By mid-October, 2012, the meningitis outbreak caused by contaminated steroid injections reached over 230 cases across the U.S. Steroid injections are often used for back pain treatment, despite the lack of FDA approval for this application.
The fact that contaminated medicine was sent to medical facilities around the country brings to light an chasm in current regulatory mechanisms. The steroid in question was sourced back to New England Compounding Center (NECC), a compounding pharmacy in Framingham, Massachusetts. Compounding pharmacies exist to provide special medications to individuals on a prescription basis that can’t be obtained from pharmaceutical manufacturers, such as combinations of medications.
The meningitis outbreak may have occurred because compounding pharmacies aren’t as heavily regulated as normal drug manufacturers, even though compounding pharmacies have overstepped their bounds in recent years and actually manufactured and marketed medicines. Also, the number of pharmacies has increased from 5,000 in 2009 to 7,500 in 2012. State boards, not the FDA, are responsible for oversight of compounding pharmacies. Questions are being raised as to whether the industry has outgrown the regulatory capacity of such limited boards.
The use of steroid injections for the treatment of lower back pain has been under scrutiny in recent years. Aside from offering only temporary benefits, there is no evidence to support the use of these injections for lower back pain without radiating leg pain (see one study concluding such at www.ncbi.nlm.nih.gov). Steroid injections are administered by injecting a steroid solution combined with an anesthetic into the epidural space surrounding the spinal cord; the steroid acts as an anti-inflammatory agent while the anesthetic temporarily numbs pain sensations.
Despite a lack of evidence, and serious but rare steroid injection risks (like meningitis infection), this procedure continues to be a popular choice among health professionals. The injection is convenient. It doesn’t take long to perform and, when effective, delivers fast (though temporary) pain relief. Though they are sometimes marketed as an alternative to surgery, it should be remembered that injections are themselves invasive procedures. It’s always best to seek more conservative treatments for back pain first, such as the array of manual therapies and exercise therapies available.
Take charge of your back pain management plan; do your research, ask questions and find out what treatments are safe. See news.yahoo.com for information on where contaminated steroids were distributed and other recalled products from NECC.