Are Spinal Injections Worth the Risk?

Back pain and neck pain are among the most common physical conditions requiring professional health care and affecting an individual’s ability to work and manage the daily activities of life. Annually, more than 60 million patients visit a physician with a complaint of back or neck pain.

Because of the enormity of these problems, there are numerous methods that attempt to reduce the symptoms of these patients. One method that has become popular is epidural steroid injections. About nine million Americans receive these procedures yearly.

This procedure involves injecting a medication into the epidural space, where irritated nerve roots are located. This injection includes both a long-lasting steroid and a local anesthetic. Theoretically, the steroid reduces the inflammation and irritation, and the anesthetic works to interrupt the pain-spasm cycle. But according to the research, these injections are neither safe nor effective.

Numerous studies published in major medical journals conclude that there is no evidence to support the use of injections for the treatment of low back pain and sciatica. In fact, epidural corticosteroid injections are not better than injections with placebo solutions long-term. Some studies have shown a small reduction in pain short-term, but this effect faded with time. Injections for neck pain are likewise not supported by current evidence. Injections for severe neck pain with arm pain yields short-term symptomatic improvement, but no long-term effects.

Numerous potential adverse reactions have been associated with epidural steroid injections. Although the vast majority are minor and transient in nature, serious complications, including nerve damage, permanent pain, paralysis, strokes and death, may also result. The 2012 outbreak of fungal meningitis that killed 36 people and sickened 510 highlighted the additional risk of infection from spinal injections.

The Mayo Clinic warns patients that repeated steroid injections can weaken spinal bones and nearby muscles and upset natural hormone balance, leading to potentially serious medical conditions. As might be expected, risks of side effects or serious adverse events increase with a greater frequency of steroid injections.

Overall, epidural steroid injections are not better than placebo long-term, and they carry a strong risk of serious side effects. Is the possibility of short-term pain relief worth the risk?

Dr. Hari Dass Khalsa is a chiropractor with offices located in the Hawthorne District. Call 503.238.1032 for more information.

Are Spinal Injections Worth the Risk?

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