the root cause of your condition and the reason you feel pain. By addressing these imbalances, you are killing two birds with one stone – you not only get rid of the pain but you also eliminate the cause.
As you go through recovery, you likely will try a number of techniques, which is fine. In fact, it’s highly desirable. I strongly support incorporating a multi-dimensional strategy, including a natural approach to inflammation and spine decompression, as part of a comprehensive program.
A couple of final points about steroid injections. I’ve been working as a physical therapist for more than 16 years, and I have not heard of a single case where they provided total and lasting relief. It’s a sad truth that borders on criminal.
The second point is a cautionary tale: I have as a client an elite triathlete who comes to me to get a massage once a week. About five years ago, she had sciatica and went to a doctor who recommended a steroid injection. She agreed. Well, that doctor stuck that needle straight into her sciatic nerve and pushed the plunger. For legal reasons, I can’t tell you what happened next, but I can tell you it wasn’t good.
Remember, there is no silver bullet for back pain relief. So do your homework and then get busy.
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Updated: April 13,2017