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Should my mother be injected with steroids for her leg pain?

Q: My 65 years old mother is suffering from acute pain in the leg starting from left hip right up to the ankle. It worsens when she gets up from sleep and after sitting for a prolonged time. There is no pain as such while sleeping. She underwent laminectomy six years back and was also operated for ovarian cancer two years back. Currently she is in hospital and the doctor has suggested for steroid injections, as her age and past history of surgery don't make her applicable for surgery. However, she is scared of injections as in before laminectomy she was given a steroid injection which was very painful. Kindly recommend what can be done in such case, also if at all she is injected, what all precautions can be taken after discharge. She uses a belt now while walking. Should she continue using the belt all her life, even while sleeping in night? Kindly advise.

A:If your mother was operated for ovarian cancer in two years back, it is important that she should be investigated for any metastasis from the cancer. I would not recommend any steroid injection till the cause of pain is found out. Please get further investigations done to find the cause of her backache. Usually an MRI should suffice, however, if she has been operated for laminectomy then she will need a scan with a contrast dye. That pushes up the cost of MRI but it is worth it. Steroidal injection to the back are often given but there is no convincing evidence that it has any long term benefit and it works any better than placebos. There is an additional risk of introducing infection locally. In any case there are papers which suggest that six months post injection there is difference between the patients that have had the injection or those without the injection. I would recommend that she get the investigations done and get her case reviewed.

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