"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 injection. Even imagery-guided injections have a risk of severe nerve damage. Although the risk is very small or rare, it does exist.
One person’s heart stopped after having a cervical epidural steroid injection.4 Somehow the signals to the heart were scrambled after this injection, but luckily she was revived and will probably never have another epidural. Again, this rare, nearly fatal, complication from an epidural steroid injection did happen.
Because these rare complications do happen, everyone must treat the needles with respect and take every precaution necessary to prevent the problems. Ultrasound-guided or fluoroscopy-guided epidurals have become the standard of care to expect. Although, as already mentioned, that still does not make these procedures 100 percent safe.
Not many things are 100 percent safe in this world, and certainly not when needles are concerned. It concerns me the way people line up for these procedures so nonchalantly. Are people are being fully informed of the risks? Or are doctors just lining up the uninformed to cash in?
Having had three epidural myself, I can truly say that they did help temporarily. However, I cannot say that they were completely necessary for my prolonged recovery process from two herniated discs. Now that I know the real risks and real potential benefits, I’d probably think twice. At the time, I was not aware that the remote possibility of becoming paralyzed or worse even existed. If more people and doctors were fully aware of the worst that could happen, more would think twice before sticking a large needle into the back. Epidural steroid injections are not as safe as you or the rest of the world thinks.
- Pain Med. 2011 May;12(5):726-31
- Ann Phys Rehabil Med. 2010 Nov;53(9):575-83
- Pain Med. 2009 Nov;10(8):1389-94
- Pain Physician. 2012 Mar-Apr;15(2):147-52.