When you’re experiencing excruciating back pain, it overtakes your entire life. Every waking moment you’re reminded by the pulsating pain that just doesn’t seem to go away. As a last resort, you turn to epidural steroid injections – but the pain gets worse.
But wait, aren’t steroid injections that your doctor enthusiastically recommended supposed to make the pain go away? Not necessarily.
Unfortunately, many people who experience intense back and neck pain are left with little to no other options. That is, if they turn to their medical doctors for help managing the pain. When it comes to back pain, medical doctors often recommend pain-killers like ibuprofen, or prescription-only NSAIDs like diclofenac (Voltaren), or celecoxib (Celebrex). If those don’t work, they’ll often recommend epidural steroid injections, which come with some terrifying risks.
What Are Epidural Steroid Injections
Epidural steroid injections are a treatment option commonly used for low back and leg pain. They have been used for low back problems since the early 1950’s, and are currently used for non-surgical management of sciatica and low back pain (1).
To help a patient relieve spinal pain, a doctor will inject the epidural space (between the spinal cord and bony structure of the spine) with steroids.
The injection usually consists of (2):
– Steroids or cortisone (anti-inflammatory agent)
– Lidocaine (fast-acting local anesthetic)
– Saline (dilutes local anesthetic)
Once the steroids are injected, the mixture is supposed to have an anti-inflammatory effect that can last anywhere from a few days to a few months (3).
Unfortunately, the epidural space is a very delicate part of the body, making the procedure extremely risky.
The Risks of Epidural Steroid Injections
In April 2014, the U.S. Food and Drug Administration (FDA) issued a drug safety communication entitled “FDA requires label changes to warn of rare but serious neurologic problems after epidural corticosteroid injections (ESI) for pain (4).” The FDA’s warning even stated that they could “result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death (5).”
The side effects of epidural steroid injections are so severe that the FDA ruled that all injectable steroid must carry an updated warning that includes the above risks, as well as “arachnoiditis, bowel/bladder dysfunction, headache, meningitis, paraparesis/paraplegia, seizure, [and] sensory disturbances (6).”
The FDA’s website also warns that “the effectiveness and safety of injection of corticosteroids into the epidural space of the spine have not been established, and FDA has not approved corticosteroids for this use (7).” This is largely due to the fact that research into the risks of epidural steroid injections is still being conducted. Approved or not, Dennis Capolongo of the ENDC, a ground that has campaigned against epidural steroid injections for years, believes that warning labels need to be stronger, and more visible – not just confined to the small print.
Australia and New Zealand updated their warnings in February 2018, such that steroid injections “MUST NOT be used by the intrathecal, epidural, intravenous or any other unspecified routes (8).” Unfortunately, this isn’t the case for corticosteroid injections in the USA, as doctors still use them for purposes that carry much too heavy of a risk.
In a forum on SPINE-health, one woman with pain in her lumbar spine described her first steroid injection as following:
“I don’t know what went wrong, as was told I’d feel a couple of bee stings, then maybe some pressure. I have a new scale for pain now, and on a scale of 1-10, it was 15. The most excruciating pain I’ve ever experienced. I passed out from it, and my blood pressure dropped to 78/52. They had to give me oxygen, smelling salts, wet towels, etc. They will NEVER do that to me again. Intensely painful and a nightmare.”
Another woman, Helen Bertelli, was diagnosed with arachnoiditis, an incurable condition that can be associated with epidural steroid injections. After her epidural steroid injections for back pain, she started feeling electric shocks, muscle cramps, and a sensation of water running down her legs (9). “I had this feeling I was connected to the end of a guitar string and someone was plucking it. My legs just exploded like there were fireworks in them. My muscles twitched like they were boiling.”
While this pain-relieving procedure may initially provide some relief, the scary symptoms and risks make it not so worth it.
What You Can Do Instead
While seeking medical aid from a doctor is important if your back pain came on suddenly, or if your back pain is so bad that day-to-day life becomes a constant struggle, managing back pain can be much simpler than you think. While it may require a little effort on your behalf, managing back pain doesn’t always have to be remedied with epidural steroid injections.
If you haven’t tried the following suggestions to help remediate your lower back or hip pain, I recommend giving them a try!
Stretch
This one might seem obvious, but I’m serious when I say stretch! Regular stretching helps protect your back by increasing flexibility and decreasing the risk of injury. A lot of people go for epidural injections for sciatica pain to release the sciatic nerve. However, more often than not, the sciatic nerve is being pinched by a tight piriformis muscle, which needs to be released. Check out my article on stretching the piriformis, and if your issue is more back-related, I have tons of articles on stretching out the muscles that trigger tightness in the back muscles.
Eat an Anti-Inflammatory Diet
Consuming an anti-inflammatory diet is crucial if you’re wanting to live pain-free. Many foods have been shown to reduce (or increase) inflammation, a known cause for back pain and inflamed nerves (which epidurals are designed to alleviate). So when you have back pain, changing your diet may help you avoid it.
