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Disc Pain on Steroids

Anyone who's had a disc removed knows the disappointment of waking up after the operation with pain. Going into surgery with hopes of immediate pain relief isn't always realistic. It may take time for the body to recover from the pain response that started long before surgery.

A disc that protrudes out of its normal space is called a herniated disc. Herniated discs release chemicals that cause pain. Pressure from the disc on a nearby nerve root may cause other symptoms, such as numbness, tingling, or weakness. This pressure also sets up an inflammatory response in the nerve root. Swelling occurs with inflammation, and this causes more pain.

Doctors are looking for ways to reduce the pain right after disc removal. Steroid medicine is one method. Steroids are powerful anti-inflammatory agents. Steroids reduce the swelling around the nerve root. Less swelling and less pressure means less pain. These drugs can be put directly into the bloodstream with an IV or into the muscle by injection. Some doctors have tried injecting steroids into the spinal canal, the opening for the spinal cord.

A new method of steroid application has been reported. A group of doctors in Israel soaked sponges with a steroid and placed these on the nerve root during surgery. The sponges were left in place when the operation was over.

Patients with this type of steroid application had less back pain in the first two weeks after the operation, compared to patients who didn't receive the steroid. There was no difference in pain levels a year after surgery, however. This was based on patients' reports of back pain.

References: Ronen Debi, et al. Local Application of Steroids Following Lumbar Discectomy. In Journal of Spinal Disorders. August 2002. Vol. 15. No. 4. Pp. 273-276.

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