Radiculopathy occurs when something irritates a spinal nerve—say a “slipped disc” causing a pinched nerve. This is also called sciatica . There are resident stem and other cells in the local tissues everywhere in our body. Many live around blood vessels. These are obviously also present in the disc and nerves in the epidural space and they usually play an important role in suppressing inflammation and repairing damage. We know, based on a copious in vitro (lab) data, that the high-dose steroids used in epidural injections can kill these cells. So the progression of the series of epidural steroid injections looks a little something like this:
During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.
Not shortly after Roger Maris record was broken, another baseball player, Jason Giambi and various other athletes were either suspected of, or proven to have, taken anabolic steroids. Again, Congress convened a hearing, and just as they did the first time in 1990, they did not determine that steroids were a danger, but rather that the danger was more in protecting professional sports organizations. The updated statute has been updated to proscribe pro-hormones also The definition of an anabolic steroid as defined currently in the United States under (41)(A) is that "anabolic steroid" means any drug or hormonal substance, chemically and pharmacologically related to testosterone (other than estrogens , progestins, corticosteroids, and dehydroepiandrosterone (7).