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Severe lower back pain. No improvement with physical therapy. Would steroid epidural injection be helpful?

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I have been having a lot of lower back pain. Would a steroid epidural injection work for this pain. I have been doing physical therapy and it does not seem to help.

Or should I try a different physical therapist?
Posted Tue, 22 May 2012 in Back Pain
Answered by Dr. Praveen Tayal 9 hours later
Thanks for posting your query.
A lower back pain can be due to many causes like
Nerve root syndromes- Herniated discs, Spondylosis and Spinal disc degeneration

Musculoskeletal pain syndromes that produce low back pain includes myofascial pain syndromes and fibromyalgia.

• Infections of the bones: Bacterial and spinal Tuberculosis

• Noninfectious inflammation of the spine (spondylitis) can cause stiffness and pain in the spine that is particularly worse in the morning
Since the cause of pain is not known, it is advisable to undergo investigations like MRI and a few blood tests to find out the cause of this pain.
Usually mild pain subsides with muscle relaxants if used in appropriate dosage in combination with a potent analgesic. You can get these prescribed from your orthopedician.
Local analgesic gels and hot fomentation may provide a short term relief. You can use analgesic gels like Volini gel. Exercise is not advisable in the times of acute pain.
Using an LS contour belt of appropriate size might be helpful in providing support to back muscles.
Physiotherapy also plays a major role in treating such conditions. Epidural steroid injections have been used if oral pain killers and muscle relaxants are not very effective. These are not the first line of treatment.
You can consult your orthopedician for necessary investigations and start with teh treatment according to the diagnosis.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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