Ninety percent of us will suffer from low back pain at some point in our lives, according to statistics gathered by United Healthcare. And if you suffer from chronic pain, chances are you’ll be offered a procedure called an epidural steroid injection or “ESI.” It is also known as a “cortisone shot.” ESIs are placed in your spine like an epidural for childbirth, but use different drugs.
Epidural steroid injections have become the most common procedure doctors do for low back pain – done nearly 9 million times a year, according to an analysis of Medicare records by Dr. Laxmaiah Manchikanti. But here’s what most people are never told: ESIs are not FDA approved. And, yet, when Dr. Oz Show producers called more than 20 pain clinics, posing as patients, all but one insisted that epidural steroid injections are FDA approved. That’s wrong.
The steroids used in epidural steroid injections are FDA-approved for your muscles and joints, but the FDA has never approved the injections for spinal use. Doctors are allowed to use drugs for other purposes than those they were originally approved for -- this is called “off-label use” – but that means that use never underwent an official study to make sure it’s safe and effective. Even so, Medicare covers ESIs and insurance companies also pay for many of them.
Epidural steroid injections are promoted as a less invasive alternative to back surgery, but there are potential problems when doctors work so close to your spinal cord, even if they’re using needles instead of knives. It’s impossible to get a grip on the number of injuries and deaths due to ESIs because doctors are not required to report them. So the best hard evidence of catastrophic complications comes from isolated case reports rather than large-scale stats or studies.
Dennis Capolongo says he’s one of the injured. Capolongo was suffering from hip pain – not back pain – and says a doctor recommended an epidural steroid injection to treat it. He says that a 15- to 30-minute procedure turned into 3 days in the hospital, 3 years unable to walk without a cane or walker, and a lifetime of work as an anti-ESI activist. “It outrages me … how something like this… has become the standard of care,” he says.