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Most people who experience “sciatica” are really experiencing the shooting, searing sensation of neurogenic pain (pain coming from a nerve) as discussed in the previous article, “Sciatica: What is it?” As mentioned, nerve pain can affect both the arms and legs depending on whether the pinched nerve is in the neck or low back. When a nerve is pinched by a herniated disc, the nerve becomes inflamed. Thus, the most potent anti-inflammatory medications, steroids, are used to control the inflammation around the nerve and stop the nerve pain. These steroids are placed next to the nerve by a procedure called an epidural steroid injection (ESI). For the past 50 years, millions of dollars have been spent on epidurals despite the fact that these injections do not cure the problem. ESI’s only temporarily provide symptom relief for nerve pain. Sally, a young woman who has just herniated a disc, still has burning pain that goes all the way down her leg. Relentlessly, ...
“Doc, I just want one of those epidurals to get rid of the pain.”
Really, you want a large needle stuck into your spine? Do you know what could happen to you if you have an epidural spinal injection? Usually, nothing bad happens at all. The complication rates are very low . 1 At the most, you might get some flushing , increased pain or persistent numbness. If you are a diabetic, you might experience a spike in your blood sugar levels temporarily . None of those complications are really a big deal; so the epidurals seem worth the risk to most people. But most people don’t know that rare serious and potentially fatal complications from these “safe” procedures have been reported.
A few people have become paralyzed as a result of having an epidural injection. 2, 3 This complication is thought to be caused by a disruption in the blood supply to the spinal cord. A spinal cord injury is a most unfortunate and unforeseen risk from an epidural steroid inj...
On October 5, I reported a recall of three lots of methylprednisolone acetate manufactured by the New England Compounding Center that could impact Migraine treatment. (See Methylprednisolone Recall Could Impact Migraine Treatment .) Methylprednisolone is sometimes used in nerve block injections for Migraine, so we all needed to be aware of the recall if we were considering this treatment.
Today, the FDA has issued an additional statement through their Medwatch program. To be sure you have all the available information, here's information about that statement:
FDA Statement on Fungal Meningitis Outbreak: Additional Patient Notification Advised
AUDIENCE : Pharmacists, Risk Managers, Pain Medicine
ISSUE : As a result of the ongoing investigation of New England Compounding Center (NECC), a patient with possible meningitis potentially associated with epidural injection of an additional NECC product, triamcinolone acetonide, has been identified through active surveillan...
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