FDA Warns of Dangers of Epidural Spinal Injections

Editor’s Note: This post was updated and verified for accuracy on 8/10/19.


While the Ehlers-Danlos Community has known for some time about the deleterious effects of corticosteriods on collagen, the FDA has recently released a statement that they are now requiring additional labeling on the use of corticosteroids for Epidural Spinal Injections (ESI’s) used to treat back pain. They state:

…injection of corticosteroids into the epidural space of the spine 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. We are requiring the addition of a Warning to the drug labels of injectable corticosteroids to describe these risks. Patients should discuss the benefits and risks of epidural corticosteroid injections with their health care professionals, along with the benefits and risks associated with other possible treatments.

Injectable corticosteroids are commonly used to reduce swelling or inflammation. Injecting corticosteroids into the epidural space of the spine has been a widespread practice for many decades; however, the effectiveness and safety of the drugs for this use have not been established, and FDA has not approved corticosteroids for such use. We started investigating this safety issue when we became aware of medical professionals’ concerns about epidural corticosteroid injections and the risk of serious neurologic adverse events.1 This concern prompted us to review cases in the FDA Adverse Event Reporting System (FAERS) database and in the medical literature (see Data Summary).2-16

To raise awareness of the risks of epidural corticosteroid injections in the medical community, FDA’s Safe Use Initiative convened a panel of experts, including pain management experts to help define the techniques for such injections which would reduce preventable harm. The expert panel’s recommendations will be released when they are finalized (fda.gov).

It has long been known in the zebra community that corticosteriods contribute to the breakdown of collagen, which is why most of us caution their use in only the most necessary circumstances. It would appear there is even more reason for concern when it comes to spinal injection, which leads me to question how this substance can be safe for injection anywhere in the body, so I decided to do more research about steroids and their safety. You can find that article here: Are Steroids Safe?

As usual, I caution you to stay safe and question everything you put into your bodies, my friends. This is a drug that has been in use for many decades, without warning of any kind that these things have been taking place until now, but you can believe these warnings (and more) are on the waivers we all sign but pay little attention to at the offices and clinics where we have these procedures.

As it appears I’m now attracting the occasional doctor and my aim is to educate laypeople and medical professionals alike, I am including a link to a journal article which discusses some of the specific “catastrophic events” that have occurred with ESI’s and specific recommendations made by the panel considering whether additional warnings need to be made: Improving the Safety of Epidural Steroid Injections

Need a natural anti-inflammatory? Check out some of the ones I use on my list of supplements.

"injection of corticosteroids into the epidural space of the spine 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. We are requiring the addition of a Warning to the drug labels of injectable corticosteroids to describe these risks."
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15 thoughts on “FDA Warns of Dangers of Epidural Spinal Injections

  1. No opiates, no steroids? What do people do. Your article jumped to conclusions and was not well thought out. Epidurals don’t work for all, but definitely worth a try with shooting, sciatic type pain.

    Felix Brizuela D.O.

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    1. My conclusions are not well thought out? They do work some of the time when properly administered: However, there are risks and side effects, both of which increase exponentially when administered in the region of the spine. These are not my “opinions.” They are warnings which come from the FDA for consumers, to protect them from careless doctors and they’ve been out for 3 years. This is why I argue it is necessary for patients to do their own research before undertaking any procedure, so that they may protect themselves where practitioners may not because they are acting on faulty information. Thanks ever so much for your comment. It’s been quite educational.

      Liked by 1 person

  2. In this article, this blogger says, “I look forward to the FDA’s final findings on this topic and frankly hope that corticosteroids are removed from use once their investigation is completed.”
    Well, zebra pit blogger, so on your whim, you would have our freedoms taken away too! Who do you think you are? PAIN IS NO JOKE! You’ve obviously never witnessed the pain of induced labor. It is excruciating, worse than natural labor. I was in tears waiting for the epidural to come for her. I THANK GOD for epidurals!!
    The FDA. They’re a bunch of pharma funded bureaucratic liars! Pharmaceutical commercials give appalling side effect warnings all the time–including DEATH. Even drugs taken as directed can kill you.
    (FoodMatters video). My daughter has had 3 epidurals and she’s JUST FINE!
    She chose life for her children. Why don’t you give the ignorant one more reason to murder their babies knowing they can’t have epidurals.
    I would remove that part of your comment.

    Like

    1. I hope you got some relief from this rant for whatever you’re experiencing, because it obviously has nothing to do with me and this procedure performed for CHRONIC BACK PAIN. 1. These aren’t the epidural they’re giving pregnant women. 2. I have a right to my own opinions. 3. It’s none of your fucking business if I’ve experienced the miracle of birth and if that’s what your argument is based on, you’re a giant whack job who doesn’t deserve a response. Try actually reading my post. Finally, I’m only giving you a response so people can see the sort of ridiculous vitriol I have to put up with for speaking the truth based on FDA findings. Try learning something before attacking someone who intends you no harm. I will remove nothing for you or anyone else.

