For many people, back pain goes away on its own or with nonsurgical treatments. Epidural steroid injections shouldn't typically be used as a first-line therapy for back pain relief, but that doesn't mean they can't play a role in treating pain. But injections won't cure the underlying cause of back pain, and they provide only temporary relief. Unfortunately, in many cases, chronic back pain can't be cured, but must instead be managed, like other chronic conditionsand patients must have realistic expectations of what epidurals can do.
Steroid injections are commonly used to treat rotator cuff tendinopathy, but controlled studies have demonstrated modest benefit, particularly in the long term. 34 Steroid injections should be reserved for patients who have discomfort that would limit them from engaging in rehabilitative exercises. Injections into the gluteal muscle versus guided injections into the subacromial bursa have demonstrated similar levels of pain relief. 35 Surgical options are available for patients with persistent symptoms, or for patients in whom function cannot be maintained.
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