Jun 30

Corticosteroids For Back Pain

Let’s explain in a simple way what the corticosteroids before anything are. It is a group of substances that we produce naturally in our body and that participate in numerous metabolic processes. These substances are manufactured in the laboratory for use as a medicine by two properties that have mainly:

1 – They are the most powerful anti-inflammatory drugs available. This is why they will be used in certain back and neck injuries.

2 – They have immunosuppressive properties. In other words, they leave us with less defenses, which is useful in diseases where our own defenses are attacking us.

In column injuries are sometimes used for their anti-inflammatory effect. What it does is diminish or suppress the process of inflammation. This can be given as a pill or intramuscular injection (in the cuff) for its generalized effect on the body. But we sometimes inject it into specific areas when we want to have a more pronounced local effect.

They are very striking drugs because of their high effectiveness. It is what injected athletes occasionally to recover before. That said looks very nice, but as one old teacher said, “Steroids look like a panacea but they are not.”

Let’s try to understand. As we have said are substances that circulate naturally by our body. If an exaggerated amount of this substance suddenly circulates, other processes of our body that are dependent on it will go away. The most dangerous are the following situations:

Corticosteroids For Back Pain– If we are diabetic, steroids trigger our sugar to levels that can put our lives at risk. This happens because in the body corticosteroids do the opposite of insulin. And a diabetic as he does not have enough insulin will not be able to counteract this excess.

– If we have an active infection we can suffer a worsening. We have commented that the corticosteroids lower the defenses. Well, if we have an infection we can detract from the defenses that are struggling to heal us. In certain infections this can end in serious situations, although most often nothing important happens if we use corticosteroids in a punctual way.

– They can raise blood pressure, which is always undesirable. Caution should be exercised in hypertensive patients (those who take medication for stress are also hypertensive even if their tension is well controlled).

– Gastritis. Like the anti-inflammatories we all know, they hurt the stomach. Caution should be exercised in people with a tendency or history of such problems.

I comment on these situations because they are the ones that most concern us when we make a timely use of these substances. In back treatments we do not usually use these drugs beyond a few days. In prolonged uses (more typical of autoimmune, rheumatic and oncological diseases) there are other added problems such as osteoporosis, eye problems such as cataracts and glaucoma, muscular problems, etc.

As you see what looked very nice is not so much if we see the complete photo, but that does not mean that they are not very useful drugs in certain situations.

Corticosteroids may be the solution in certain lesions. I am going to put an example. Suppose a patient comes to the office with an important pain in the neck and arm for a cervical disc herniation that is compressing a nerve. Sometimes when we explore the patient we discover that the injury that has occurred in the nerve has caused loss of strength in the arm. This situation can be very serious if we do not act. The nerve problem is that leaving the neck does not have enough space because the herniated disc and inflammation are crushing the nerve against the areas of bone and injuring it. In this situation sometimes a treatment with adequate doses of corticosteroids can remove the inflammation and leave more space to this nerve, which will not continue to be damaged.

More controversial is its use in uncomplicated back pain. In the emergency services is very widespread its use when a patient with a lot of low back pain, for example, using the famous Inzitán of which we spoke in another post. Is it correctly used this way? It depends. It is probably used more than it should because of the relief effect it produces as a potent anti-inflammatory and the gratefulness that sometimes results to the patient.

The complexity and variety of these drugs makes it necessary to have strict medical follow-up and in no case take them on our own. Well used can be a powerful ally.

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