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 corticosteriods for Epidural Spinal Injections 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 dire of circumstances or not at all. 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, though the statement doesn’t explain if these injuries and deaths usually occur due to the procedure, the substance itself, or perhaps both. 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.
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 doctor’s offices and clinics where we have these procedures.
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