Intervertebral discs are soft, gel-like structures that act as cushions between the vertebrae in the spine. A herniated disc occurs when the outer layer (annulus fibrosus) is damaged or weakened, allowing the inner gel-like substance (nucleus pulposus) to protrude outward. This protrusion can press against spinal nerves, causing pain, numbness, tingling, or weakness, depending on its location.
A herniated disc can be a source of intense pain, affecting daily activities and reducing quality of life. Common treatments range from physical therapy to surgical interventions, with cortisone shots (also known as corticosteroid injections or epidural steroid injections) being a popular option for managing pain. In this article you will learn what these injections are, how they work, and their effectiveness in treating herniated disc symptoms.
What Is a Cortisone Shot?
Cortisone shots contain corticosteroids, which are synthetic hormones designed to mimic the effects of cortisol, a natural hormone produced by the adrenal glands. These injections are commonly used to reduce inflammation and manage pain in various conditions, including joint disorders, tendonitis, and herniated discs.
How Do Cortisone Shots Work for Herniated Discs?
When used to treat a herniated disc, cortisone shots are typically administered into the epidural space, the area surrounding the spinal cord. This is why they are often called epidural steroid injections. The injection’s purpose is to reduce inflammation around the herniated disc, which in turn can relieve pressure on the surrounding nerves and reduce pain.
The injection procedure typically involves a local anesthetic to numb the injection site and, in some cases, the use of imaging guidance (such as fluoroscopy) to ensure accurate placement of the needle.
What Are the Benefits of Cortisone Shots for Herniated Discs?
The primary benefits of cortisone injections for a herniated disc include:
- Rapid pain relief – One of the main benefits of cortisone shots is the rapid relief they can provide. While the full effects may take a few days to a week to become apparent, many patients experience a noticeable reduction in pain soon after the injection.
- Noninvasive treatment – Compared to surgical options, cortisone shots are minimally invasive. This makes them an attractive option for patients who prefer to avoid surgery or for whom surgery is not recommended.
- Temporary relief to aid recovery – Cortisone shots can provide a “window of opportunity” for patients to engage in physical therapy or other rehabilitative exercises without significant pain. This can help them build strength and flexibility to support long-term recovery.
What Are the Limitations and Risks of Cortisone Shots?
While cortisone injections offer relief for many patients, they are not without risks and limitations, such as:
- Temporary relief – Cortisone shots are not a permanent solution. While they can provide relief for weeks or even months, the effects are generally temporary, and multiple injections may be needed over time.
- Potential side effects – Corticosteroids can cause side effects, especially with repeated use. These may include increased blood sugar levels, higher risk of infection, and bone density loss. Patients with diabetes or other medical conditions should discuss these risks with their healthcare providers.
- Not always effective – Cortisone shots do not work for everyone. In some cases, they might not provide significant relief, especially if the herniated disc is causing severe nerve compression. In such cases, surgical intervention may be discussed and potentially recommended.
When Are Cortisone Shots Recommended?
Cortisone shots are typically recommended when other noninvasive treatments (such as physical therapy, pain medications, or lifestyle modifications) have not provided sufficient relief. They can also be used to delay surgery or manage pain while a patient undergoes rehabilitation.
Cortisone shots can be an effective treatment for managing the pain and inflammation associated with a herniated disc. They offer a noninvasive option that can provide rapid relief, allowing patients to pursue other forms of therapy to aid their recovery. However, they are not a cure and come with limitations and potential risks. Patients should consult with their healthcare providers to determine whether cortisone shots are the right option for their specific condition and treatment goals.
If you have a herniated disc that is not responding to conservative treatment, a discectomy or less invasive microdiscectomy may be discussed and potentially recommended. Although these are generally very successful back surgery procedures, having a large hole in the outer ring of the disc more than doubles the risk of needing another operation. A new treatment, Barricaid, is a bone-anchored device that closes this hole, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital.
If you have any questions about the Barricaid treatment, ask your doctor or contact us.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.
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