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How Safe are Spinal Injections for Pain?

The type of spinal injections that are being blamed for the nationwide outbreak of fungal meningitis are meant to provide patients relief from pain for a couple of weeks or months. But the practice has been considered controversial since before the New England Compounding Center (NECC) in Framingham, Massachusetts, said it would recall more than 17,600 vials of such steroid shots because they might be contaminated with fungus.

An epidural steroid injection, a shot, delivers powerful anti-inflammatory medicine directly into the space outside of the sac of fluid around your spinal cord, says the MedlinePlus website, which is administered by the U.S. National Library of Medicine and the National Institutes of Health.

Epidural steroid injections provided for pain are not the same as epidural anesthesia given prior to childbirth.

An epidural spinal injection is normally administered for pain that spreads from the lower spine to the hips or down the leg (radicular low back pain). This kind of pain is caused by pressure on a nerve as it leaves the spine, most often due to a bulging disc. These types of injections are rarely used unless medicines, physical therapy and other nonsurgical treatments have not helped the patient, according to MedlinePlus.

Dr. Laxmaiah Manchikanti, who is chairman of the American Society of Interventional Pain Physicians and who operates pain-management clinics in Marion, Illinois, and Paducah, Kentucky, told USA Today that about 8.9 million such spinal injections were given in 2010.

The number of Medicare patients receiving such injections grew by 159 percent between 2000 and 2010, according to Manchikanti.

USA Today found several people who think epidural steroid pain injections “are far too dangerous and should be limited or even banned.”

“But those who give the injections say they are safe when done properly and note the current outbreak appears to have originated from the medicine, not the procedure itself,” the newspaper said.

One detractor is Terri Lewis, a psychological rehabilitation specialist from Cookeville, Tennessee.

Tennessee has seen the highest number of cases (59) and deaths (six) among 231 fungal meningitis cases plus two peripheral joint infections (e.g., knee, hip, shoulder, elbow) that the Centers for Disease Control and Prevention says have caused at least 15 deaths in 15 states.

Lewis told USA Today that epidural steroid shots unrelated to the meningitis outbreak injured her 29-year-old son. She says the shots caused him to develop arachnoiditis, an incurable condition in which scar tissue slowly builds in the spinal column, compressing nerves that lead to debilitating pain and, ultimately, death.

She said more people like her son are being hurt as the number of injections grows.

Matthew Clark, of Rogersville, Tenn., received several epidural steroid injections when he lived in Michigan. He now has arachnoiditis, which he blames on the shots.

Dr. Ray Baker of Kirkland, Washington, president of the International Spine Intervention Society, told the newspaper that serious complications occur in only one of every 100,000 epidural injections. “We’re not talking about a very risky procedure,” he said. “We’re talking about a very safe procedure that has been performed for a very long time.”

MedlinePlus says epidural injections are generally safe, but receiving them too often may weaken the bones of the patient’s spine or nearby muscles. Receiving higher doses of the steroids in the injections may also cause these problems. As a result, most doctors limit patients to two or three injections per year.

Possible complications of a single spinal injection may include:

  • Dizziness, headache, or feeling sick to the stomach
  • Nerve root damage with increase pain down the leg
  • Infection in or around the spine (meningitis or abscess)
  • Allergic reaction to the medicine used
  • Bleeding around the spinal column (hematoma).

Contact a Salvi, Schostok & Pritchard P.C., Drug Injury Lawyer

The drug injury attorneys of Salvi, Schostok & Pritchard P.C., in Chicago assist residents of Illinois and elsewhere in the Midwest who have been harmed by faulty drugs and dangerous medical products or procedures. Contact us at 877-568-5419 toll free, or through our online contact form, for a free, no-obligation legal consultation if you have been harmed by an epidural injection or any medical product or procedure.

Patrick A. Salvi

Patrick A. Salvi concentrates his legal practice in several limited areas primarily involving a trial practice in cases concerning serious personal injury, medical malpractice, wrongful death, and mass torts. Mr. Salvi has achieved record-breaking jury verdicts and settlements on behalf of his clients, including serving as lead counsel in obtaining an Illinois record-high $148 million jury verdict and a Lake County record $33 million jury verdict.

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