For some patients, pharmacologic pain management through the use of corticosteroids is an effective treatment for mild to severe pain. A corticosteroid is a type of medication – classified as an anti-inflammatory drug – that is used to provide symptomatic relief of lower back pain, bursitis, cancer pain, and other conditions. Some may be purchased over-the-counter at local pharmacies, while other, more potent, variations are prescribed by pain management physicians, such as those found at the Regional Pain Institute. At our pain treatment center, we can determine if pharmacologic pain management is the best course of action for you and your pain, and if so, whether corticosteroids are an appropriate treatment option. Corticosteroid medications are available in one of the following types:
- Pill or liquid that is taken orally
- Syringe and catheter that is administered intravenously
- Cream that is applied topically
- Needle injection that is delivered hypodermically (i.e. epidural steroid injections)
- Inhaler, nebulizer, or nasal spray that is used respiratorily
- Drop or ointment that is given ocularly
- Enema, foam, or suppository that is administered rectally
Cortisol is a naturally produced hormone in your body that balances salt and water; regulates the metabolism of carbohydrates, fats, and proteins; and suppresses inflammation, which causes swelling and pain. Synthetic versions of cortisol, corticosteroids function in the same way. Certain substances, such as prostaglandins, in the immune system trigger allergic and painful inflammatory reactions. The primary job of corticosteroids is to block the production of these substances. Whether a cream is applied to the skin, a pill is ingested, or a needle is injected into the epidural space of your back, corticosteroid medication will have an analgesic (or numbing) effect. Some patients who have acute or chronic pain take corticosteroids when needed, while others undergo corticosteroid therapy in which the dose and schedule is measured and the response to the regimen is assessed over a period of time. Injections are commonly used in corticosteroid therapy.
As with any pain treatment – pharmacologic or otherwise – there are side effects and risks to consider and corticosteroids are no exception. Side effects of short-term corticosteroid use as pain management may include hyperglycemia, fluid retention, and insomnia. Long-term corticosteroid use is generally avoided due to risks of toxicity and potentially more serious side effects, including diabetes, osteoporosis, and decreased immune response. It is important that you discuss both risks and benefits with your pain management physician. He or she will be able to give you the information you need and advise you on the best treatment for your acute or chronic pain so that you can find the relief you deserve. Contact the pain management center at the Regional Pain Institute to find out if corticosteroid therapy is right for you.