Treating Degenerative Disc Disease with Steroids

Steroid treatments, particularly corticosteroid injections, are commonly used to manage pain and inflammation associated with degenerative disc disease (DDD). Here are some pros and cons:

Pros

• Quick Pain Relief: Steroids can provide rapid relief by reducing inflammation around the affected discs.

• Targeted Treatment: Injections deliver medication directly to the inflamed area, minimizing systemic side effects.

• Non-Surgical Option: For those looking to avoid surgery, steroids offer a less invasive alternative.

• Diagnostic Benefits: Injections can help determine whether inflammation is the primary cause of pain.

• Minimal Downtime: The procedure is outpatient, allowing patients to resume daily activities quickly.

Cons

• Temporary Relief: Effects wear off over time, often requiring repeated injections.

• Potential Side Effects: Risks include localized pain, infection, bleeding, and in rare cases, nerve damage.

• Limited Efficacy for Chronic Pain: Steroids may not be effective for long-term pain management.

• Inflammation Cycle Disruption: While steroids reduce inflammation, they may also interfere with the body's natural healing process.

  
  

Do Steroids Work For Degenerative Disc Disease?

To start, I want to give thanks to the doctors who've specialized in traditional pain management to provide much-needed relief to sufferers of spinal injuries and conditions. However, I also question the popularity and prevalence of traditional pain management techniques despite the numerous innovations in regenerative medicine, namely PRP. Some doctors offer both traditional and regenerative techniques, but more often than not, doctors specialize in one or the other. This blog post explores some of the conflicts of interest and realities facing patients when it comes to pain management.

I made an appointment with a highly-rated pain management doctor in Portland, OR and was eager to discover what this specialist would share about my condition. Unfortunately, the person who met with me was his assistant and I was informed that the actual doctor only does the procedures. I found this really disappointing. His explanation did not match the countless online reviews by people sharing positive feedback about their consult with the main doctor. When did he stop seeing people directly and why? I consider this a bait and switch tactic which should ring alarm bells in anyone's head.

Furthermore, I'd sent my MRI and x-rays to this doctor's office and confirmed their receipt before coming in, yet the assistant still didn't have the correct documents to review when I arrived. The assistant briefly looked at the MRI analysis on my phone and told me I needed a steroid shot, then started to talk about submitting a request to my insurance company without skipping a beat. This clearly wasn't a person who was going to provide deeper insight into my medical condition. If this happens to you, please know this is not the norm and there are higher levels of care available from pain management physicians.

I stopped the direction of our conversation and asked about other methods or alternatives that could be explored. He replied that they have many "tricks in their bag." And the thing is, he's absolutely right to refer to traditional pain medicine techniques as tricks. The fact is, many traditional methods, such as steroid shots, are not sustainable and actually cause degeneration to worsen over time. They simply "trick" the body into thinking it's feeling better, but in many cases, the pain eventually returns.

Seeking Regenerative Alternatives to Steroids

I then inquired about PRP. The assistant shared that the doctor doesn't do PRP but that he'd heard positive things anecdotally. I told him that I have a benefit that covers PRP treatment costs 100% and his ears immediately pricked up. He then remarked that he needed to explore this option for himself since we have the same insurance company. I relayed that it was made available to me because of my spouse's specific employer and not the insurance carrier. He appeared genuinely disappointed. I thought this was a really interesting coming from an assistant of a reputable pain medication doctor. It made me think that more people would opt for regenerative procedures if they weren't so cost prohibitive.

I then asked him if there was something less invasive than a steroid shot. He said we could do a round of oral steroids to lower my inflammation. I asked the assistant how long I could expect the benefits of the oral steroids to last and he said it really depends and sometimes patients never return because their symptoms cease. Ultimately, that's the route I decided to try. I wish he had suggested the least invasive method in the first place. My cynical side wonders whether he offered the steroid first because it's substantially more expensive. The appointment left me with the impression that I wasn't viewed as a patient, but rather a customer there to book a costly steroid injection that carries the risk of nerve damage to fund the doctor's lifestyle.

I was prescribed Methylprednisolone and received a pack of pills for roughly 6 days. You start off with a high dosage of pills every couple hours and then taper off slowly. I experienced pretty immediate relief from the oral steroid, but I knew it wasn't going to regenerate my body in any way. That's why I ultimately opted for PRP through the company Regenexx. You can read more about my experiences in my blog post: Treating Degenerative Disc Disease with PRP from Regenexx.

Due to my poor experience with the first pain management physician, I decided to get a second opinion. I went to a different pain management doctor who made the time to see me personally and explained my MRI in detail. After listening to my story about childbirth, he believed my pain stemmed from my SI joint and recommended a steroid injection in the SI joint to determine if that was the cause of pain. Many doctors can't tell where the pain is coming from when looking at x-rays or MRI imaging so they use trial and error through the use of steroid injections. If the patient reacts well to the shot, they attribute that part of the body to be the source of pain. I think it's interesting that PRP is considered "experimental", yet traditional pain management techniques are literally based on trial and error. In a sense, it doesn't get much more experimental that testing a hypothesis on a patient in real time.

I asked him how long the pain relief would last from a steroid shot and he told me roughly three months. I responded that I was 41 and believed that receiving consistent steroid shots was not sustainable or good for the body long term. He agreed. How then would that be a good idea? The question seemed obvious.

I asked about PRP and he said his department doesn't provide them and he doesn't usually recommend them because they're too costly for most patients since they're out of pocket. In essence, his hands were bound by the limitations of insurance carriers. He also shared he didn't know how long the benefits of PRP would last. His comment revealed his lack of knowledge on this treatment. The point of PRP is not to provide a band-aid solution like steroid injections, but to actually help the body heal itself. Many times, the full benefits of PRP aren't apparent until even 9 months later. This otherwise well-meaning doctor failed to fully understand just how much his patients could benefit from PRP. This takes me back to my initial recommendation of doing your own research. Doctors are intelligent people. But don't underestimate your ability to research solutions. At the end of the day, your body is your responsibility.