Back Pain Steroid Injections Dangerous

Dr Timothy Lim

July 7, 2014

If you knew that the commonly practiced back pain steroid injections are dangerous, would you take it if you are in severe pain? Take the poll below to find out how others feel. If you suffered neurological complications from steroid injections here are some facts directly from the US government Food and Drug Administration you want to know:

- Steroid injections have been a “widespread practice for many decades”
- Steroid Injections “effectiveness and safety of the drugs for this use have NOT been established”
- The”FDA has NOT APPROVED corticosteroids for such use” as in for back and neck pain relief
- Medical professionals’ are concern about epidural corticosteroid injections but most still perform it anyway
- Serious Side effects of steroid injections are RARE.

So my question is what are the serious side effects and how rare are they? According to the FDA again, they say epidural steroid injections “may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death. The injections are given to treat neck and back pain, and radiating pain in the arms and legs.” Now I could not find any data how rare the chances of those serious side effects but according to the American Journal of Neuroradiology, inaccuate injection placement of the 20-guage needle can be as high as 25%! Now would you consider getting treatment with the epidural injection is you are in pain and admitted to hospital?

Back Pain Steroid Injection Summary:
In a recent well-designed study published in the New England Journal of Medicine on July 3, 2014, showed that The much more costly Epidural steroid injections or ESI for back pain are not only ineffective when compared to using lidocaine much cheaper pain relieving drug) alone, but can also be dangerous.

Don’t get the idea these pain injections did not provide any relief, in fact, patients did indicate some satisfaction for the injections, perhaps not just what the researchers would have hoped. In this study with 400 people with chronic back pain caused by lumbar sternosis, a condition in many elderly people where the arthritis of the spine essentially choke the spinal cord to cause among other symptoms like numbness, tingling but also pain.

So how satisfied we the patients with the pain results? Well, they started with an average pain score of 15.7 out of 25 (0 is no pain, 25 is worst pain) and after one and a half months later, their average pain dropped to 12.5 out of 25. That’s about 20% improvement in 6 weeks.

The issue here is whether using the more expensive back pain epidural steroid injections were justified while considering its efficacy to improve pain reduction outcome and undesirable side effects discussed above. Interestingly, they did make no mention of chiropractic, osteopathy or even physical therapy as a first non-invasive option despite increasing evidence their efficacy.