Eating a mostly plant-based diet, which includes anti-inflammatory foods like chia seeds, broccoli, leafy greens, turmeric, watermelon, and the like, is a great option to help reduce body aches and pains. It is also important to reduce the consumption of foods that cause chronic inflammation in the body like wheat, refined sugar, trans fats, conventional meats, dairy and vegetable and seed oils.
Also, don’t forget to drink enough water! Drinking 3-4 liters a day will ensure you’re flushing out all the acidic waste deposits that contribute to body pain.
Essential Oils
Utilizing pain-relieving essential oils in your day-to-day regimen to alleviate different aches and pains is actually more effective than you might think. Studies have found that applying essential oils on the skin allow their natural components to absorb into the bloodstream (10). So while you may think that putting essential oils on the skin and area of pain is pointless, it actually really works (I can attest to this myself!).
One of my favorite pain-relieving essential oils is copaiba essential oil, which contains the cannabinoid beat-caryphyllene (BCP). It specifically targets CB2 receptors, which aid in the reduction of inflammation and pain.
Other pain-relieving essential oils include things like rosemary, frankincense, myrrh and spruce.
Prolotherapy
Prolotherapy is a natural, alternative therapy, also known as regenerative joint injection or non-surgical ligament and tendon reconstruction. Prolotherapy is a procedure whereby a natural irritant is injected into the soft tissue of an injured joint or spine, which then kick-starts the body’s healing response. Prolotherapy can be expensive, but the results, according to many, are very worth it.
I have had I jections before for my back pain and because it hurt so bad I never went back until now when all pain medication didn’t work so here I am back to the injections and I am just about to get my second one after the first one didn’t work so I am hoping to get some relief from it otherwise I have to look for another option. I just know I cannot go through my day with this sort of pain every day. I am also trying hemp oil so I hope and pray this will be my alternative to pain.
Also try anti-inflammatory herbs like turmeric and ginger! A product called the biomat has also been shown to help with pain, but they are a little pricey.
I have had many. Never without mild sedation, lasting only a few minutes but preventing me from feeling anything. Change doctors!
Francoise, I am nearly 75 years old and have had excruciating neck / shoulder pain since 2002. In Dec. of 2017 I had an epidural injection which too k my pain away for almost 3 months; the minimum time required before another injection. – I received a second one 3 months later and a third one in Aug of 2018 which has kept me pain free for 10 months with NO side effects. ( I have never used sedation ; I left the office and drove myself home ).
I got my 1st one and it didn’t work went back as soon as I could get another and it worked great. I have had 4 and it’s been wonderful for me. The 2nd one I got lasted 6 months 3rd one I had lasted 8 months.
Has anyone tried laser surgery, and did it work?
Thank you so much Carly for posting this important article. This is Dennis from the EDNC, you referenced me in your article. Its so vitally important for all to know the truth when it comes to this off-license treatment. No one is ever told that Epidural Steroid Injections are not approved by the FDA… and that because of their unproven Safety and Efficacy record ESI’s have not been approved by any Health Authority anywhere on the planet!… that back in 2014 an FDA advisory panel voted to have ESI’s contraindicated (banned) because of continuing reports of serious medical events… but the FDA said “no” anyway for unknown reasons. Did you also know that Pfizer had asked the FDA back in 2013 to ban their steroid Depo-Medrol for ESI’s at all levels of the spine due to serious adverse medical event reports and yet again the FDA said “no” again because of Market concerns? Please visit my YT Channel for more information: https://www.youtube.com/user/EndDepoNowCampaign or https://lnkd.in/e3cdrHy
Thanks Dennis for the comment! It is really sad that so many people are not told the negative effects this injection might have.
I just had laser surgery on my neck by a very skilled surgeon. Unfortunately I am worse. In regards to steroid injections I have had over 12 in my lower back and 4 in my neck. Absolutely no pain relief. Ever. I follow a mostly inflammation free diet and take 14 supplements including turmeric. PEA amino acid has helped somewhat with my pain. But I am still at an8 or 9 everyday all day. I also have fibromyalgia and lupus.
Sorry you’re experiencing this. Stick to the anti-inflammatory diet, and consider integrating yoga (hot yoga is even better, because of the heat aspect).
Lori, yes it is important to reduce as many inflammatory triggers as you can or they will eventually overwhelm your sensory nervous system becoming additive thus harder to differentiate and properly manage. I’m also saddened to learn of your plight through the endless maze of pain intervention specialists which can often lead to further damage and poorer outcomes. The fact that none of your Epidural Steroid Injections produced any relief should have alerted your doctors to terminate any further ESI treatments after the first 3 failed to produce any measurable efficacy. Yet they continued to inject you 13 more times despite all this. The practice is out of control and requires better regulation. Unnecessary multiple ESI’s will often produce severe compounding complications, such as nerve root scarring & encapsulation from the build-up of steroid injection residues and bleeds that in combination will force those nerves to endlessly trigger. These outcomes are often irreversible and are now frowned upon by competing specialists in the medical literature.
