Got Chronic Lower Back Pain- Steroids Injections May Not Be the Answer

The results of a study published this week in the Annals of Internal Medicine, found that a single steroid injection to reduce disc inflammation in people with chronic low back pain provided relief for a month in 55% of those treated. These results led researchers to conclude that steroids were not effective for long-term pain relief.

Journal article abstract:

Summary of research:

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According to the National Institutes of Medicine National Institute of Neurological Disorders and Stroke, 80% of adults suffer from chronic lower back pain at some point in their lives. Most of us have acute or short term back pain for a few days or weeks that usually goes away with over-the-counter pain or anti-inflammatory medication, heat/ice compresses, massage, and resumption of our normal activities as soon as possible.

Chronic back pain, the type addressed in the study above, is the kind that lasts more than 12 weeks. Since the research addressed in this article found steroid injections ineffective for long term pain relief caused by disc inflammation, below are some other non-surgical treatment options as from the National Institutes of Health:

  • Chiropractic care

Provided by doctors of chiropractic care, these professionally licensed specialists use their hands to mobilize, adjust, massage, or stimulate the spine and the surrounding tissues. The techniques have been shown to provide small to moderate short-term benefits in people with chronic low back pain.

  • Acupuncture

Provided by licensed professionals, this is moderately effective for chronic low back pain. It involves the insertion of thin needles into precise points throughout the body. Acupuncture is a practice of traditional Chinese medicine that helps clear away blockages in the body’s life force known as Qi (pronounced chee). For those who may not believe in the concept of Qi, it is  theorize that when the needles are inserted and then stimulated (by twisting or passing a low-voltage electrical current through them) naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine are released.


  • Biofeedback

This therapy involves the attachment of electrodes to the skin and the use of an electromyography machine that allows people to become aware of and self-regulate their breathing, muscle tension, heart rate, and skin temperature. People regulate their response to pain by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects.



  • TENS

 Transcutaneous electrical nerve stimulation (TENS) involves intermittently wearing a small battery-powered device connected to electrodes placed on the skin over the painful area. The device produces electrical impulses that block pain signals from the nerves. The idea is that by stimulating the nervous system the perception of pain can be reduced. Early studies of TENS suggested that it elevated levels of endorphins, the body’s natural pain-numbing chemicals.

  • Physical therapy

Provided by a licensed professional, physical therapy aims to strengthen core muscle groups that support the low back, improve mobility, flexibility, promote proper positioning and posture. It is often used in combinations with other treatments, most notably chiropractic care.​​​​​​​


  • Massage therapy

Provided by a licensed professional, massage therapy encompasses many different techniques. In general, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body. They most often use their hands and fingers, but may use their forearms, elbows, or feet.

  • Yoga
           Offered by a certified practitioner, yoga is a mind and body practice with origins  
            in ancient Indian philosophy. The various styles of yoga typically combine
            physical postures, breathing techniques, and meditation or relaxation. There are  
            numerous schools of yoga. Hatha yoga, the most commonly practiced in the   
            United States and Europe, emphasizes postures (asanas) and breathing
          exercises (pranayama). Some of the major styles of hatha yoga are Iyengar,
          Ashtanga, Vini, Kundalini, and Bikram yoga.


Not all therapies work for everyone, but they are worth checking into. If you suffer from long term, chronic back pain, talk with your health care provider about trying one or more of these options.

For more information see:

Mayo Clinic
Self-care approaches for acute pain

National Institutes of Health
Yoga or stretching eases low back pain

National Institutes of Health - National Institute of Neurological Disorders and Stroke
Low back pain fact sheet

National Institutes of Health - National Institute of Complementary and Integrative Health

National Health Service (UK)
Treatment for back pain


Joanna Hayden, PhD, CHES is the principal of Associates for Health Education and Behavior, LLC, in Sparta, a practice focused on improving health through education. Her office offers individual and group health education, and individual health behavior change guidance.  For more information please see  To contact Dr. Hayden, email her

The opinions expressed herein are the writer's alone, and do not reflect the opinions of or anyone who works for is not responsible for the accuracy of any of the information supplied by the writer.

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