Cortisone is active primarily as an agent for the rapid conversion of proteins to carbohydrates (a glucocorticoid ) and to some extent regulates the salt metabolism of the body (a mineralocorticoid). The therapeutic dose, however, when used as an anti-inflammatory drug, is much larger than the amount normally present in the body, and the minor functions of the hormone become exaggerated, leading to edema (swelling), increased gastric acidity, and imbalances in metabolism of sodium, potassium, and nitrogen. Continued research has resulted in drugs in which the glucocorticoid activity is enhanced and undesirable actions are practically eliminated.
As mentioned above, there may be more than one spinal structure causing your spine pain. Sometimes, there are multiple causes for your spine pain or radiculopathy. In this case, Dr. Lee may recommend alternative treatment options or steriod injections. For example, if your sciatica/leg pain or hand pain improves with epidural steroid injection but you still have low back pain or neck pain, you may benefit from facet joint injections. But, whatever the case, you will need further evaluation by Dr. Lee to decide on further treatment. Remember that there are multiple treatments available now for pain and just because one method yielded partial or no response DOES NOT necessarily mean you will “just have to live with the pain”!
As with any medication, there are possible side effects or risks involved. Common risks from steroid injections include pain at the injection site, bruising due to broken blood vessels, skin discolouration and aggravation of inflammation. Rarer risks include allergic reactions, infection, tendon rupture and serious injury to bones called necrosis. Long term side effects (depending on frequency and dose) include thinning of skin, easy bruising, weight gain, puffiness in the face, higher blood pressure, cataract formation, and osteoporosis (reduced bone density). Steroid injections may be given every 3-4 months but frequent injections may lead to tissue weakening at the injection site and is not recommended. Side effects do not happen in everyone and vary from person to person.