On April 23, 2014 the U.S. Food and Drug Administration issued a Safety Alert warning that injection of corticosteroids into the epidural space of the spine may result in rare but serious neurologic problems, further, it also states that they are not effective.
While the FDA is justified in issuing such warnings, this specific warning is based on inappropriate interpretation of data. Almost all the complications have occurred in the patients undergoing transforaminal epidural injections and majority in the cervical spine (neck). There are 2 types of epidural injections; one is known as interlaminar, or caudal, which enters the epidural space directly; whereas transforaminal epidural injections are placed over the nerve root close to the ganglion. A radicular artery accompanies the nerve and injections may be placed into the radicular artery or radicular artery may go into spasm with an injury to the artery. In either case, all the complications are limited to these injections and the infection issues are related to New England pharmacy and others. Majority of these issues are related to poor training and improper techniques utilized; however, FDA does not discriminate these and they have dumped all epidural injections into one category.
Continue reading here: FACT SHEET ON FDA WARNING ON CORTICOSTEROID INJECTIONS