Back pain and steroids


Most back pains calm down over a few weeks when taking over-the-counter medication, staying as active as possible and including physical therapy. This form of treatment is conservative management of back pain.

For some back pain, the conservative management may not relieve the agony of pain soon enough especially if the back pain is caused by an irritated spinal nerve.

A range of steroids exist, some are short-acting which works almost immediately but they only give short lived relief. Longer-acting steroid takes around a week to work but can last for several months. The clinician who will be performing the injection will choose the most appropriate steroid medicines and dose for your condition and symptoms.


If you have local anaesthetic, your pain will be relieved within minutes but may wear off after an hour or two. It usually takes several days for the effect of the steroid to fully begin to work.

Local anaesthetic may cause numbness and make it difficult to drive as a result you may wish to arrange alternative transport home after injection.

If you had an injection into the joint you should try to avoid strenuous exercises for two days after the injection. If you are having an injection around a tendon, you may be asked to avoid heavy impact and loading activities for two or three weeks.


  • Pain at the injection site.
  • Occasionally people may notice a flare-up of their pain within the first 24 hours after injection. This usually settles itself within a couple of days.
  • Injections can occasionally cause some thinning and changed in the colour of the skin at the injection site. In rare cases, a steroid injection into muscles or joints can cause an indentation in the skin around the area.
  • Infection. Very rarely, an infection can occur in the joint. If the joint becomes more painful and hot, you should seek medical attention immediately especially if you are also feeling generally unwell.
  • People are often concerned around the possibility of steroids related side effects such as weight gain. One of the advantages of the steroids injection, compared with steroids tablets, is that the injection dose can be kept at a low dose. This means the chances of these systemic side effects are very rare.
  • Other possible side effects include facial flushing, temporary changes in mood.

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