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      1. I sincerely apologize for the vitriol-ness (as you correctly put it) of my comment. I feel very badly. Because you’re right. And even though I misunderstood that this procedure isn’t for the same outcome, more importantly in the future, I will act with more charity and clarity. I don’t know how you can consider my apology, but I hope you do.

        Liked by 1 person

        1. Thank you, Marianne. We all have bad days, take things out of context and have reasons for our anger people can’t always see from the outside. I have a rather passionate personality myself. From personal experience, I know It’s not easy to come back and apologize. So thank you. It’s forgiven and forgotten.

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  3. My (former) neurologist said he “knew all about EDS” (yeah right), misdiagnosed my EDS-induces tiredness as CFS and offered me steroid infusions. I declined and vowed to find someone else. Glad I listened to my gut on this one.

    Liked by 1 person

    1. I’m glad you did, too! I’m sorry to say I had quite a few steroid injections before I suspected this was my diagnosis and unsurprisingly, they usually made things worse. I’ve also had extensive damage from the use of floroquinolones. I’m fairly certain Cipro was responsible for my Achilles shredding on a leisurely walk up some stairs in college and had no choice but to be on it again a few years ago during a c-diff infection. It was NOT good! The ignorance of most doctors makes it pretty much essential to educate ourselves and make the best decisions possible, because doctors will often give us bad advice. I fear those who claim to know and don’t more than those who will admit their ignorance. To try to protect against some of this, my new GP and I put these drugs in my list of “allergens” and noted their effects. I’m not sure it’s the best way to do it, but I feel better having it listed on my chart so some know-it-all ER intern is less likely to argue with me.

      I have a CFS diagnosis, too. I got it before my EDS dx and they won’t take it off. I did have severe fatigue, caused by being an untreated trifecta zebra. I wonder all the time how many CFS people are misdiagnosed, but with the the new hereditary a-trypasemia diagnosis and studies, I get the distinct feeling we’ll mostly be under the same dx eventually anyway, as it’s looking very likely we’re all sick from the same genetic cause and the only real difference is a few of the symptoms and by whom or how you get diagnosed. Of course it needs more study, but the initial studies were quite compelling. I have an article about it coming out soon on the Unchargeables and how it all relates to mast cell disorders. Fascinating stuff. But seriously, if you’re suffering from a lot of fatigue and neurological symptoms, you might look into mast cell. I’m in the process of being diagnosed and already using a lot of OTC treatments and it’s helped tremendously. If any of this sounds familiar and you need more info, I’m happy to help.

      Liked by 1 person

      1. Unfortunately no Mast Cell Experts is Ireland so I’d have to go to UK and that costs a fortune. But I highly suspect it. I’ve got dermatographica, plus so many symptoms. I’m just permanently itchy. I do take antihistamines. Actually they are the only drugs I actually take anymore.
        The CFS thing annoyed me. Not that it matters but I don’t need a dx of it as the fatigue explained by the EDS. Same as with the fibro dx I have. Which I made the mistake of mentioning to that neurologist. Amazing how his tone changed completely after I told him that. And he dxed the CFS without telling me!!! Just wrote it in his letter to my GP. She just laughed and ignored it. And put me on list for public neurologist. Which was two years ago….. Oh well, as long as I don’t have to see him again. Fingers crossed next guy is better. I’m getting rather sick of seeing specialists tbh.

        Liked by 1 person

        1. I’m sorry. I would be pissed, too. I hate when doctors dx things and don’t even discuss it. God complex?? They do love to pile on the diagnoses. I hate seeing new doctors at all, I’ve had such rotten experiences. It’s awful you can’t get mast cell treatment there. Look into quercetin. It’s an over the counter supplement that works better at mediating mast cells than cromolyn in most parts of the body. It’s not well known, but my bet is you can have it shipped if you can’t find it at a local health food store or chemist. I’ve only been taking it a couple of months. Huge difference! Here are some of my thoughts and research on it, in case you want to know more. https://zebrapit.com/2018/06/27/quercetin-and-mcads/

          Liked by 1 person

    1. How does this apply to oral steroids given for mast cell? We keep them to a minimum anyway because of other potential side effects but am I making my joints worse when I have to take oral prednisone to calm down my immune system reactions?

      Liked by 1 person

      1. Hi Amber. I have been compiling research to write about steroid use and its effect on collagen, as I have some of the same questions. Having MCAS, there are times when I can’t avoid taking them. What I’ve found so far doesn’t make any form of steroid look very healthy. I’ll be writing this article in March if at all possible. My recommendation is always to rely on other anti-inflammatory options when available and save the steroids for emergency or last resort situations, but don’t beat yourself up about it when you have to do it. I’ll see if there’s any advice for detox post-steroid to be found, too. I suspect taking aloe during and after would go a long way, for example.

        Like

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