Is Solucortef (Hydrocortisone) effective for back pain?

From the Guidelines

Solucortef (Hydrocortisone) is not effective for back pain.

Evidence Summary

• The evidence from multiple studies, including a systematic review published in the Annals of Internal Medicine in 2017 1, suggests that systemic corticosteroids, such as hydrocortisone, do not seem to be effective for low back pain.
• Another study published in the same journal in 2007 1 also found that systemic corticosteroids are not recommended for treatment of low back pain with or without sciatica, as they have not been shown to be more effective than placebo.
• A review of the evidence on medications for acute and chronic low back pain, also published in the Annals of Internal Medicine in 2007 1, found good evidence that systemic corticosteroids are ineffective for low back pain with or without sciatica.

Key Points

• The evidence is consistent across multiple studies, suggesting that hydrocortisone is not an effective treatment for back pain.
• Other medications, such as NSAIDs, skeletal muscle relaxants, and tricyclic antidepressants, have been shown to be effective for short-term pain relief in patients with low back pain.
• The lack of efficacy of systemic corticosteroids, such as hydrocortisone, for low back pain is likely due to the fact that they do not address the underlying causes of the pain, such as inflammation or muscle strain.

From the Research

Effectiveness of Solucortef (Hydrocortisone) for Back Pain

• The effectiveness of systemic corticosteroids, such as Solucortef (Hydrocortisone), for back pain has been studied in various trials 2, 3.
• For radicular low back pain, moderate-certainty evidence suggests that systemic corticosteroids probably slightly decrease pain and may slightly increase the likelihood of experiencing improvement in pain at short-term follow-up 2.
• However, the effects of systemic corticosteroids in people with non-radicular low back pain are unclear, and they are probably ineffective for spinal stenosis 2.
• A study found that oral corticosteroids, such as prednisone, did not provide significant benefits for patients with musculoskeletal low back pain in the emergency department 3.
• Other studies have investigated the use of local corticosteroid injections for low back pain and sciatica, with some evidence suggesting a short-term analgesic effect 4, 5, 6.

Types of Back Pain

• Radicular low back pain: Systemic corticosteroids may be slightly effective at improving short-term pain and function 2.
• Non-radicular low back pain: The effects of systemic corticosteroids are unclear 2.
• Spinal stenosis: Systemic corticosteroids are probably ineffective 2.

Administration and Dosage

• Systemic corticosteroids can be administered orally, intravenously, or intramuscularly 2.
• Local corticosteroid injections can be given epidurally, transforaminally, or intra-articularly 4, 5, 6.
• The dosage and duration of corticosteroid therapy vary across studies 2.