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Epidural Steroid Injections Under Scrutiny

FDA warns against rare but serious pain management complications.

Published: April 30, 2014

Pain management practitioners have been injecting corticosteroids into the epidural space of the spine for decades to reduce swelling and inflammation, but this practice has on occasion caused serious neurological complications, including vision loss, stroke, paralysis and even death, warns the Food and Drug Administration.

In a recent safety warning, the agency notes that the effectiveness and safety of treating neck and back pain through epidurally administered hydrocortisone, dexamethasone, methylprednisolone or other corticosteroids has not been established, and that it has not approved them for this use.

The FDA is requiring the drugs' labeling to include descriptions of these risks. The agency has convened panels of experts to recommend injection techniques that could prevent harm and to discuss whether further examination and action on the risks of epidural corticosteroid injection is necessary.

David Bernard

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