The FDA has issued a warning that cortisone injections in the spiny may, in rare cases, result in loss of vision, stroke, paralysis and death. Epidural cortisone injections are a widely used treatment for radiating back and neck pain. While many patients and physicians swear by the treatment, the use of corticosteroids injected into the spinal space has never been shown safe and effective in clinical trials assessed by the FDA.

Later this year, the drug-safety agency said it will convene an advisory panel to discuss the risks and benefits of such injections and explore whether further regulation would reduce injuries from this use of injected methylprednisolone, hydrocortisone, triamcinolone, betamethasone and dexamethasone. An expert panel of pain specialists convened by the FDA has drafted a slate of recommendations to minimize possible harms from this specific use of corticosteroids, and the FDA says it will release those guidelines when they’re finalized.

In 2012, a compounding pharmacy unintentionally introduced fungal contamination into injections, resulting in 48 deaths after the patients contracted fungal meningitis. Late last year, the pharmacy agreed to a $100 million settlement with victims and their families.