1. Infection – severe infections are rare, they occur in 0.1% to 0.01% of epidural injections performed at a clinic such as at pain clinics in Jacksonville Fl.
2. Dural puncture – a dural puncture occurs in 0.5% of lumbar epidural injections. Typically it will seal up just fine on its own and the patient will not have any symptoms. However, it may cause a post-dural puncture headache, which is also known as a spinal headache, that typically will improve over a few days. Often times, having the individual stay on significant bed rest can utilize antigravity to help the puncture seal over.
Infrequently, an epidural blood patch maybe necessary to get rid of the headaches. A blood patch is a simple and quick procedure where the doctor obtains a small amount of blood from a patient’s arm and immediately injects it into the dural space where it then clots around the dural puncture area and stops the spinal fluid from leaking.
3. Bleeding – this is a rare complication and is most commonly seen in those with an underlying bleeding disorder or those who take anticoagulant medications. It is extremely important to notify your pain management doctors in Florida if you take any anti-clotting medications such as Coumadin. Those should be stopped approximate 5 to 7 days prior to the procedure, your doctor will tell you specifically the time frame.
4. Nerve damage – this is also exceptionally rare, but nerve damage can occur from direct needle trauma or maybe a result of an infection or bleeding that results from the procedure.
Along with the above potential risks, there’re also some potential side effects that may occur from the Cortisone medication utilized in the injection. These are also uncommon and are much less prevalent than what is seen when a person takes steroid by mouth. Nevertheless, here are some potential side effects from epidural steroid injections:
-Localized increase in pain around the injection area
-Headaches that are non-positional and resolve within a day
-Temporary high blood sugar
-Fever the night of the injection -Transient decrease in immune system -Avascular necrosis of the hips
As mentioned, an epidural steroid injection into the lumbar spine is a low risk procedure. However, things do happen and if so they should be reported to your doctor.
If you have a fever of 101° or greater for over 24 hours, this should be reported to your doctor as it may indicate an infection. If you’re losing function or feeling in your legs or arms this should also be reported to your pain management doctor. Experiencing a painful headache while sitting or standing after a lumbar epidural injection that feels better after laying down should be reported, as this may be indicative of a dural puncture.
In addition, if you have severe pain that is not controlled by over-the-counter pain medication or other measures that have you utilized in the past this should be reported. And especially if you lose bowel or bladder control after the local numbing medicine wears off, this is concerning and it should be reported immediately.
In general, epidural steroid injections are an extremely useful and an excellent nonoperative method of combating lower back pain and sciatica. The risk profile is low but cannot be ignored.
The typical amount of pain relief that has been shown in research studies is good to excellent in over 75% of patients. Their relative effectiveness and safety make epidural steroid injections an integral part of the nonsurgical treatment of low back and radicular pain such as with sciatica.
The Florida Pain Network includes pain clinics throughout the state such as pain clinics in Orlando and pain clinics in Jacksonville Florida. The listings are geographically targeted, so those closest to people on the site show up first. Detailed information is on the site, or people may call (877) 877-8556 for assistance.