Facts About Epidural Side Effects
Everything you need to know about potential epidural complications, from headaches and back pain afterward to other, more serious risks.
Considering that at least 60 percent of American women today have an epidural for pain relief during labor, it’s surprising how misunderstood this procedure is. For starters, even doctors use the word “epidural” generically, to encompass three similar, yet distinct procedures: epidurals, spinals, and a more recently perfected procedure, the combined spinal epidural , or “walking” epidural. Because deciding whether or not to have an epidural means becoming informed about the benefits and risks well before labor begins, here are the facts to help you make sense of some misconceptions.
How Long Does An Epidural Nerve Block Last Center
An epidural nerve block is a procedure to block pain by injecting anesthetic medication into the epidural space of the spine. The procedure numbs the relevant nerve region thereby blocking the transmission of pain signals from those nerves to the brain. An epidural nerve block may be administered in the cervical, thoracic, lumbar or the caudal region of the spinal column. Read more: How Long Does an Epidural Nerve Block Last? Article
How Epidural Steroid Injections As Back Pain Relief Work
For people suffering from chronic low back pain, receiving an epidural steroid injection can significantly provide immediate pain relief and improve body functions.
Doctors typically recommend this procedure, in conjunction with physical therapy, to alleviate pain from:
- Herniated discs that damage and press nerves causing pain
- Spinal stenosis or the narrowing of the spinal canal
- Failed back surgery syndrome
- Bone spurs due to joint damage associated with osteoarthritis
- Other injuries to spinal nerves, vertebral column, and surrounding tissues
Epidural steroid injections involve injecting steroids and anesthetics into the inflamed nerve roots within the epidural space.
The steroid reduces inflammation in the area with back pain while the anesthetics interrupt the pain-spasm cycle. The combination of the two helps with the pain management abilities of other areas of the spine.
One to two injections with 1-4 week intervals can give a satisfactory effect to patients with mild low back pain. Meanwhile, those with chronic conditions can get the injections at 3-6 months intervals.
The length of pain relief varies, lasting for weeks or years. Its ideal to receive epidural injections together with exercise programs such as physical therapy to reinforce back muscles and prevent future inflammation.
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Steroids Shots Have Risks
Harmful side effects of cortisone injections are uncommon, but they do happen. The main risk is infection, which occurs less than 1% of the time. Less commonly, the needle could injure a nerve or blood vessel.
Having too many injections in the same target area can cause nearby tissues, such as joint cartilage, to break down. Corticosteroids can also cause skin at the injection site or the soft tissue beneath it to thin. This is why its recommended to limit the number of cortisone injections to three or four per year at any body region treated.
Should You Get Epidural Injections For Your Back Pain
Chronic back pain is a condition that interferes with your daily activities for at least three months. It can cause persistent discomfort that ranges from a subtle ache to a sharp jab, resulting in limited mobility.
To avoid the risks and recuperation associated with back surgery, the first course of treatment for back pain often begins with conservative, non-surgical care such as physical therapy, medication, or behavior modification. If these options prove inadequate, many patients find temporary relief with epidural injections.
Epidural injections deliver anti-inflammatory medication into a specific area of the spine. The medication helps decrease inflammation, which can reduce pain and help the injury heal.
Youll get optimal results when your treatment is delivered by an experienced epidural injection professional. Board-certified anesthesiologist and pain-management specialist Anjum Bux, MD, specializes in the use of epidural injections and other back pain treatments at Bux Pain Management in Lexington, Cynthiana, and Danville, Kentucky. After a thorough physical examination and diagnostic tests, Dr. Bux determines the source of your back pain and advises whether epidural injections and/or other therapies can deliver relief.
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Whats The Difference Between An Epidural And A Spinal Block
An epidural and a spinal block both provide pain relief through an injection in the area around your spine. The differences are the placement and the effect.
With an epidural, your healthcare provider injects anesthesia into the epidural space around your spinal nerves. With a spinal block, your provider injects the anesthesia into the dural sac around your spinal nerves that contains cerebrospinal fluid. This placement of a spinal block injection means that it gives immediate relief. Epidural injections usually take 20 to 30 minutes before you feel the full effect of pain relief or lack of feeling.
It Started A Couple Months After Her Birth And Has Only Gotten Worse
I remember a nurse/assistant holding me while I sat on the table, telling me to bend slightly forward. It didn’t happen the first time but after a few tries, I started to feel my lower body go numb.
It wasnt exactly painful, but it was uncomfortable and strange. Little did I know the pain would come afterwards.
My daughter is now two years old, and my back pains are so severe sometimes that I can hardly even turn or move at night when in bed.
Some days, the aches are so intense I dont even know how to sit or stand. It started a couple months after her birth and has only gotten worse.
