From the Guidelines

Solumedrol (methylprednisolone) is not effective for back pain.

The evidence from multiple studies, including those published in the Annals of Internal Medicine 1, consistently shows that systemic corticosteroids, such as methylprednisolone, are not effective in treating back pain.
Specifically, a 2007 study found that systemic corticosteroids were associated with no clinically significant benefit compared to placebo in patients with acute sciatica or sciatica of unspecified duration 1.
Another study published in 2017 found that low-quality evidence showed no difference in pain or function between a single intramuscular injection of methylprednisolone or a 5-day course of prednisolone compared to placebo in patients with acute low back pain 1.
The evidence suggests that other treatments, such as NSAIDs and opioids, may be more effective in managing back pain, although their benefits are generally small to moderate and short-term.

Lack of efficacy: Systemic corticosteroids, including methylprednisolone, have not been shown to be effective in treating back pain.
Alternative treatments: Other medications, such as NSAIDs and opioids, may be more effective in managing back pain, but their benefits are generally small to moderate and short-term.
Need for further research: More research is needed to determine the optimal selection of medications, the best combinations and sequencing of treatments, and the most effective medications for radicular low back pain.

From the Research

The effectiveness of Solumedrol (methylprednisolone) for back pain has been studied in various clinical trials 2, 3, 4, 5, 6.
A study published in 2007 compared the clinical response of 80 mg versus 40 mg methylprednisolone in epidural steroid injections (ESI) for lumbar radicular pain, and found that both doses were comparable in terms of pain relief and had similar results 3.
Another study published in 2003 compared epidural Depo-Medrol (methylprednisolone) with aqueous betamethasone in patients with low back pain, and found that methylprednisolone was more effective in reducing pain and disability scores 4.
A systematic review published in 2022 evaluated the benefits and harms of systemic corticosteroids for radicular and non-radicular low back pain, and found that systemic corticosteroids probably slightly decrease pain and improve function in people with radicular low back pain, but the effects are unclear for non-radicular low back pain and probably ineffective for spinal stenosis 5.
A pilot study published in 2011 found that caudal 40 mg methylprednisolone acetate was as effective as 80 mg in improving disability associated with chronic low back pain, and suggested that the 40 mg dose should be considered for outpatients with chronic low back pain attending for repeat caudal steroid injection 6.

The studies suggest that different doses and forms of methylprednisolone may have varying effects on back pain, with some studies finding that lower doses (40 mg) are as effective as higher doses (80 mg) 3, 6.
The form of methylprednisolone used may also affect its efficacy, with depo-steroids (such as Depo-Medrol) appearing to be more effective than non-depo steroids (such as betamethasone) 4.

The findings of these studies suggest that Solumedrol (methylprednisolone) may be a useful treatment option for back pain, particularly for radicular low back pain 2, 3, 4, 5, 6.
However, the optimal dose and form of methylprednisolone, as well as the potential risks and benefits of treatment, should be carefully considered in each individual case 3, 4, 5, 6.