Overview
Prednisone for back pain helps relieve swelling and pain related to sciatica, herniated discs, and spinal stenosis. But Prednisone is a steroid, and taking it without a doctor’s prescription can cause side effects. Prednisone doses aren’t one-size-fits-all. They vary and are based on:
- Your symptoms
- Medical history
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Get a Prednisone NowWhat is Prednisone?
Prednisone prescription medication is a corticosteroid used to reduce inflammation and alleviate pain in conditions that affect the spine, such as herniated discs, sciatica, or other inflammatory back problems or arthritis.
How does Prednisone work to treat back pain?
Prednisone works by reducing inflammation, which in turn can help alleviate discomfort and improve mobility. Inflammation is a natural response of your immune system to injury, but sometimes, it can cause ongoing pain and damage to your body’s tissues. Prednisone helps by blocking the production of inflammatory chemicals like prostaglandins and cytokines, which normally contribute to pain and swelling. It also targets immune cells like T-cells and B-cells involved in the inflammatory process, reducing their activity and overall inflammation.
How do you take Prednisone for back pain?
Your prescription for prednisone depends on your symptoms, but here is the usual starting dosage of Prednisone:
- 10 to 60 mg/day given in a single daily dose or in 2 to 4 divided doses;
- Low dose: 2.5 to 10 mg/day;
- High dose: 1 to 1.5 mg/kg/day (usually not to exceed 80 to 100 mg/day).
The typical Prednisone dosage for back pain treatment involves a tapering schedule, starting with a high dose and gradually reducing it. A common 5-day Prednisone dosage for back pain might look like this:
- Day 1: 60 mg (once a day)
- Day 2: 40 mg (once a day)
- Day 3: 40 mg (once a day)
- Day 4: 20 mg (once a day)
- Day 5: 20 mg (once a day)
This gradual reduction in dose helps reduce inflammation without overwhelming the body with high steroid levels. However, the dosage of Prednisone for back pain may vary based on the severity of the condition, the individual’s health, and how well they respond to treatment. However, it’s important to follow the prescribed Prednisone dosing for back pain and consult a doctor to ensure safe use.
Research Says: In a large trial, 269 patients with radicular pain were given either oral Prednisone (60, 40, 20 mg over five days) or a placebo. While the Prednisone group showed modestly higher disability score improvements at 3 and 52 weeks, the difference was statistically significant but of limited clinical value.
How quickly does prednisone work for back pain?
Prednisone typically starts working within a few hours to 2 to 3 days after the first dose, if the back pain is caused by inflammation or an autoimmune disorder. However, the exact speed at which it works can depend on several factors, including:
- The severity of the condition
- The dose prescribed
- Individual responses to the medication
In cases of acute inflammation, patients may notice significant improvement within 24 to 48 hours. However, if the pain is due to a chronic condition, it might take longer to experience noticeable relief.
“Prednisone can be an effective option for reducing inflammation and managing pain in conditions like herniated discs or sciatica, especially when more conservative treatments fail. However, it’s important to use this medication under close supervision, as prolonged use can lead to significant side effects.” — Dr. Richard Honakar
Precautions to follow when taking Prednisone for back pain
It’s important to be aware of potential side effects. Common ones include weight gain, mood swings, sleep problems, and an increased appetite. Long-term use can lead to more serious issues like osteoporosis or high blood pressure. However, you can take the following precautions to avoid these side effects:
- Taking Prednisone: Always take Prednisone with food to minimize stomach upset. Follow your doctor’s Prednisone dosage for back pain and inflammation carefully to ensure effective pain relief. Avoid exceeding the prescribed amount, and never stop the medication suddenly without consulting your doctor.
- Missed Doses: If you miss a Prednisone dose, take it as soon as you remember unless it’s almost time for your next dose. Never double the dose to make up for a missed one.
- Duration of Treatment: The duration of Prednisone for back pain dosage should be short-term. Most treatments last around 5 days, but your healthcare provider may adjust the duration based on your progress.
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Get a Prednisone PrescriptionWhat are the short-term vs. long-term treatment considerations for using Prednisone?
The following table simplifies the actions you can take to avoid side effects when on short-term and long-term Prednisone use.
| Consideration | Short-Term Treatment | Long-Term Treatment |
| Monitoring for Side Effects | Limited monitoring; mainly check for immediate issues | Regular check-ups; blood/urine tests for adverse effects |
| Pregnancy | Caution during pregnancy; effective birth control recommended | Avoid pregnancy; report pregnancy suspicion immediately |
| Stress and dose Adjustments | Adjustments are typically not needed unless stress is severe | Dose may need to be adjusted with added stress or anxiety |
| Adrenal Gland Function | Rare, short-term issues | Increased risk of adrenal problems; seek immediate medical attention for symptoms |
| Increased risk of Infections | Temporary increase in susceptibility | Higher long-term risk; avoid sick individuals and monitor for infections |
| Eye health monitoring | Generally not required | Regular eye checks needed for vision changes or cataracts |
| Immunizations and vaccines | Vaccinations typically safe with a doctor’s approval | Live vaccines should be avoided; consult a doctor before immunizations |
| Mood and behavior changes | Occasional mood changes are possible | Higher likelihood of mood swings, depression, or sleep disturbances; report changes |
| Osteoporosis and growth | Unlikely to affect bone health | Risk of osteoporosis and slowed growth in children; discuss concerns with the doctor. |
When should I see a doctor?