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How Painful Is A Lumbar Epidural Steroid Injection
Youll likely experience a minor pinch when your provider injects the local anesthetic to numb the area before your lumbar epidural steroid injection.
You may not feel anything during your lumbar ESI, or you may feel the following:
- A burning sensation.
- Momentary pain.
If you have any discomfort during the injection, it usually goes away once the injection is finished. If you feel intense, sharp pain during or after your lumbar ESI, tell your provider immediately.
Stand On A Sloped Surface
The other cows never understood how Daisy managed to stay standing longer than them.
Now Im not convinced with this one personally.
Because from my own experience I know that my back starts screaming after standing on an uneven surface, even for just a short amount of time.
But there is science to back up the benefits of standing on a sloped surface so I thought Id include it and you can make up your own mind!
For example one study tested how small groups of workers would react to standing on a sloped surface rather than a flat one.
And they found that the workers using the sloped surface had:
- Different pelvis and spinal postures while they stood which reduced the load on their lower back.
- Less hip and trunk muscle co-activation .
Both of these factors had a positive effect on the workers and they had less lower back pain afterwards.
In fact, many requested to keep using the sloped surface afterwards.
So there might be something in this!
And while I wont be rushing to try this out for myself, if you do fancy investigating further then the sloped surface they used in the study was the eQuilibrium Almond.
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How Will I Feel After The Injection
Most people do not feel any different immediately after the injection, although the pain may be temporarily improved or worsened. The steroid takes two to three days to start to have an effect in most people, and it peaks in about two weeks. Therefore, it may be a while before you feel a change in your pain.
Some local tenderness may be experienced for a couple of days after the injection. Using an ice pack three to four times a day will help this. You may take your usual pain medications as well after the injection.
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How Long Does An Epidural Last
How long an epidural lasts depends on what kind of epidural you got and what kind of medicine your healthcare provider injected. Your provider will let you know what to expect. In general, heres how long certain types of epidurals last:
- Epidural with a catheter: If you have an epidural with a catheter, your provider can give you a continuous flow of anesthetic medicine or multiple separate doses, depending on your situation and pain level. Once your provider has stopped the medication, youll likely experience numbness for a few hours before the effect of the medicine begins to wear off. Youll likely have to rest in a lying or sitting position until you have full feeling in your legs again. You may feel a slight tingling sensation while youre waiting.
- Single-injection epidural: Single injection epidurals usually last a few hours before you begin to regain feeling in the area that was numb.
- Epidural steroid injection: The length of time an epidural steroid injection can provide pain relief varies. Some people experience permanent pain relief if they have a new disk herniation. For people who have chronic pain, epidural steroid injections usually last 3 to 6 months or more.
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Nerve Damage From Epidurals
In rare cases, the back pain you experience will be directly related to the process of receiving an epidural.
The most common example is nerve damage that results from the injection itself. This will usually impact a single nerve and cause numbness on the skin or limited weakness in the muscles, along with back pain. There may also be sensory issues or loss of motor control associated with nerve damage. In most cases, these symptoms will be temporary and resolve within a few weeks. Even rarer is permanent nerve damage that results in the loss of use of a limb or loss of control of the bladder or bowels.
When nerve damage does occur, it can be a result of an injury caused by the needle or catheter, a blood clot, infections, or inadequate blood supply.
If you are concerned about nerve damage, a neurologist will be able to evaluate you to understand the cause of your symptoms and the extent. You may undergo an MRI or CT scan in addition to nerve conduction studies. This will help guide a treatment plan to attempt to reverse the nerve damage or prevent further complications.
How Do Epidural Corticosteroid Injections Work
Epidural steroid injections work by delivering a potent anti-inflammatory to the site of nerve impingement in the spine. Injected medications may include steroids, local anesthetics, and saline, and they can vary in volume and concentration on an individual basis.
Three routes may be used for epidural injections in the lumbosacral spine:
Your physician will choose which method is right for you based on your diagnosis and if you have had any prior spine surgeries.
- A caudal injection is the least complicated way to access the epidural space but is also the least specific. It can be useful if multiple areas of the spine are involved or if post-surgical changes prevent other approaches.
- An interlaminar injection delivers the medication directly into the epidural space at the affected level, can be targeted to one side or the other, and can treat multiple levels at once.
- A transforaminal injection delivers the medication to the area where the specific affected nerve root exits the spine and is compressed by a disc herniation. It is the usual first choice approach for an epidural injection.
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Do Epidural Injections Work Well For Back And Leg Pain
Theres good evidence that epidural injections can help many people with back and leg pain. But its important to realise that it doesnt work for everyone. How likely it is to work for you depends on many factors. For instance, youre more likely to benefit if your pain is due to a slipped disc, rather than spinal stenosis. And the injection is more likely to work if you havent had symptoms for very long. The success rate will also vary between doctors and depend on the technique they use. Ask your doctor how these factors apply to you.
