FDA Cracks Down on Epidural Corticosteroids

By Editorial Staff

Just after publishing Dr. Deborah Pate's review of epidural corticosteroid injections for sciatica (April 22 newsletter – "Steroids for Sciatica: More Trouble Than They're Worth), which concluded, based on the available evidence, that epidural steroid injections "have little clinical benefit (short or long term), and are associated with significant risks ... cause deterioration of bone quality, elevating the risk of spinal fracture ... and have increased dramatically [in terms of use] despite lack of evidence to justify the procedure," the Food & Drug Administration has issued a warning regarding their use that specifies even more severe potential consequences. According to the FDA in its April 23, 2014 announcement:

"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. The effectiveness and safety of epidural administration of corticosteroids have not been established, and FDA has not approved corticosteroids for this use."

The FDA is requiring that drug labels of injectable corticosteroids carry a warning detailing these potential risks, and recommends that patients "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."

The administration also announced plans to convene a meeting of "external experts" later this year to discuss the benefits vs. risks of epidural corticosteroid injections. The advisory committee meeting could lead to further FDA actions.

In the meantime, talk to your doctor of chiropractic about if you're experiencing back pain, neck pain or any other condition commonly addressed by a DC with conservative, drug-free care.