Despite the fact that Epidural Steroid Injections (ESIs) have never been FDA-approved for spinal use, they are currently the most popular treatment of lower back pain in the U.S, performed nearly 9 million times a year.  Yet there are growing rumblings among the public and professional community alike, culminating in a widely-discussed Dr. Oz “investigative journalism” show on ESIs in May.

As Dr. Oz discussed, possible side effects of ESIs include thinning of the skin, easy bruising, weight gain, puffiness of the face, acne, elevation of blood pressure, cataract formation, thinning of the bones (osteoporosis), and a rare but serious type of damage to the bones of the large joints (avascular necrosis).  Moreover, adverse effects of corticosteroid injections for plantar fascitis include fat pad atrophy, plantar fascia rupture, local skin effects and steroid flare.

Thankfully, these growing concerns with ESIs are yet another reason patients are turning away from these invasive procedures and may be more open to holistic joint and pain treatment, like that offered by ProActive Chiropractic. Chiropractic has strong support from medical research.

In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy resulted in faster recovery than physiotherapy and general practitioner care. Moreover, total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care.

 — Korthals-de Bos et al (2003), British Medical Journal

Another option for some patients is custom-made orthotics. Custom orthotics are an attractive option for patients unwilling to go under the knife (or the needle) and be very helpful for a variety of foot ailments and related issues, like low back pain. Custom-made orthotics also tend to be less expensive than surgery or injections, with fewer side effects. If you’re on the fence on whether ESI or a more conservative approach is right for you schedule a complementary consult today.

•    “A Guide To Conservative Care For Plantar Heel Pain,” Podiatry Today, by Jamie Yakel, DPM, Volume 26 – Issue 11 – November 2013.
•    “Cortisone Injection (Corticosteroid Injection) of Soft Tissues & Joints,” by Catherine Burt Driver, MD,, no date given.
•    “An In-Depth Investigation: Epidural Steroid Injections,” by Elisabeth Leamy,, posted on May 6, 2013.
•    “Dr. Oz Warns Against Epidural Steroid Injections; Harvard-trained Pain Management Specialist Dr. Reza Ghorbani Responds,” press release posted to PR Web, May 9, 2013.