Epidural Steroid Injection Risks May Outweigh Benefits: Study

A new study suggests that epidural steroid injections do little to alleviate the back pain they are supposed to address, raising questions about the widespread use of the pain management treatment. 

Researchers from the Rothman Institute in Philadelphia published a study last month in the medical journal Spine, which looked at the effectiveness of epidural steroid injections and found that patients who were given the shots to manage pain from a pinched nerve actually showed less improvement than those who did not get the shot.

The researchers looked at 276 patients who suffered from a pinched spinal nerve, also known as a lumbar stenosis. They found that over four years there was less improvement in physical function and reduction of pain, and 58% of those who received epidural steroid injections later opted for surgical treatment. In addition, those who received the injections stayed nearly a day longer in the hospital on average than those who did not get the shots.

In their conclusion, the researchers theorize that the additional volume added to the body by the fluid in the injection may actually exacerbate the pinched nerve and cause more pain after the short-term pain relieve is gone. The shots may also cause long-term damage to the nerve roots. Researchers called for further investigations into the biological effects of epidural steroid injections.

The study comes on the heels of a nationwide fungal meningitis outbreak that was linked to epidural steroid injections, which were distributed by a now-defunct Massachusetts compounding pharmacy, the New England Compounding Center. The injections were used at hospitals and pain management centers nationwide for back pain treatments, but many were contaminated with fungus, resulting in an outbreak that sickened about 700 people across the country and led to 48 deaths.

NECC faces a growing number of fungal meningitis lawsuits following the outbreak, and declared bankruptcy late last year under the weight of the oncoming litigation. The owners may also face state and federal criminal charges. The outbreak has also led to increased crackdowns on compounding pharmacies by state and federal agencies nationwide.