Epidural Steroid Injections

Spinal Corticosteroids Run Risk of Severe Neuro Effects

Robert Lowes April 23, 2014 Epidural injections of corticosteroids to relieve pain — a widespread, off-label use — run the rare risk for blindness, stroke, paralysis, and death, the US Food and Drug Administration (FDA) announced today. The FDA is requiring manufacturers of corticosteroids to revise drug labels to include this warning. In today’s announcement, […]

How Important Is Evidence-Based Medicine in Epidural Injection for Low Back Pain?

New study sheds light on day-to-day practice versus guidelines, with variations in practice related to indications, the duration of conservative treatment before initiating injections, and the time between injections. By Girish P Joshi, MBBS, MD There are several evidence-based (EB) guidelines that address the use of epidural injections for the treatment of low back pain. […]

Tainted Steroid Shots Led to Varying Ailments

Published: Oct 23, 2013 | Updated: Oct 23, 2013 By Michael Smith, North American Correspondent, MedPage Today Full Story:  http://www.medpagetoday.com/Neurology/GeneralNeurology/42449 Patients made sick by contaminated steroid injections had a “broad spectrum of disease,” ranging from stroke to abscess, researchers reported. The pattern of disease varied over time, with meningitis dominating early in the outbreak and […]

Epidural steroids for spinal pain and radiculopathy

Epidural steroids for spinal pain and radiculopathy A narrative, evidence-based review. Wilkinson I, et al. Curr Opin Anaesthesiol. 2013 Jun 19. [Epub ahead of print] Affiliation aWomack Army Medical Center, Fort Bragg, North Carolina bDepartment of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore cUniformed Services University of the Health Sciences, Bethesda, […]

Spine Treatments Little Help in Fibromyalgia

Published: Sep 16, 2013 | Updated: Sep 16, 2013 By Nancy Walsh, Staff Writer, MedPage Today Full Story:  http://www.medpagetoday.com/PainManagement/Fibromyalgia/41626 Action Points Individuals seeking care for back pain whose symptom pattern was typical of fibromyalgia derived little benefit from minimally invasive spine therapies such as epidural steroid injections. Note that on univariate analysis, patients who met […]

Strokes Tied to Tainted Steroid Injections

by Chris Kaiser Cardiology Editor, MedPage Today Action Points   Note that this small case-series documented ischemic stroke in three patients who had recently received a contaminated steroid injection. Of particular concern, two out of the three cases did not present with classic meningeal signs or fever. There should be a “high index of suspicion […]

Epidural steroid injection therapy for low back pain: a meta-analysis

Authors Choi HJ1, Hahn S, Kim CH, Jang BH, Park S, Lee SM, Park JY, Chung CK, Park BJ. Journal Int J Technol Assess Health Care. 2013 Jul;29(3):244-53. doi: 10.1017/S0266462313000342. Epub 2013 Jun 17. Affiliation Abstract OBJECTIVES: The aim of this study was to systematically assess the long-term (≥ 6 months) benefits of epidural steroid […]

Spine Injections May Set Stage for Fractures

Published: Jun 7, 2013 | Updated: Jun 10, 2013 By Elizabeth DeVita Raeburn , Contributing Writer, MedPage Today Download Complementary Copy of Article Action Points Lumbar epidural steroid injections are often prescribed for the treatment of radiculopathy or neurogenic claudication arising from compression of spinal nerves. In this retrospective cohort study, an increasing number of […]

Spinal manipulation vs image guided lumbar nerve root injections for lumbar disc herniation

J Manipulative Physiol Ther. 2013 May;36(4):218-25. doi: 10.1016/j.jmpt.2013.04.005. Epub 2013 May 22. Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections. Peterson CK, Leemann S, Lechmann M, Pfirrmann CW, Hodler […]

Spinal Manipulation as Effective as Epidural Injections for Lumbar Disc Herniation

Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections. Peterson CK, Leemann S, Lechmann M, Pfirrmann CW, Hodler J, Humphreys BK. J Manipulative Physiol Ther. 2013 May;36(4):218-25. doi: 10.1016/j.jmpt.2013.04.005. Epub […]

Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections

J Manipulative Physiol Ther. 2013 May;36(4):218-25. doi: 10.1016/j.jmpt.2013.04.005. Epub 2013 May 22. Peterson CK1, Leemann S, Lechmann M, Pfirrmann CW, Hodler J, Humphreys BK. Abstract OBJECTIVES: The purpose of this study was to compare self-reported pain and “improvement” of patients with symptomatic, magnetic resonance imaging-confirmed, lumbar disk herniations treated with either high-velocity, low-amplitude spinal manipulative […]

Epidural corticosteroid injections in the management of sciatica: a systematic review and meta-analysis

Ann Intern Med. 2012 Dec 18;157(12):865-77. Pinto RZ1, Maher CG, Ferreira ML, Hancock M, Oliveira VC, McLachlan AJ, Koes B, Ferreira PH. Abstract BACKGROUND: Existing guidelines and systematic reviews provide inconsistent recommendations on epidural corticosteroid injections for sciatica. Key limitations of existing reviews are the inclusion of trials with active controls of unknown efficacy and […]

Effect of epidural steroid injection on bone mineral density and markers of bone turnover in postmenopausal women

Al-Shoha A, et al. Spine (Phila Pa 1976). 2012. Show full citation Abstract STUDY DESIGN: A prospective, observational study. OBJECTIVE: To evaluate the effect of epidural steroid injection (ESI) on bone mineral density (BMD) in postmenopausal women. SUMMARY OF BACKGROUND DATA: ESIs are used to treat the pain associated with radiculopathy. Although it is known that exogenous steroid […]

Effect of epidural steroid injection on bone mineral density and markers of bone turnover in postmenopausal women

Al-Shoha A, et al. Spine (Phila Pa 1976). 2012 Dec 1;37(25):E1567-71. doi: 10.1097/BRS.0b013e318270280e. Abstract STUDY DESIGN: A prospective, observational study. OBJECTIVE: To evaluate the effect of epidural steroid injection (ESI) on bone mineral density (BMD) in postmenopausal women. SUMMARY OF BACKGROUND DATA: ESIs are used to treat the pain associated with radiculopathy. Although it is […]

Cardiopulmonary Arrest Following Cervical Epidural Injection

Cardiopulmonary Arrest Following Cervical Epidural Injection Case Report Bradley Stauber, BS, Lin Ma, MD, and Reza Nazari, MD Pain Physician March/April 2012 – Vol 15 Issue 2 Epidural steroid injection is a common treatment for the management of pain in a wide variety of patients. It is generally well tolerated and perceived to have few […]

Epidural Injections for Lumbar Discs

The Study: A randomized, controlled, double-blind trial of fluoroscopic caudal epidural injections in the treatment of lumbar disc herniation and radiculitis The Facts: a. The authors evaluated the effectiveness of the procedure of fluoroscopically directed caudal epidural injections for chronic low back/lower extremity pain. This was done for patients who suffered from disc herniation and […]