Back pain after epidural steroid injection

Although epidural steroid injections (also called epidural corticosteroid injections) may be helpful to confirm a diagnosis, they should be used primarily after a specific presumptive diagnosis has been established. Also, injections should not be used in isolation, but rather in conjunction with a program stressing muscle flexibility, strengthening, and functional restoration.
Proper follow-up after injections to assess the patient's treatment response and ability to progress in the rehabilitation program is essential. A limited number of injections can be tried to reduce pain, but careful monitoring of the response is required prior to a second or third injection.

This is a rare complication that may occur if a small hole is made in the fibrous sac and does not close up after the needle puncture. These small holes are only made in less than 1% of epidural injections and usually heal on their own. The spinal fluid inside can leak out, and when severe, the brain loses the cushioning effect of the fluid, which causes a severe headache when you sit or stand. These types of headaches occur typically about 2-3 days after the procedure and are positional - they come on when you sit or stand and go away when you lie down. If you do develop a spinal headache, it is OK to treat yourself. As long as you do not feel ill and have no fever and the headache goes away when you lay down, you may treat yourself with 24 hours of bed rest with bathroom privileges while drinking plenty of fluids. This almost always works. If it does not, contact the radiologist who performed the procedure or your referring physician. A procedure (called an epidural blood patch) can be performed in the hospital that has a very high success rate in treating spinal headaches.  

There is general agreement that patients with acute nonspecific spine pain or nonlocalizable lumbosacral radiculopathy (without neurologic signs or significant neurologic symptoms) require only conservative medical management. Patients should abstain from heavy lifting or other activities that aggravate the pain. Bed rest is not helpful and has been shown to delay recovery. 9 Bed rest may be recommended for the first few days for patients with severe pain with movement. Recommended medications include nonsteroidal anti-inflammatory drugs such as ibuprofen or aspirin. If there are complaints of muscle spasm, muscle relaxants such as cyclobenzaprine may be used in the acute phase of pain. Narcotic analgesia should be avoided, in general, but it can be prescribed in cases of severe acute pain.

However, epidural fibrosis, the formation of scar tissue near the nerve root, can put pressure on the nerve roots and thereby cause pain. Typically, symptoms associated with epidural fibrosis appear about 6 to 12 weeks after back surgery. Sometimes patients experience good pain relief early on after their surgery, but as the scar tissue slowly forms, the pain relief diminishes and leg and back pain recurs or increases. Occasionally the nerve damage from the original cause of the patient's pain makes the nerve heal more slowly. Burning pain, or a constant gnawing pain that does not change with position, can be suggestive of scarring around nerves.

I had an L5S1 microdiscectomy 8/29/12. My only symptom was a numb foot and 3 doctors said the surgery would be my best chance for recovery. Now almost 6 months later and I now have excruciating left lower back pain and what feels like hot coals on my knee and thigh…and my foot is still numb. 2nd MRI shows nothing and the surgeon has said he can’t do anything to help. Quality of life is pretty bad. I am only 63 and wonder if this is it for the rest of my life. I did have symptoms in the same area before the surgery occasionally which had never been diagnosed but nothing like this. This is simply awful. I was an idiot to let myself be talked into this operation. Something must have occured in the OR to cause my symptoms (which I started to notice right after surgery.) I am hoping that maybe a nerve got tweaked and will work itself out but after 6 months I am getting more and more depressed. Have never taken any pain meds but may have to consider it if I want to go on living.


Symptoms

Other symptoms may accompany liver pain. The following are some of the possibilities ( some of these, found with liver discomfort, may indicate a serious condition):

Portal hypertension ; breathing troubles ; eating disorders; exhaustion ; itching ; jaundice ; pain when breathing or coughing; right shoulder pain; swollen testes

Differentiating

Liver pain and abdominal pain in general are sometimes confused with each other. For reference purposes on this site, all upper-right abdominal pain is considered as potentially being liver pain. A doctor or medical professional may be able to determine the difference between particular types of pain in the abdomen, and whether they are related to the liver itself. Kidney pain is distinguished as it is located below the liver. Pancreas pain is also distinct, as it is also underneath.

Excessive drinking, or alcohol abuse, is commonly associated with liver pain. However, such pain as a symptom after drinking may also imply another underlying cause (such as hepatitis), which could itself be caused or worsened by the alcohol.

Diagnosis and treatment

A doctor may use some of the other present symptoms to assist in making a diagnosis of the liver pain cause. Treatment methods that may be used vary based on the diagnosis of the underlying cause. You can learn more about the particular potential causes mentioned on this site. Liver pain treatment methods may also include symptomatic options to relieve the pain and other symptoms experienced by the patient.

Back pain after epidural steroid injection

back pain after epidural steroid injection

However, epidural fibrosis, the formation of scar tissue near the nerve root, can put pressure on the nerve roots and thereby cause pain. Typically, symptoms associated with epidural fibrosis appear about 6 to 12 weeks after back surgery. Sometimes patients experience good pain relief early on after their surgery, but as the scar tissue slowly forms, the pain relief diminishes and leg and back pain recurs or increases. Occasionally the nerve damage from the original cause of the patient's pain makes the nerve heal more slowly. Burning pain, or a constant gnawing pain that does not change with position, can be suggestive of scarring around nerves.

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