If you do get pain relief from an epidural injection, it tends to be short lived . Some people do find that it works for longer up to several months or more. The amount of pain relief you get and how long it lasts varies from person to person. If youve found it helpful, your doctor may recommend you have repeat injections until the pain has gone.
If an epidural injection does help to relieve your pain, you may find it easier to keep active or take part in other treatments, such as physiotherapy. This is important because keeping active is likely to improve your pain in the long run and also means its less likely to come back.
What Are Epidural Injections
An epidural injection contains a steroid medicine, usually together with a local anaesthetic. These injections are also called epidural steroid injections. The liquid is injected into a gap called the epidural space, which surrounds your spinal cord. The steroid reduces inflammation around your spinal cord, while the local anaesthetic provides faster pain relief.
The injections can be given at different points along your back. An injection in your lower back is called a lumbar epidural. There are different techniques for giving epidural injections for lower back and leg pain:
- interlaminar this is given between two of your vertebrae
- transforaminal this is an injection into the side of your spine
- caudal this is given through an opening at the base of your spine
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Back Pain After Epidural
Suffering lingering back pain after an epidural injection is one of the many possible complications of these common needle-based procedures. Epidural injections are used for many purposes, including anesthetic introduction, diagnostic processing, spinal fluid sampling and various intervertebral disc-related procedures. By nature, all of these injections penetrate the epidural space, which contains the dura mater, spinal fluid, the spinal nerves and the spinal cord within the central vertebral canal.
Epidural injections are known to be very painful and most patients fear them for this reason. However, the true risk factors associated with epidurals are far more serious than a few moments of pain experienced while the procedure is taking place. The real risks can spell dire consequences that might last forever or even kill the patient quickly.
This essay focuses on the incidence of suffering chronic pain following an epidural injection and the possible causes of this increased symptomology. For the purposes of this article, we will look at injection techniques that access the epidural space, the dura mater and the spinal components themselves.
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An irritated, inflamed or compressed that is, pinched nerve in the spine can cause excruciating back pain that can radiate to an arm or leg. And leave you longing for immediate relief.
When oral medications or other therapeutic methods dont help, your doctor may recommend an epidural injection.
Epidural injections have been used for many years to deliver anti-inflammatory drugs such as steroids directly to the troubled area in the spine, to relieve the pain and inflammation.
Your spine or backbone is made up of many small bones the vertebrae. Theyre stacked atop one another with cushioning intervertebral disks between them.
Within the backbone, and protected by it, is the spinal column, a bundle of nerves that runs from the base of your brain all the way to your lower back. The material covering the spinal cord is called the dura, and the space between it and the spine is called the epidural space.
Epidural injections are delivered into the epidural space, close to the affected nerve.
The length of pain relief from an epidural injection varies from one person to another from a few days to many months. You may need periodic injections.
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Back Pain After Childbirth
It can be difficult to understand how much back pain is caused by epidural injections as opposed to how much results from the experience of giving birth in the same time frame. Symptoms that are often cited in relation to both include:
- Pain at the injection site
- Lingering numbness in the back
- Pain throughout the back
- Weakness of the core muscles
- Sharp pains when sitting or standing for long periods of time
- Unstable back or hips
During pregnancy, there is extreme pressure placed on the pelvis as it changes shape and grows to accommodate delivery. Immediately after giving birth, the pelvis begins to shrink back to a smaller size and tries to realign, which places additional pressure on the sacroiliac joints. Other strain on muscles and ligaments is also attempting to repair itself during this time. As women move more or exert themselves in the postpartum period, it can cause pain that radiates through the back.
If the pain seems to be linked directly to the injection site, or the pain lasts for more than a few days, you should seek care related to your epidural. In most cases of pain after giving birth, a chiropractic adjustment should help your body as it returns to a new state of normal.
What Are Lumbar Epidural Steroid Injections Used For
Healthcare providers use lumbar epidural steroid injections to manage a type of chronic pain known as lumbar radicular pain, which is caused by spinal nerve root inflammation and irritation in your low back. Lumbar radicular pain is often called sciatica. Lumbar radicular pain can cause the following symptoms, which can radiate from your low back down the back of your leg below your knee to your calf and/or foot:
- Muscle weakness.
Many conditions can irritate your spinal nerve roots in your low back and cause lumbar radiculopathy , including:
Other conditions that may be treated with lumbar ESIs include:
- Localized low back pain : Axial low back pain can vary widely and have numerous causes. It can be a sharp or dull pain that you experience constantly or infrequently, and the pain can range from mild to severe.
- Neurogenic claudication: This condition happens from compression of the spinal nerves in your lumbar spine. It can cause pain or tingling in your low back and one or both of your legs, hips and buttocks. These symptoms are especially present when youre standing upright or walking.
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