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Oral Steroids Strengths and Weaknesses. Among the biggest benefits of oral steroids is that they offer relief from pain and inflammation without the invasiveness of their injected counterparts. Unlike spinal injections, oral steroids do not require MRI or radiation exposure, and may pose less of a risk for some patients. Spinal injections, however, deliver a more concentrated dose of corticosteroids with a lower degree of systemic (whole body) side effects. Oral steroids do have some drawbacks, though. Compared to steroid injections, it takes longer for oral forms to take effect. Oral steroids also impact your entire body’not a single area like an injected form. Because of this, oral steroids carry more significant side effects than other delivery methods. Possible side effects may include: Weight gain Elevated blood pressure Increased eye pressure (glaucoma) Swollen legs Psychological changes, such as mood swings, memory loss, and behavioral changes Sleep difficulties. It is a long-held belief that short-term use of oral steroids provides protection against more serious side effects. However, a recent study published in April 2017 in the BMJ found that adults using oral steroids had a two-fold increased risk of fractures, a three-fold increased risk for venous thromboembolism, and a five-fold increased risk of sepsis within 30 days of starting the medication. The study authors recommend using the lowest dose of oral steroid possible to reduce the potential for these complications. If oral steroids are required as a long-term treatment’such as in treatment of certain inflammatory disorders (eg, lupus, ankylosing spondylitis)’you should be aware of the following side effects that may occur with prolonged use: Slower wound healing and increased skin bruising Increased infection risk Clouding or blurred vision High blood sugar Osteoporosis and fractures Avascular necrosis of bone (death of bone due to lack of blood supply) Safely Using Oral Steroids for Spine Pain. Oral steroids are prescription-only medications. During your visit with your doctor, ask about the side effects and complications associated with these drugs. Also, make sure you understand exactly how to properly use your oral steroid, as it may be on a tapered schedule in contrast to a simple one-pill-per-day regimen. Safely using your drug means using it exactly as your doctor prescribes. 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