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Posted on 11-20-2013

YOU NEED TO KNOW: CORTICOSTEROID INJECTIONS

Good morning!

There have been some public rumblings as of late on the safety and proper use of Epidural Steroid Injections (ESIs). Many of you may not know this but epidurals are used for more than just delivery in childbirth but also in invasive pain management.  

In May, Dr. Oz of television fame aired an "investigative" piece on their off-label use, pointing out that while ESIs are the most common medical procedure for treating low back pain-performed nearly 9 million times a year in the U.S.-ESIs have not been approved by the FDA for spinal use.

Not surprisingly, Dr. Oz's report elicited a great deal of pushback from the medical community. Also in May, Dr. Reza Ghorbani, an internationally recognized Board Certified Interventional Pain Management Specialist, echoed the concern of many when he wrote, "There have been numerous scientific and clinical studies showing the benefits and safety of this procedure... I have witnessed countless lives changed and improved as a result of these procedures (ESIs). These patients were able to go back to work, play with children and grandchildren, carry groceries, work in the yard again, among many other things. As a result of this alleviated pain patients then move on to exercise and losing weight-reclaiming a healthy life style."  Dr. Ghorbani went on to stress that ESIs are not for every patient, and believes that they should be administered by a Fellowship trained, Board Certified Interventional Pain Management doctor in the right setting, like an Ambulatory Surgery Center or Hospital.

In the Podiatrist's (foot doctor) office, Corticosteroid Injections are frequently used to address joint pain and are a common treatment for plantar fasciitis. Administered correctly, ESIs can provide rapid and lasting pain relief, restoring function for weeks if not months to a body part previously immobilized by inflammation.

Yet as Dr. Ghorbani alluded to, not every patient is a candidate. Corticosteroid Injections can be problematic for diabetics and for anyone who is actively suffering infection or bleeding disorder. Also, the growing public interest in more conservative and/or preventative medicine may turn certain patients off to injections when other treatments are available. Patients who do their homework may be hesitant when considering the possible (though relatively minimal) side effects: thinning of the skin, easy bruising, weight gain, puffiness of the face, acne, elevation of blood pressure, cataract formation, thinning of the bones (osteoporosis), and a rare but serious type of damage to the bones of the large joints (avascular necrosis).  Moreover, adverse effects of Corticosteroid Injections for plantar fasciitis include fat pad atrophy, plantar fascia rupture, local skin effects and steroid flare. Clinicians should be well-versed on possible adverse events secondary to Corticosteroid Injections.

Before surgery or injections to treat joint or low back pain, doctors may want to consider prescribing orthotics.  Custom-made prescription orthotics may be an attractive option for patients unwilling to go under the knife (or the needle) and be very helpful for a variety of foot ailments and secondary issues, like low back pain. Custom-made prescription orthotics also tend to be less expensive than surgery or injections, with fewer side effects.

This is why here at WellnessOne we custom digitally fit and order the our orthotics from the world leader in custom orthotic technology….Footmaxx!  We utilize their state of the art Metascan diagnostic tool to help us best deliver the perfect orthotic that is right for you.  Check out this short video clip by clicking HERE  on warning signs of foot problems as well as a little on the Metascanner itself.   

Mention this blog and receive a Metascan at no charge!  To set up your appointment call 530.243.9464 or to make an appointment online click HERE.

It's your future…be there healthy with WellnessOne! Have a blessed day!

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