The FDA recently issued a safety warning about serious adverse effects associated with spinal injections of corticosteroids. Injectable corticosteroids are drugs that are often used to reduce swelling or inflammation. These include methylprednisolone, hydrocortisone, triamcinolone, betamethasone, and dexamethasone. Spinal injections of corticosteroids have been widely practiced for years to treat neck and back pain, as well as radiating pain in the arms and legs. However, such use is not approved by the FDA.

FDA’s investigation was prompted by “medical professionals’ concerns about epidural corticosteroid injections and the risk of serious neurologic adverse events.” Though rare, such injections could result in serious harm, “including loss of vision, stroke, paralysis, and death.” FDA’s risk assessment is based on a review of its own Adverse Event Reporting System, as well as cases described in the medical literature.

The FDA is advising patients to seek immediate medical treatment in case they experience “any unusual symptoms after receiving an epidural corticosteroid injection…” It further requires that vendors of injectable corticosteroids add a warning to the drug labels describing the risks of serious neurologic problems.