"It is a very rare event, but it is not zero, and it's devastating," says James Rathmell, a doctor at Massachusetts General Hospital in Boston. "We used to say this is so safe." As David Armstrong reports for Bloomberg Businessweek, steroid injections - epidurals near the spinal cord - in some cases cause paralysis in patients.
Such is the case with 60-year-old Rollie Parrish, who, now wheelchair-bound, brought a claim for medical malpractice against his health care providers after suffering paralysis (from a stroke) after doctors administered a steroid injection meant to ease chronic pain in his neck and back.
Of course, the market for steroid injections, as Armstrong reports, is said to be in the $300 billion range. So many Americans suffer from chronic back and neck pain, and the injections take very little time to administer - the costs of which are billed back to Medicare and private health care insurers.
Two Contributing Factors in Growth of Steroid Injections
The population is getting older, which leads to more people who have chronic pain. That's the first factor. The second factor is that it costs relatively little to administer the injections, yet Medicare and private health care insurers seem to be almost overpaying when it comes to reimbursement.
These two factors add up to a "boom in epidural shots," writes Armstrong,
The drugs used in steroid injections are known to be good at fighting inflammation, a significant cause of pain, but many injections are done too close to the spinal cord, or the drugs themselves are injected directly into arteries that cause blockages - which can lead to strokes, which is exactly what seems to have happened to Parrish.
Source: Bloomberg Businessweek, "Epidurals Linked to Paralysis Seen With $300 Billion Pain Market," by David Armstrong, 1/4/12