pain after epidural an injection

Understanding the Pain After an Epidural Injection: Causes and Solutions

Experiencing pain after an epidural injection? This guide explains the possible causes and offers solutions to help alleviate your discomfort.

Epidural injections are a common treatment for pain management, but sometimes they can cause discomfort or pain after the procedure. If you’re experiencing pain after an epidural injection, it’s important to understand the possible causes and seek appropriate treatment to alleviate your discomfort. This guide will provide you with information on what to expect and how to manage your pain.

Common causes of pain after an epidural injection

There are several common causes of pain after an epidural injection. One of the most common is simply the injection itself, which can cause some discomfort or soreness at the injection site. In some cases, the needle may have accidentally touched a nerve, causing nerve irritation and resulting in pain. Additionally, some patients may experience an allergic reaction to the medication used in the injection, which can cause pain and other symptoms. It’s important to discuss any pain or discomfort with your healthcare provider to determine the cause and appropriate treatment.

Another common cause of pain after an epidural injection is the underlying condition that the injection was intended to treat. For example, if the injection was given to treat back pain, it’s possible that the pain may persist or even worsen after the injection. In some cases, the injection may not have been effective at all, and the pain may continue or return. It’s important to follow up with your healthcare provider to discuss any ongoing pain or discomfort and to determine if additional treatment options are necessary. In rare cases, complications such as infection or bleeding may also cause pain after an epidural injection. If you experience any unusual symptoms or severe pain, seek medical attention immediately.

Post-dural puncture headache

A post-dural puncture headache (PDPH) is a type of headache that can occur after certain medical procedures involving a needle inserted into the spine, such as a spinal tap or epidural. The headache is caused by a leak of cerebrospinal fluid (CSF) from the puncture site, which leads to decreased CSF pressure and subsequent symptoms. These can include a headache that is typically worse when sitting or standing and improved when lying down, neck stiffness, nausea, and sensitivity to light or sound. PDPH can be treated with various medications such as caffeine, acetaminophen, and opioids, as well as non-pharmacological approaches like bed rest and hydration. In some cases, a blood patch procedure may be required to seal the puncture site and prevent further CSF leakage.  Although painful, PDPH is self limiting and will usually resolve with 72 hours without any type of treatment at all.  

How to manage pain after an epidural injection

If you are experiencing pain after an epidural injection, there are several solutions that can help alleviate your discomfort. First, applying ice to the injection site can help reduce swelling and inflammation. Over-the-counter pain medications, such as acetaminophen or ibuprofen, can also be effective in managing pain. If the pain persists or is severe, your healthcare provider may recommend a stronger prescription pain medication. It’s important to communicate with your healthcare provider about any pain or discomfort you are experiencing to ensure proper treatment.

When to seek medical attention for pain after an epidural injection

While some discomfort after an epidural injection is normal, there are certain symptoms that may indicate a more serious issue and require medical attention. If you experience severe pain, numbness or tingling in your legs, difficulty walking or standing, or loss of bladder or bowel control, seek medical attention immediately. These symptoms could indicate nerve damage or other complications and should be addressed promptly by a healthcare professional.  

Although extremely rare, infection is a known risk of any invasive procedure.  Look out for fever accompanied by severe pain and swelling around the injection site at approximately 24-48 hours after the injection.  Seek attention from your doctor if this were to occur.

Related: What is an epidural steroid injection

About the author: Rainier Guiang, MD is board certified in Pain Management and Anesthesiology and has been in academic and private practice since 1999.

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