New Recommendations Aim to Improve Safety of Pain-Relieving Spinal Steroid Injections

Steroid injections for back and neck pain, which deliver medications mimicking the effects of cortisone and hydrocortisone, can bring relief but also carry risks. In 2011, about 2.3 million such injections were administered among people covered by Medicare. While they can provide profound relief, there are potential risks, including partial or total paralysis, brain damage, stroke, and even death. Although these severe complications are rare, a recent Viewpoint article in The Journal of the American Medical Association highlights safety recommendations to minimize these risks. It’s important for individuals considering such injections to be aware of potential complications and discuss them with their healthcare providers.

The thin margin

Steroid injections in the spine pose a particular risk due to their proximity to the spinal cord and brain, making precision crucial. The margin for error is small, and there is potential for severe complications, including paralysis, brain damage, stroke, and even death. When considering steroid injections for joint pain, the primary safety concern is infection. Steroids are potent anti-inflammatory drugs, and repeated injections may cause soft tissue and cartilage to break down and shrink. To mitigate risks, the general recommendation is to limit the number of injections to three or four per year per site treated.

Safety roadmap for spinal injections

Steroid injections in the spine pose a particular risk due to their proximity to the spinal cord and brain, making precision crucial. The margin for error is small, and there is potential for severe complications, including paralysis, brain damage, stroke, and even death. When considering steroid injections for joint pain, the primary safety concern is infection. Steroids are potent anti-inflammatory drugs, and repeated injections may cause soft tissue and cartilage to break down and shrink. To mitigate risks, the general recommendation is to limit the number of injections to three or four per year per site treated.

Be informed and inquisitive

Dr. James P. Rathmell encourages patients to be informed and ask questions about potentially harmful procedures, including spinal steroid injections. While the risk of serious harm from these injections is low, it’s crucial to address legitimate concerns and provide reassurance. Dr. Rathmell emphasizes the importance of open communication and welcomes questions from patients, allowing them to make informed decisions about their medical care.