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Healthcare providers use lumbar epidural steroid injections to manage a type of chronic pain known as lumbar radicular pain, which is caused by spinal nerve root inflammation and irritation in your low back

[DOI] [PubMed] [Google Scholar] Pei J, Xiao Z, Guo Z, Pei Y, Wei S, Wu H, Wang D

The mechanism of metabolic acidosis and 5-oxoprolinuria is the following: decreased levels of cellular glutathione lead to decreased feed-back inhibition of -glutamylcysteine synthetase

doi: 10.1016/j.bios.2020.112764

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This is one reason some patients report inconsistent results after switching pharmacies or even between refills from the same pharmacy