Prednisone for back pain: Benefits, dosages, and side effects

In this article:

• Does prednisone help with back pain?
• How does prednisone help back pain?
• Prednisone dosage for back pain
• Prednisone side effects

In this article

• Does prednisone help with back pain?
• How does prednisone help back pain?
• Prednisone dosage for back pain
• Prednisone side effects

In 2019, a National Health Interview Survey found that back pain was the most common location for pain, with 39% of adults saying they’d experienced it in the last three months. As a common healthcare concern that can interfere with normal activities, there are several treatment options available. Occasionally, doctors will prescribe prednisone to treat back pain, but this is usually in specific situations.

Below, we’ve spoken with the experts to learn the benefits of prednisone and everything you may want to know when taking the prescription drug for back pain.

Does prednisone help with back pain?

“Yes, prednisone can help with back pain,” said Dr. Zeeshan Ahmad, a pain and spine specialist who works at OSF HealthCare in Illinois. “However, it only helps with pain, which is inflammatory in nature.”

Not all back pain is caused by inflammation. There are several ways back pain is classified. The types of back pain can be described as:

• Acute back pain: Sudden pain persisting for several days to a few weeks.
• Subacute back pain: Back pain lasting 4 to 12 weeks, happening suddenly or over time.
• Chronic back pain: Daily back pain lasting more than 12 weeks, happening suddenly or worsening over time.

Different sources may be the cause of back pain. They are typically categorized as:

• Mechanical or structural problems can develop in the spine, discs, muscles, ligaments, and tendons. This could be from things like a sprain, unnecessary strain, degenerative disc disease, or scoliosis.
• Inflammatory conditions, including autoimmune diseases like ankylosing spondylitis, which causes inflammatory arthritis in the spine.
• Other health conditions can sometimes feel like symptoms of low back pain or cause chronic pain throughout the entire body, including the area of the back. This can include kidney stones, urinary tract infections, endometriosis, or fibromyalgia.

However, it’s not just inflammatory conditions that lead to inflammation. There can be inflammation in the tissues from other medical conditions, mechanical problems, and structural issues. The best way to determine if prednisone would work for you is by speaking with a specialist or your primary healthcare provider.

That being said, doctors don’t typically prescribe prednisone to patients as a first-line treatment when seeking help for back pain. Doctors are more likely to try conservative treatments first. 

“Prednisone can be effective for short-term inflammation relief, but is typically used as a last resort for severe back pain due to its side effects,” said Dr. Gbolahan Okubadejo, a spinal and orthopedic surgeon in New York City and the surrounding areas. “Many doctors prefer starting with physical therapy, pain management techniques, or non-steroidal anti-inflammatory drugs before considering steroids.”

This is also aligned with the American College of Physicians guideline for treating nonradicular low back pain, which suggests non-drug therapies first and foremost. 

Pain management techniques could include acupuncture, massages, or electrical nerve stimulation. Non-steroidal anti-inflammatory drugs, also called NSAIDs, can be prescription strength, but there are also over-the-counter medications available, like ibuprofen (Advil), aspirin (Bayer), and naproxen (Aleve) to help with pain control.

Steroid injections, or corticosteroid injections, may also be treatment options for some individuals seeking short-term pain relief. A single dose of injectable steroids can make a difference in providing effective pain relief for certain conditions.

If you are prescribed prednisone, it should begin working quickly to relieve pain. Depending on the underlying condition, it can take anywhere from a few hours to two or three days to notice a change in improvement.

How does prednisone help back pain?

Prednisone belongs to a class of medications called corticosteroids, which are human-made, synthetic steroids. How exactly does it work?

“It works by calming the body’s immune response, reducing swelling and nerve pressure. This relief can make it easier for people to move and feel more comfortable while they heal,” said Dr. Okubadejo.

Depending on the amount of swelling and inflammation, it may only take a few hours after your first dose to begin to notice the prednisone working. However, it may take a couple of days, which is also when the full effects of the prednisone will begin.

Prednisone dosage for back pain

There is a large range for the possible dosage of prednisone for back pain. This is because it’s tailored to your specific needs. Mild bouts of back pain, like a strain or pinched nerve, could start around 10 milligrams of prednisone per day, while severe cases, such as a herniated disc causing compressed nerves, could be prescribed higher doses of up to 60 milligrams per day. Technically, prednisone can start as low as 1 milligram, but this is less likely.

Here is the average dosage you might expect when taking prednisone for back pain:

• Mild back pain: 10 to 20 milligrams per day
• Severe back pain: 40 to 60 milligrams per day

For back-related pain, prednisone is typically prescribed for shorter periods, such as 5 to 7 days. 

Dr. Okubadejo explained, “The key is that prednisone isn’t ‘one size fits all’ — it’s customized to your body, the cause of the pain, and how your symptoms respond. Doctors often start with a higher dose for a few days, then taper it down. The goal is to control inflammation quickly without long-term use.”

A 2022 review looked at the use of systemic corticosteroids for the treatment of radicular back pain and non-radicular lower back pain. Simply put, this means the researchers looked at studies of back pain involving corticosteroids administered through the oral, intravenous, or intramuscular routes for various types of lower back pain, some including pain relating to a nerve root (radicular). The authors found corticosteroids are “slightly effective at improving short-term pain and function in people with radicular low back pain not due to spinal stenosis, and might slightly improve long-term function.”

Prednisone side effects

While the dosages of prednisone may vary, the time frame typically doesn’t. 

“It should be used in the short term, five to seven days, and not long term,” warned Dr. Ahmad. This is mainly because of the unfavorable side effects when taking it long term, as well as the possibility of withdrawal symptoms after extended use. 

Just like any medication, prednisone can come with side effects and adverse events to be aware of, even if only taken for a short period of time. Common side effects of prednisone can include:

• Weight gain
• Indigestion
• Insomnia
• Restlessness
• Sweating
• Mood swings
• Serious allergic reaction

When taking prednisone for extended periods, there are long-term, significant side effects that may appear, including:

• Osteoporosis (thinner bones)
• Poorly controlled diabetes
• Vision problems
• Hypertension (high blood pressure)

There are medication interactions you’ll want to avoid when taking prednisone. Your doctor or pharmacist can verify if there are any potential risks with your medications. Some of the most common interactions may include:

• Other immunosuppressants, such as prednisone, also suppress the immune system. 
• Diabetic medications, as prednisone, can increase blood sugar levels, making them less effective.
• NSAIDs taken with prednisone can increase the risk of stomach-related upset and bleeding ulcers.

Learn more about prednisone side effects and how to avoid them.

The bottom line

Prednisone is a short-term option for treating back pain caused by inflammation, but it’s not the first line of defense. Other options, like pain management and physical rehab, may be more appropriate. If you are prescribed prednisone to treat back pain, it will likely be given for short-term use, as it’s best not to take the drug for a long time.

“Prednisone can be a good option for short-term relief of severe back pain caused by inflammation, but it’s not a long-term solution,” advised Dr. Okubadejo. “While it can reduce pain quickly, it carries potential side effects, especially with prolonged use. It’s best used under a doctor’s guidance, often alongside other treatments like physical therapy, to address the underlying issue.”