What are the risks and dangers of epidural steroid injection in the back?

Pain, numbness: Esis are often done in the lumbar & cervical spine, often under fluoroscopy (live x-ray), bathing this joint with an anesthetic (lidocaine, etc.) and steroid/cortisone. Common side effects include pain (during and for the first 48 hours), numbness (often temporary) and bleeding (usually minimal). Rare & serious side effects include infection, nerve injury and spinal fluid leak.

Minor: Until recently where there have been several deaths and long-term hospitalization because of faulty pharmacy preparation of the steroid drug used. Most commone risk would be a headache (from the needle) or some water retention and maybe a change in mood from the drug effects. There was always a chance of infection but that was always small. Using an uncertified compound pharmacy-big mistake.

Generally safe: These are generally extremely safe. All of the risks are very rare and are as follows: infection, bleeding, allergic reaction(less than 1 in 80, 000), spinal cord injury or permanent severe nerve damage (less than 1 in 2 million). The most common risk is failure to improve pain and spinal headache (less than 1 in 200).

Like Any Other Inj: The worse part of an epidural injection is typically the local anesthetic administered to numb the skin. After that the needle typically feels like pressure. However as the needle enters the spinal canal or around the nerve root there can be some pain that is transient. Complications can be bleeding, infection, nerve damage and paralysis, but these are extremely rare.

The FDA: recently required a warning on injectable steroids that epidural injection can rarely cause adverse events, including loss of vision, stroke, paralysis, and death. Epidurals can be an easy procedure but have a long learning curve to be consistently good at them and know exactly where the needle tip is and how to get it there without x-ray.

Minimal: An accidental dural puncture Localized increase in pain. Non-positional headaches resolving within 24 hours. Facial flushing. Anxiety. Sleeplessness. Fever the night of injection. High blood sugar. A transient decrease in immunity because of the suppressive effect of the steroid.