Can anabolic steroids help a herniated disc? There is no clinical evidence that they do. Anabolic-androgenic steroids (AAS) are not used to treat herniated discs, and their muscle-building effects do not repair a damaged disc. The steroids that doctors sometimes use for disc-related pain are corticosteroids, a completely different class of drug that reduces inflammation.
This article explains what a herniated disc is, why anabolic and corticosteroids are often confused, what the evidence shows for different treatments, and when back pain needs urgent attention.
What is a herniated disc?
The spine contains discs that sit between the vertebrae and act as cushions. Each disc has a tough outer ring and a softer, gel-like center. A herniated disc occurs when part of the center pushes through a weak spot or tear in the outer ring.
A herniated disc does not always cause symptoms. When it does, the material can press on or irritate nearby nerves, causing back pain and, in the lower back, pain that travels down the leg, known as sciatica. Numbness, tingling, or weakness can also occur.
Can anabolic steroids help a herniated disc?
No clinical trials have shown that anabolic steroids help a herniated disc heal, relieve its symptoms, or speed recovery, and they are not part of any recognized treatment guideline.
Claims that AAS help through “tissue repair” or “reduced inflammation” do not hold up. AAS increase muscle protein synthesis, but a herniated disc is not a muscle injury, and stronger muscles do not repair disc tissue. AAS are also not anti-inflammatory drugs in the way corticosteroids are.
At the same time, AAS carry well-documented risks, including suppression of natural testosterone, changes in cholesterol and blood pressure, and liver injury from oral compounds. Our guide to the key facts about steroids explains the difference between anabolic steroids and corticosteroids, and the risks of each.
Which steroids are used for herniated discs?
When doctors use steroids for disc-related pain, they use corticosteroids, which reduce inflammation around irritated nerves.
Epidural steroid injections
A corticosteroid, usually combined with a local anesthetic, can be injected near the affected nerve. Guidelines such as those from the UK’s National Institute for Health and Care Excellence (NICE) suggest considering these injections for people with acute and severe sciatica (NICE, 2020). They can provide short-term pain relief for some people, although they do not appear to change the long-term outcome for most.
Oral corticosteroids
Short courses of oral corticosteroids, such as prednisone, are sometimes prescribed. In a randomized controlled trial in people with sciatica from a herniated disc, a short course of prednisone modestly improved function compared with placebo but did not significantly improve pain (Goldberg et al., 2015).
Oral corticosteroids have their own side effects, including sleep problems and raised blood sugar. Even short courses are associated with a higher risk of blood clots in the veins, as explained in our article on whether steroids cause blood clots. Our article on caffeine and prednisone covers some common prednisone side effects.
What actually helps a herniated disc?
Time
Many herniated discs improve on their own. A systematic review found that herniated disc material often shrinks or is reabsorbed over time without surgery, particularly in larger herniations where material has broken away from the disc (Chiu et al., 2015). Symptoms often improve over several weeks to months.
Staying active and exercise therapy
Guidelines generally recommend staying as active as possible rather than prolonged bed rest. Exercise programs, often guided by a physiotherapist, can help with pain and function, and gradual strengthening supports a return to training.
Pain relief
Pain relievers, such as anti-inflammatory medications, may be used for short periods under medical advice. A doctor can recommend appropriate options based on individual health and other medications.
Surgery
Surgery, usually a procedure called a discectomy, may be considered for people with persistent severe symptoms that do not improve with other treatment, or with progressive nerve problems. Surgery often relieves leg pain faster, although long-term outcomes can be similar to non-surgical treatment for many people.
Returning to training after a herniated disc
Many people return to resistance training after a herniated disc. A gradual, supervised return is generally recommended, often starting with movements that do not provoke symptoms and building load over time. A physiotherapist or sports medicine doctor can help plan this.
When to seek urgent medical help
Some symptoms can signal a serious condition called cauda equina syndrome, in which the nerves at the bottom of the spinal cord are severely compressed. Seek emergency medical care for:
Numbness in the groin, buttocks, or inner thighs.
New difficulty passing urine, loss of bladder or bowel control, or new constipation.
Weakness in the legs that is getting worse.
Sexual dysfunction that develops suddenly with back pain.
Back pain with fever, unexplained weight loss, or a history of cancer should also be assessed promptly.
The bottom line
Can anabolic steroids help a herniated disc? No. There is no clinical evidence that anabolic steroids help a herniated disc heal or reduce its symptoms, and they carry significant risks. The steroids doctors sometimes use for disc-related pain are corticosteroids, such as epidural injections or short courses of prednisone, which can help some people in the short term.
Most herniated discs improve over time with staying active, exercise therapy, and pain relief, and surgery is an option for persistent or severe cases. Anyone with a herniated disc should be assessed by a healthcare professional, and symptoms such as numbness in the groin or loss of bladder control require emergency care.
References
Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clinical Rehabilitation. 2015;29(2):184–195.
Goldberg H, Firtch W, Tyburski M, et al. Oral steroids for acute radiculopathy due to a herniated lumbar disk: a randomized clinical trial. JAMA. 2015;313(19):1915–1923. National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management (NG59). Updated 2020.
