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Epidural steroid injection (ESI) has become a common procedure to treat a number of spinal issues that cause neck and back pain. Naturally, you might assume that means ESI is perfectly safe and approved for this application. Unfortunately, that’s not the case. Before getting an epidural for back pain, please read on.


Despite widespread belief to the contrary, the U.S. Food & Drug Administration has not approved this procedure – or any drug – for spinal injection as a treatment for neck or back pain. And that’s been the case for years. In 2014, the FDA published a safety announcement on its website that states, in part (emphasis ours):

  • “The U.S. Food and Drug Administration (FDA) is warning that injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death. The injections are given to treat neck and back pain, and radiating pain in the arms and legs. We are requiring the addition of a Warning to the drug labels of injectable corticosteroids to describe these risks. Patients should discuss the benefits and risks of epidural corticosteroid injections with their health care professionals, along with the benefits and risks associated with other possible treatments.

    Injectable corticosteroids are commonly used to reduce swelling or inflammation. Injecting corticosteroids into the epidural space of the spine has been a widespread practice for many decades; however, the effectiveness and safety of the drugs for this use have not been established, and FDA has not approved corticosteroids for such use. We started investigating this safety issue when we became aware of medical professionals’ concerns about epidural corticosteroid injections and the risk of serious neurologic adverse events.1 This concern prompted us to review cases in the FDA Adverse Event Reporting System (FAERS) database and in the medical literature (see Data Summary).2-16″

Based on these findings and others, the Journal of the American Medical Association (JAMA) has advised physicians against recommending injection therapy to patients dealing with chronic back pain.

It doesn’t mean you don’t have options. In Reno, Drs. McSweeney and Allen use a holistic, multi-technique approach to chiropractic care for consistent relief. Learn more about what to expect at your first visit, and schedule an appointment.