Are steroid injections the best treatment option for low back pain?

And while low back pain is often manageable, it’s also one of the leading causes of disability worldwide.² So when the pain sticks around, it’s natural to want fast relief. But are steroid injections the best way to get it?

Let’s take a closer look at what causes low back pain, how it’s usually treated, and where steroid injections fit in.

What is low back pain and what causes it?

Low back pain, also known as lumbar pain, can be short-term (acute, lasting less than 6 weeks), medium-term (sub-acute, lasting 6 to 12 weeks), or long-term (chronic, lasting more than 12 weeks). 90% of cases fall into the “non-specific” category, meaning there’s no clear medical cause like a fracture, infection, or cancer. Instead, it’s often linked to things like muscle strain, ligament issues, or wear and tear in the spine (degenerative disc disease).²

Sometimes, back pain can also cause pain that travels down the leg. This is called radicular pain, and it’s usually due to a nerve being compressed or irritated, often from a slipped (herniated) disc or spinal narrowing (stenosis).²

What are the best ways to manage low back pain?

While living with back pain can be frustrating and exhausting, the good news is there are several proven treatments that can help, none of which involve invasive procedures like injections or surgery.

Exercise therapy: Regular, guided movement (like physio-based strength, mobility, or aerobic programs) is one of the most effective ways to manage persistent back pain.^3.4 The key is finding something that works for you and sticking with it. There’s no one-size-fits-all approach, so pick something you enjoy and are likely to continue.

Psychological support: Back pain isn’t just physical, it can also affect your mood, sleep, and stress levels. Cognitive Behavioural Therapy (CBT) helps you manage the emotional side of pain and has been shown to reduce both pain and disability. ^5,6,7 Once typically only available in person, appointments with a psychologist are now easy to access online or over the phone. 

Multidisciplinary pain programs: These programs combine physical therapy, psychology, and lifestyle coaching. This holistic approach is often more effective than injections or medication alone.⁸

Medication (short-term only): While not a cure, anti-inflammatories can help during flare-ups. However, long-term use of opioids (medications related to morphine) or muscle relaxants (like Valium) isn’t recommended due to limited benefit and potential harm.⁸

What about steroid injections?

Epidural steroid injections deliver corticosteroids into the space around your spinal cord, with the aim of reducing inflammation and relieving pain.⁹ These injections are sometimes used when other treatments, like those listed above (exercise, physiotherapy, or medication), haven’t provided enough relief, especially if the pain includes leg symptoms (known as radicular pain).

So, are steroid injections worth it? For most people with low back pain that doesn’t involve nerve symptoms, the answer is likely no. Here’s why:

• For people with non-radicular low back pain (pain that stays in the lower back or buttocks), the evidence supporting steroid injections is weak.¹⁰
• While they may offer short-term relief, the long-term benefits are limited.^11,12,13
• Like any procedure, steroid injections carry risks, including infection, nerve damage, and high costs, which may outweigh the benefits.¹⁴

The bottom line

Steroid injections aren’t a first-line fix for most types of low back pain. They may help in specific cases, but for many people, they’re considered low-value care, meaning they offer little benefit and may even cause harm. Instead, the best approach is often a combination of movement, support, and self-management, backed by strong evidence and fewer risks.

If you’re living with back pain, talk to your GP or physio about evidence-based options that can help you feel better and stay active, without unnecessary procedures.

How HBF can help

If you decide an epidural steroid injection is right for you, HBF is here to help. Log in to myHBF or call 133423 to check your level of cover and find a specialist using our Find a Provider tool.

If you have eligible extras cover with HBF, you may be able to claim benefits for services that support managing back pain, such as:

• Physiotherapy: A physio can assess your condition, provide targeted exercises to strengthen your back, and help you maintain mobility while reducing discomfort.
• Exercise physiology: Get expert guidance on physical activity tailored to your needs, focusing on improving your strength, flexibility, and overall fitness to support your spine.
• Remedial massage: Recover with massages designed to ease muscle tension, reduce spasms, and alleviate back pain.
• Psychology: A psychologist can help you develop strategies to manage stress effectively, promoting better mental and physical health.
• Nutrition and dietetics: A dietitian can provide advice on a balanced diet to support weight management and overall wellness.