Bironas also had field goals of 22 and 38 yards in the first quarter, and his 47-yarder on the final play of the first half gave Tennessee a 16-10 lead.
Tennessee capitalized on a blocked punt to take the lead early in the second quarter.
On the final play of the first quarter, Tim Shaw broke through the middle of the line and blocked Drew Butler's punt. Jason McCourty recovered at the 1 to give the Titans first-and-goal. That set up a 1-yard burst from Jamie Harper that gave the Titans a 13-10 advantage.
Harper's touchdown left St. Louis as the only team without a rushing touchdown this year.
"We couldn't lose tonight," Shaw said. "We were desperate. We needed this win more than anything. It's gotten us in a good place."
The Steelers failed at moving above .500 for the first time this season after splitting their first four games. They should have felt right at home in Nashville, as roughly half the fans at LP Field were waving Terrible Towels while dressed in Steeler black-and-gold. They even had a fan run onto the field after the third quarter, waving a towel before being tackled.
Notes: Titans cornerback Jason McCourty had an interception, the fifth of his career and first this season. ... Tomlin is 3-2 against the Titans. Tomlin now is 15-6 in October. ... Tennessee has won two of its last three home games against Pittsburgh. ... Titans cornerback Tommie Campbell hurt his ankle on punt coverage and did not return.
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