Patients receiving epidural injections of corticosteroids for neck, back, or limb pain are at risk of rare but serious adverse events, including blindness, stroke, paralysis, and death, according to a US Food and Drug Administration (FDA) warning.
Epidural injections of corticosteroids are a common treatment offered to patients who experience back pain, neck pain, or pain that radiates to the arms and legs. However, such injections are not FDA approved, and there is limited evidence backing their safety or effectiveness, according to the agency. A review of data from the FDA Adverse Event Reporting System found cases of death, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, stroke, seizures, nerve injury, and brain swelling in patients who had received epidural steroid injections. These events occurred within minutes to 2 days after injection. According to the FDA, many of the patients did not recover from these injuries.
Kuehn BM. FDA Warns of Risks Related to Epidural Injections. JAMA. 2014;311(20):2057. doi:10.1001/jama.2014.5759