For decades now, pain doctors have been injecting steroids around the spine for pain relief from multiple conditions. These include relief of the pain from herniated discs, bulging discs, facet arthritis, and degenerative disc disease.
Do they work? Yes they do. Multiple studies show the benefits of steroid injections for alleviating pain, improving function, and avoiding surgery for multiple painful conditions. However, they are not without their downside.
For example, steroids are a huge anti-inflammatory substances. This is great for pain relief. But the method by which steroids provide pain relief is with cortisone, which knocks out inflammation high on the flowchart of how anti-inflammation works. At this high level on the chart, it also emulates the cortisone that is produced by the adrenal glands and may affect those glands.
If the adrenal glands receive feedback that the body is receiving cortisone from another source, the response may simply be to cut back its own production. When the body cuts back its production, and the steroid wears off, then it may take a while for the adrenal glands to realize it needs to ramp up production again. The body may suffer some deleterious effects while that process is occurring.
Steroid injections have very low side effects overall. However, they may transiently raise blood sugars and cause a small weight gain. This is because although the steroid material is injected into a defined area, that steroid may slowly get absorbed into the blood stream and have that effect. Usually it is mild and transient.
Physicians performing injections are cognizant of these effects and therefore limit the amount of steroid injections given. In the case of an older citizen trying to function Oxymetholone and enjoy life, he or she may suffer from arthritis in the spine, knees, hips, and shoulders. If a limit is set at say 6 injections per year, there is no way to cover all these areas. If a steroid injection lasts for 3 months (typical), that one joint will receive 4 injections per year. A typical patient with facet arthritis of the spine will have pain at multiple levels – is that one or two levels going to get injected and suck up all the injections for the whole year?
Clearly there is room for improvement in this area, as limiting treatment based on the “weakest link” being simply too many injections from steroids leads us to the obvious question – Isn’t there a better injection substance?
What if a material existed that could have the same (or better) pain relieving effects of steroid injections, however, be non-steroidal? What if that substance also showed promise for cell regeneration, of which steroid doesn’t do?
That question is one of the most burning and appropriate questions for interventional pain management. There is a potential revolutionary option for pain management on the horizon and that is… stem cell injections.