Epidural Spinal Injection

Treatment for back pain using epidural shot

Benefits and potential side effects

There is no question that a large number of problems that people can experience due to back pain can be extremely difficult to deal with. This is the reason why so many people will experiment with as many alternatives as they can before they decide to get any kind of surgical procedure done.

In this article, we are going to be talking about the epidural shot and this option has become popular because of the relief it can provide, but we are going to be talking about the issues involved, the numerous risks and the possible side effects related to it. Unfortunately, there is too much to risk for a fix that is not going to last very long.

Pain relief for a few WEEKS

The truth is that the epidural shot is not a long term solution and all it will do is get rid of the pain for a while, but this is ideal for people who need comfort while they decide on a more permanent solution. The procedure itself takes a few minutes, but it’s risky in itself because you are using a needle on a very delicate area of the body and the pain is actually more likely to get worse during the first two days after you get the shot instead of being better, but then after 2 or 3 days the pain should be at a much lower level of intensity and for some people it could be nearly gone.

The risks

We already mentioned a very common risk that might be making some people have second thoughts about these shots, but the truth is that any kind of invasive procedure in that area is going to produce a series of risks that doctors cannot control even if they are extremely careful.

There is a chance that there will be nerve damage and this is going to make the problem ever worse than it was before the epidural was given to you. This is not a common issue, but it has happened to a number of people who have decided to use this treatment. There is also the chance that bleeding might occur, but these cases are usually only seen in people who already experienced bleeding issues before.

There is also a complication that is known as a Dural puncture and this is also very rare but if it happens, it can cause backache or a very peculiar headache that is caused entirely by the procedure and it is known as a spinal headache. This will usually go away on its own after a few days. However in a study published by MacArthur C, Lewis M, Knox EG BMJ 1993 Apr 3;306(6882):883-5 Accidental dural puncture in obstetric patients and had long term symptoms. In this study MacArthur talks of long-term headache following dural puncture and found that of 74 women who had suffered an accidental dural puncture during epidural anaesthetic, 10 had persistent headache after several years. In yet another study by Vartis A, Collier CB, Gatt SP Anaesth Intensive care 1998 Jun;26(3):256-61 talks about potential intrathecal leakage of solutions injected into the epidural space following combined spinal epidural anaesthesia

As can be seen there are quite a few side effects that can occur with the epidural shot, but some are more frequent than others. In some cases, the side effects can be quite severe, but most of them are mild to moderate.

Increased pain instead of relief

Sleeplessness and anxiety

Stomach ulcers

High blood sugar

Fever a few hours after the shot is given

Headaches and a flushed face

There are many people who have reported at least one of these side effects after taking the epidural shot, but there are also people who report no issues at all.

The biggest problem with the epidural injection

The truth is that this shot can help relieve pain, but the biggest problem that it has is that it will only provide relief for a few days and maybe for a couple of weeks or even months if you are lucky. Most people only experience a few days of substantial relief, while some people say there is hardly any pain relief at all.

Most people who choose this shot are unaware of very powerful options that are not going to require any kind of invasive procedure.

Conclusion

The epidural shot is a good way to ease the severe back pain that some people can experience, but it carries many uncertainties with it and this is more than enough to make some people think twice about getting this kind of treatment done.

It’s always important to talk to your doctor and explore many non-invasive options as you can before you decide to get an epidural or consider surgery.

There have been numerous articles written about relieving pain by injecting steroids into the epidural space that mention the FDA warning about Epidurals. One of the articles that follows was posted on August 24, 2014 in Pain Medication :

Patients who suffered spinal cord injuries during epidural steroid injections are cheering a decision by the Food and Drug Administration to require drug makers to put warning labels on injectable corticosteroids.

Injecting steroids into the epidural space of the spine to relieve pain caused by childbirth or back problems has been a widespread practice for decades. Less commonly known is the damage it can cause to the spine if the needle is inserted in the wrong place.

“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 FDA said in a statement. “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.”

Epidural steroid injections are increasingly being used to treat back pain of all kinds, with nearly 9 million spinal injections annually in the U.S.

The FDA said it began investigating the safety of epidural steroid injections “when we became aware of medical professionals’ concerns” and after reviewing its own adverse event database.

Patients injured by the procedure have been warning the agency for years about the “dark side” of epidurals.

“I am relieved and hopeful that things are on the right track, but there is still much more that needs to be done to stop these ineffective, harmful pain treatments from maiming and crippling people and ruining their lives,” said Dawn Gonzalez, whose spine was permanently damaged by an epidural during child birth. She now suffers from arachnoiditis and is an advocate for Arachnoiditis Society for Awareness and Prevention (ASAP).

“They need to do something to warn specifically about arachnoiditis, and do something to help those of us that have already been damaged by these procedures. They will find that these instances are not in fact rare like they say, but are in epidemic proportions relative to the number of these injections that have been given over the last 10 or so years.”

Arachnoiditis is an inflammation in the arachnoid membrane that surrounds the spinal cord. If the membrane is punctured by a needle during an epidural, it can trigger inflammation that produces scar tissue that adheres to the nerves in the spinal cord. Eventually the nerves become completely encased in scar tissue, causing severe chronic pain and other neurological problems.

Some in the arachnoiditis community wish the FDA would go further with its warning.

“We are upset that there is no mention of the risk of arachnoiditis,” said Terri Anderson, who developed arachnoiditis after receiving about 20 epidural steroid injections for a ruptured disc in her back.

Anderson has been lobbying the FDA to require warning labels for corticosteroids such as Pfizer’s Depo Medrol (Methylprednisolone).

“This drug is now banned for epidural use in Australia and New Zealand. It is time for the FDA to protect public health and make these same label changes in the U.S. The risk of serious adverse events is not rare and Arachnoiditis is grossly misdiagnosed and under-reported to the FDA for obvious reasons (fear of reprisal and legal liability),” Anderson said in an email to National Pain Report.

In addition to Arachnoiditis, several recent studies have found that epidural steroid injections raise the risk of spinal fractures and often do little to control back pain.

To raise awareness of the safety risks of epidurals, the FDA has convened a panel of experts to help define techniques for the injections which would reduce preventable harm. An advisory committee will also be formed later this year to discuss the benefits and risks of epidural injections, and whether further FDA action is needed.

Injectable corticosteroids include methylprednisolone, hydrocortisone, triamcinolone, betamethasone, and dexamethasone. The safety issue is unrelated to the contamination of compounded corticosteroids in 2012 that led to an outbreak of fungal meningitis that killed dozens of patients and sickened hundreds. Most received the injections to treat their back pain.