Question: I have a herniated disc that sometimes it hard for me to get around because of the pain. I'm thinking about going for a steroid injection, but have heard the shots can cause soft-tissue damage. What are the pros and cons?

Dr. Hibberd's answer:

Herniated discs can be painful. Acute inflammation and pain are often relieved by a single steroid injection. Often cortisone is injected as a part of a series of shots for pain management.

Yes, cortisone does weaken soft tissues and does impair healing of injured bones and soft tissue, so its use is limited and your doctor can help you weigh the potential risks and benefits. On the pro side, it seems to work very well for pain management, But, on the con side, it does not hasten healing or appear to affect the rate of resorption of herniated discs.

In addition, repeated cortisone use will weaken supportive tissues. Also, cortisone in diabetics may worsen their glucose control, making insulin adjustments necessary in some.

Some patients simply have too much pain, and recurrent local cortisone shots prove to be very effective pain-relieving strategies. So if you have tried other strategies for pain control, with your doctor’s approval, local epidural cortisone may be the best next option to consider.