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In the setting of acute low back pain with radiculopathy , oral corticosteroids are typically prescribed in a quick tapering fashion over one week. It is a simple yet important way to address symptoms. These medications will be administered in a manner which does not interfere with the patient sleep or other daily activities. Over time oral steroids will naturally work as they do within the body and help to maintain a normal and healthy weight. However, there are some important questions that remain unanswered. Some patients with chronic low back pain require more prolonged oral steroids therapy than acute low back pain. The question of what dose is best within each individual patient and the appropriate duration of therapy are important and the following discussion describes the various oral therapies currently available to promote recovery. In this discussion we will look in detail at 1) the oral corticosteroid dosage for low back pain, 2) the ideal dose for all patients, and 3) the typical duration of therapy. 1. Oral Corticosteroid Dosage How Much Oral Corticosteroid to Administer? First things first, if there is a patient who has developed chronic low back pain they also might not have pain at all. Therefore, if patients are at risk for low back pain or are at risk due to an injury, other medical condition, or medication side effect, we will not be performing oral therapy within their current range of doses. Thus, for patients who are at risk, the first question to ask is whether their pain is chronic if they have not responded to previous therapies. This is usually a very important question and for patients who have suffered an injury, the question might make sense to ask about their injury history and the history of pain and disability associated with their injuries, or they might have had other medical conditions that have precluded any response to pain management. In addition, many patients with chronic low back pain will be diagnosed with CSA or osteoarthritis. Thus, patients undergoing low back surgery may not need as much oral corticosteroid therapy as they do others because they require shorter intervals to eliminate residual inflammation. Some patients with chronic low back pain will have more severe low back pain than others. This may be in part due to the fact that low back pain patients are more likely to have chronic illnesses or medications that result in high doses of corticosteroids that can interfere with normal function. In addition, some patients with chronic low back pain have had serious or catastrophic head injuries, so we might decide this patient's need for more prolonged oral steroid therapy is higher. The dose is most often based on the patient's body weight, the nature of their Related Article: