Epidural steroids: are they really all bad?

By Dr. Mariam Ghobriel

For the last few weeks, the nation and the medical community have been shocked by the reports of a meningitis outbreak resulting from contaminated steroids administered in epidural injections.This has been linked to a compounding pharmaceutical lab and an investigation is under way and everyone is in a state of anger as to why this happened and if it could have been prevented. I have to say that our initial reaction was to make sure that we were not involved in this and that our patients were safe.We have luckily confirmed that none of our supplies came from the affected facility and we have not had any cases reported in this area.

So what do we make of all this? We hear a lot of questions from patients and there is a lot of anxiety over all of this. How safe are these treatments really and how much do we need them?

Epidural injections are great modalities that are used everyday in the United States and around the world for the management of neck and back pain. When used appropriately, they can be in a lot of cases a good alternative to surgery or medications.They have been used effectively for decades.The benefits of these procedures in terms of improvement of quality of life have far outweighed the potential risks.These are usually minimally invasive injections that take about 10 minutes to perform under little or no anesthesia.These types of interventions as well as many others have made the difference for thousands of patients, between continuing to function and disability and incapacitation. I know personally so many of my patients who can’t imagine what their lives would be without these treatments that literally keep them going and continuing to do the things that make them happy. I hear stories everyday of how these treatments have helped someone who was bed ridden to get up and walk.“I was able to play with my kids again;”“I was able to dance at my sons wedding;”“I can really work and not lose my job and I thought I was going to have to go on disability.”These are someone of the things I hear every day from happy patients with good results.

The truth is that also not all pain injections involve steroids.There are a lot of techniques that could be offered for different conditions. However, such incidents of contamination are exceedingly rare.Thousands of patients still continue to receive epidural steroid injections everyday even after this unfortunate incident and with great success and great safety.The procedure itself is extremely safe when done appropriately. Patients continue to seek it as treatment when appropriate and they can appreciate the difference it makes in their daily activities and life style. This incident will shed a lot of light on medication shortages are handled and the standards that drug manufacturing and distributing facilities are held to.

It is every physician’s goal to help their patients and to hear them say, “Thank you doc, this really helped a lot. I’m feeling great!” If you have any questions about the meningitis outbreak, call your physician.

Dr. Mariam Ghobriel is double board certified in pain management and anesthesiology. She is also the medical director of Liberty Pain Center, with offices located in Freehold and Eatontown. For more information, call 732-303-0102 or visit www.libertypaincenter.com.