Migraine and Epidural Steroid Injection - New FDA Warning

Patient Expert

Migraine patients often find ourselves living with ** _ comorbid_** conditions similar to those of other Migraineurs we meet. This can cause curiosity and confusion when some of these common comorbidities can look like Migraines or be triggers for our Migraines and other headache disorders. Treating these comorbidities won't necessarily make our Migraine attacks disappear, but they can often help us manage our Migraines by ruling out other conditions, maximizing our health. and minimizing our triggers.

Neck pain is a frequent symptom of Migraine, but spinal injury and other problems can also result in neck and back pain that can be a frequent but treatable trigger and comorbidity. _Cervicogenic headache _ is pain that originates in the neck and is felt in the head, and is often treatable as well. Cervicogenic headaches can also trigger Migraines.

One treatment many Migraine and headache patients try, is an epidural steroid injection. This treatment involves the injection of steroids, often with a numbing agent. This is placed into the epidural space between the spinal cord and the bones of the spine. The injection causes numbness to specific parts of the body. The numb feeling lasts only a relatively short time. The addition of steroids causes a longer lasting effect by helping to decrease inflammation over time. If there is inflammation causing pain and continued disability, the injection may be helpful for periods of time ranging from hours to years.

While these injections can often be quite effective, they are also treatments that should be carefully investigated before jumping into them.  The FDA has issued a new warning regarding rare but serious potential neurological problems that can result from these injections. This is a waning that anyone considering this treatment needs to know about,

**The FDA states:  **

  • Rare but serious problems have occurred after injection of corticosteroids into the epidural space of the spine to treat neck and back pain, and radiating pain in the arms and legs.
  • These serious problems include loss of vision, stroke, paralysis, and death.
  • The effectiveness and safety of injection of corticosteroids into the epidural space of the spine have not been established, and FDA has not approved corticosteroids for this use.
  • Discuss the benefits and risks of epidural corticosteroid injections with your health care professional, along with the benefits and risks associated with other possible treatments.
  • Seek emergency medical attention immediately if you experience any unusual symptoms after receiving an epidural corticosteroid injection, such as loss of vision or vision changes; tingling in your arms or legs; sudden weakness or numbness of your face, arm, or leg on one or both sides of the body; dizziness; severe headache; or seizures.
  • Report any side effects from epidural corticosteroid injections to the FDA MedWatch program, using the information in the "Contact FDA" box at the bottom of _this page _."

Unfortunately, I'm one of the many Migraine patients who struggle with the need for these injections. I have many online Migraine pals who have also struggled and continue to try to make themselves better by utilizing these tools. Personally, I'm glad I have this option and have had only good experiences from the treatment, but it is a serious consideration all should talk to their doctors about so they can make an informed, smart decision for their particular situation.


Safety Announcement. "FDA requires label changes to warn of rare but serious neurologic problems after epidural corticosteroid injections for pain." Rockville, Maryland. Food and Drug Administration. April 23, 2014.


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