Ask The Expert
January 06, 2012
Iíd like to answer your questions. But some more information would help.
Or do you have a history of:
The most common causes of chronic low back pain depend on your age. With younger people, itís muscle spasm and strain. With the elderly, itís more likely to be arthritis, disc disease, fractures from osteoporosis and spinal stenosis (narrowing of the space where the spinal cord and nerves travel). Middle-aged people may have back pain from any of these conditions. Other causes, both rarer and more dangerous, can include infection and tumors. For a majority of people with back pain, no specific cause can be found.
The role of cortisone (steroid) injections for back pain is controversial. They are commonly offered for certain conditions when other, more conservative treatments fail. For example, if your pain is due to spinal stenosis and you donít get much relief from pain relievers and physical therapy, a cortisone injection may be a reasonable next step. However, studies are mixed on whether they reliably work.
Doctors donít normally offer cortisone shots as a first treatment just after a fall. And thereís no evidence that getting one after an injury will lower the chances of long-lasting back pain in the future.
Should you ask for a cortisone injection now? That depends on the cause of your pain and what treatments youíve already tried. When a cause can be identified, it can usually be diagnosed by a detailed review of your symptoms, medical history, physical examination and, in some cases, imaging studies. X-rays and MRI scans tend to be the most useful imaging tests but theyíre not required in all cases.
Talk to your doctor about the cause of your back pain and what the best next steps are in evaluation and treatment.