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What Does an Injection Do for Lower Back Pain?

December 7, 2016

One of the top 3 most common treatments for lower back pain or sciatica currently is a cortisone injection.  So, what exactly does a cortisone injection do? As a physical therapist and a past lower back pain sufferer who has had many injections, I’m going to describe exactly what happens.

First it is important to recognize that most types of lower back pain have a level of elevated inflammation that is present. Inflammation is the bodies second phase of healing.

4 Phases of wound healing

So, it would be safe to say that cells have been damaged in your back and the body is trying to heal them.  So, it calls upon inflammation to initiate that process. The problem with inflammation is that if it hangs around too long or builds up to a level that is too high it can cause pressure.  Pressure then causes pain because it mechanically stimulates a nerve.


Cortisone is a strong anti-inflammatory drug which decreases the bodies ability to deliver inflammation to an area.  This often times reduces the inflammation and the pain.  The benefit of an injection is that it is able to deliver cortisone directly to the site that is inflamed which is much more efficient than taking anti inflammatories orally which has an effect on the entire body.  Usually with back pain there is one or two nerves that are being compressed and delivering cortisone can help reduce the pain immediately.

The overall problem with cortisone injections are not that they are effective at treating pain but the fact that they are not effective at eliminating what caused the cells to be damaged initially which led to inflammation in the first place.  In fact from my own personal experience feeling better after a cortisone injection leads to less pain and improved ability to move.  And of course I went ahead and increased my activity level because I felt better and I made my problem worse.  The reason I made my back pain worse in the long run was because I had a movement problem.  The movement problem was actually causing damage in the my spine. So my new ability to return to movement because I was pain free actually allowed me to damage my spine more.

So to get the best results we should use injections into the lower back as a way to immediately relieve pain but we should also be searching for the movement problem that caused the damage in the first place.  Most people have an  underlying movement problem that is cause inflammation.  Remember pain and inflammation are signals that something is being damaged.  Simply covering that up and making someone feel better is not going to provide a long term solution, at least not on purpose .

If you would like to learn more about Lower Back Pain and Sciatica and how Injections and  other treatments work please click the image below to learn about our upcoming free workshop.

sciatica workshop

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