It is important to promptly see a licensed doctor if you experience more than one of the following symptoms while using Prednisone:
- Blurred vision
- Dizziness or fainting
- Fast, irregular, or pounding heartbeat
- Increased thirst or urination
- Irritability
- Unusual tiredness or weakness
Additionally, any vision changes, difficulty in reading, eye pain, or other vision-related alterations during or after Prednisone treatment require an immediate check-up with a doctor.
What types of back pain can be treated with Prednisone?
Prednisone is an effective medication for various types of back pain associated with nerve root issues and inflammation. It is commonly employed for the following conditions:
Herniated or bulging discs: Reduce inflammation around the affected nerve.
Sciatica: Alleviates pain caused by nerve compression.
Cervical or lumbar radiculopathy: Eases pain from pinched nerves in the neck or lower back.
Spinal arthritis: Helps reduce inflammation in the spine’s joints.
Inflammatory conditions like ankylosing spondylitis: Reduce pain associated with inflammation of the spine.
FAQs about prednisone for back pain
Prednisone generally exhibits rapid pain relief, often within one to four days, provided the prescribed dose is sufficient to address the specific level of inflammation.
Long-term use of steroids like prednisone can lead to muscle wasting and weakness, posing a significant challenge for individuals with chronic conditions. This can sometimes necessitate discontinuation of steroid treatments.
The effects of prednisone are dose-dependent, with higher doses correlating to more severe side effects. While a daily dose of 5 mg was once considered acceptable, current recommendations lean towards minimizing or eliminating such low doses, especially for individuals prone to specific conditions.
Prednisone impacts areas of the brain regulating neurotransmitters like serotonin and dopamine, often called the “feel-good” hormones. Some individuals experience a sense of happiness as a positive side effect of prednisone.
While taking prednisone, it’s advisable to avoid or limit caffeine intake, as it can amplify the stimulant effects of the medication, potentially causing sleep disturbances, jitters or tremors, or anxiety.
Prednisone may elevate blood glucose levels, leading to increased body fat or diabetes in some individuals. Avoiding “simple” carbohydrates, concentrated sweets, and highly processed foods is essential to manage these potential side effects.
The initial daily dose of prednisone typically ranges from 5 to 60 milligrams for adults, with adjustments made as necessary. In children, the dose is weight-based and determined by the doctor, usually divided and taken 3 or 4 times a day.
Abruptly stopping prednisone is not recommended, as it can lead to withdrawal symptoms such as body aches, fatigue, and fever. Healthcare providers guide a gradual dose tapering to minimize or prevent withdrawal effects.
Tylenol (acetaminophen) can be taken with prednisone, adhering to recommended dosages and safety guidelines for each medication. It’s crucial to consult healthcare providers before starting, adjusting, or discontinuing any medication and to disclose any drug allergies or medical conditions.
There are several painkillers for back pain, especially when inflammation is a contributing factor. These include:
Non-steroidal anti-inflammatory Drugs (NSAIDs)
NSAIDs reduce inflammation, pain, and swelling without the side effects of corticosteroids. They are commonly used for treating arthritis, muscle strain, and mild to moderate back pain.
Examples: Ibuprofen, Naproxen, and Meloxicam for back pain
Acetaminophen (Tylenol)
While not an anti-inflammatory, acetaminophen can help alleviate pain, particularly for individuals who cannot tolerate NSAIDs. It’s suitable for mild back pain but doesn’t address the underlying inflammation.
Muscle Relaxants
These medications help relieve muscle spasms associated with back pain, often improving mobility and reducing discomfort in acute conditions. You may be prescribed Methocarbamol for back pain, Cyclobenzaprine, or Baclofen.
Gabapentinoids
These medications treat nerve pain, including conditions like sciatica or neuropathy. They work by calming overactive nerves but are typically slower to show results compared to corticosteroids.
Examples: Gabapentin refill, and Pregabalin
Physical Therapy
A structured physical therapy program can improve spinal alignment, strengthen muscles, and reduce pain from chronic conditions like herniated discs or osteoarthritis.
Topical Pain Relief
These provide localized pain relief by applying the medication directly to the skin. They can be effective for surface-level pain or mild muscle aches.
Examples: Lidocaine patches, Capsaicin cream, and topical NSAIDs
TENS (Transcutaneous Electrical Nerve Stimulation)
This non-invasive therapy uses electrical impulses to reduce pain by stimulating nerves in the affected area. It’s often used for chronic back pain and can be used in conjunction with other treatments.
Cold and heat therapy
Cold packs reduce inflammation and numb acute pain, while heat therapy helps relax muscles and increase blood flow, improving mobility and reducing stiffness.
Opioids (For severe pain)
Examples: Oxycodone, and hydrocodone
In cases of severe back pain where other treatments have failed, opioids may be prescribed for short-term use. However, they come with a high risk of dependency and side effects, so they are generally reserved for extreme cases. These fall under the category of controlled substances.
Biologic Medications
Examples: TNF inhibitors like Etanercept or Infliximab
These are used primarily for autoimmune-based inflammatory conditions like ankylosing spondylitis and rheumatoid arthritis, targeting specific immune system pathways to reduce inflammation.
Surgery (In severe cases)
In cases where conservative treatments don’t provide relief, surgical options like discectomy, laminectomy, or spinal fusion may be considered, especially for conditions like herniated discs or severe spinal stenosis.