That’s just one reason why Epidural Steroid Injections (ESI’s) for back pain are not approved by the FDA. Their unproven Safety and Efficacy record is undeniable. In fact ESI’s are not approved by any Health Authority anywhere on the planet for the same reasons. Did you know that an independent FDA advisory panel back in 2014 voted 15 to 7 to have ESI’s banned especially at the C-level because of numerous serious medical event reports including stroke, brain infarct, cardiac arrest, inadvertent arterial administration leading to slow multiple organ failures, intrathecal placement of the steroid following a dura-puncture that often leads to an incurable condition known as Arachnoiditis, and even death? Did you also know that one year earlier in 2013 Pfizer had asked the FDA to ban their steroid Depo-Medrol (Methylprednisolone Acetate) for ESI’s at all levels of the spine and that the agency announced they observed NO safety improvements nor reduced risk from the use of X-Ray guidance (fluoroscopy)?
Although exercise is good when done under proper instruction, I would recommend a word of caution as repeated stress on scar tissue may further your painful condition. Find a physical therapist trained to work with spinal injury patients to help minimize tearing of the scar tissue.
Hello Dennis,
I was given a an epidural of steroids, but the second and third were by a different doctor with a different pharmaceutical. I was injected with dexamethasone sodium phosphate by Fresenius Kabi. I am having extreme adverse events and illnesses that doctors cannot find a diagnosis for. Can you tell me about this drug and rare or extreme effects?
Hi Amy, although considered safer than Depo-Medrol by pain practitioners (since it is a “soluble” steroid not a particulate suspension like Depo-Medrol), Decadron (Dexamethasone Sodium Phosphate) is also NOT FDA approved for ESI use anywhere on the planet due to reports of serious adverse medical events, including death. Here is a link to its DataSheet where many of the adverse side effects are listed. If it doesn’t work, you may need to sign up to JumpShare… its free. https://jmp.sh/hudKVVt
The risk is that the preparation wasn’t stored correctly, was mixed with unauthorized agents, was inadvertently injected into the wrong place, or the needle itself caused bleeding, scarring, thus nerve encapsulation, etc. If you ave any more questions, please feel free to either visit my YouTube Channel as it may answer your questions, (The EDNC) or you may wish to contact me directly at [email protected]
Remember, you are not alone
Kindest regards
Dennis
My doctor just sent me to a pain management doctor who wants to do an epidural. After reading eveyone’s notes, I have some trepadition. (Spelling?) If FDA does not approve of this operation, how can doctors use these shots for pain? Secondinly, I have copd and my doctor has stated that I wouldn’t live through a knocked out type operation. To wit, I wonder if I would live through an epidural. Anyone with advice? Thanks.
My name is Inger Starks, and you don’t know how long I have been waiting to hear the truth about ESI. In March 2009 I had this procedure done and I have never in my life experienced the most excruciating unbearable pain ever imagined. This has taken over my whole entire life and has stripped me of everything I owned, I lost everything due to this chronic pain I suffer with everyday. My family was affected terribly by this suffering I”m going through. I had every test you can think of to try and find out what is causing so much pain, every time the test read normal. Do you know how devastating it is to suffer this hard and not one medical professional can give me a diagnosis and tell me what this is that I’m suffering with. But I definitely got injured by the Epidural injection, and it burns like hot fire and does not let up. I have been on all kinds of pain medications, mostly narcotic pain medicine. When you are on narcotic pain medication , Doctors and all other medical related career individual’s treated me so bad like I was some kind of drug addict from the streets, because my MRI is not being read correctly or they just don’t know what the hell they are doing. When they know you need them to get a desperate relief from their pain medicine prescription, they dogged me something terrible, and talked to me with constant disrespect all because I was in a vunerable state, They have went as far as saying I will call the police on you for coming here so much, REALLY! and all I do is come here a beg you all to please help me to find out what is terribly painful going on inside my lower right side of my back and traveling down my buttock down my right thigh that feels like somebody’s pouring Acid all over that area. And I get a quick NO! we will not keep you and admit you in this hospital, they said go back to the neurologist I seen last. But I cant because he told me I could not come back to see him unless I get an Epidural steroid injection first. I refuse to ever let anyone do that procedure on me ever again. I can go on and on but all I wanted to know is what happened to me and for me to get a diagnosis so this can be treated and resolved. I want my life back. I want my happiness back.
It sounds like you have piriformis syndrome or some kind of sciatica. Have you tried any of the sciatica/piriformis stretches under the fitness section of my website?
Inger, you are not alone in your plight. Do you know the name of the steroid(s) used for your ESI’s? Do you know the dose, the level where it was injected and if it was mixed with any other medication(s) before being administered as a cocktail? This is important, how soon afterwards did your original symptoms (pain) get worse or new symptoms arose?