To Your Health
April, 2013 (Vol. 07, Issue 04)
Steroids for the Spine: A Bad Combination
By Editorial Staff
All-too-commonly prescribed for back pain – despite evidence that nondrug options are equally, if not more effective – steroids have taken a justifiable beating over the past several months.
A tainted batch of epidural steroids
produced by a Massachusetts compounding pharmacy led to hundreds of cases of fungal meningitis and dozens of fatalities. But as with most news items, eventually the topic dropped from the headlines; all too soon for anyone whose health was compromised by drugs intended to relieve their pain.
Now steroids are back in the news, but for a good reason from a public-health perspective: The Congress of Neurological Surgeons and the American Association of Neurological Surgeons have issued a recommendation against the use of steroids within the first 24-48 hours following an acute spinal cord injury (generally much more severe than simple back pain). Previously, guidelines recommended steroid use in acute cervical spine (neck) and spinal cord injuries when deemed appropriate by the treating physician. The new guidelines go so far as to state that strong evidence suggests "high-dose steroids are associated with harmful side effects including death" and conclude that use of the drugs in such situations is often more likely to harm, rather than benefit patients.
Now if steroids aren't being prescribed for acute spinal cord injuries, why would anyone prescribe them for uncomplicated cases of back pain? Good question, but we guess the answer is that many physicians still will, despite the potential for side effects (or tainting). Fortunately, you have another option: visit a doctor of chiropractic, who can evaluate your back pain and perform spinal adjustments that have been proven to be more effective than pain-relieving drugs (click here).