Experiencing more discomfort after epidural anesthesia: Essential insights
Article Title: Understanding the Temporary Increase in Pain After Epidural Steroid Injections
Epidural steroid injections (ESIs) are a common treatment for various types of chronic pain, particularly back pain and sciatica. However, some patients may experience a temporary increase in pain after the procedure, a phenomenon that is relatively common and usually resolves within a few days.
After an ESI, patients can expect immediate relief due to the local anesthetic in the injection. This relief typically lasts for several hours. As the anesthetic effect fades, some patients may experience a temporary increase or return of pain, which usually lasts for 1-2 days before improving as the anti-inflammatory effects of the steroid medication kick in. Full pain relief may take several days to weeks, varying by individual.
This short-term worsening of pain is distinct from potential rare complications like infection or nerve damage, which would typically include additional symptoms and require urgent medical attention. Patients are advised to rest initially and monitor symptoms closely to differentiate normal side effects from complications.
There are several reasons why pain might increase after an ESI. One reason is the temporary irritation of spinal nerves caused by the introduction of steroid fluid into the epidural space. Another reason that is not yet fully understood is an initial rebound effect when the local anesthetic wears off before the corticosteroid begins to take effect.
While the benefits of ESI, such as temporary to longer pain relief, improved ability to move, and the ability to help doctors pinpoint the cause of pain, are well documented, there are potential drawbacks to consider. These include temporary increase in pain, headache, reaction to the steroid, and minimal low-level radiation from X-ray guidance.
In some cases, there may be a small risk of injury to a nerve during the injection that may trigger sciatica. However, studies have shown that neither ESI nor IV anesthesia have been found to significantly increase the risk of back pain in the early postpartum or 6 months after delivery.
To manage discomfort after an ESI, applying an ice pack three to four times a day may provide relief. If pain persists beyond the initial 1-2 days or worsens severely, it is important to consult a healthcare provider.
[1] Mayo Clinic. (2021). Epidural steroid injections. [online] Available at: https://www.mayoclinic.org/tests-procedures/epidural-steroid-injection/about/pac-20394680
[2] Johns Hopkins Medicine. (2021). Epidural steroid injections. [online] Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/epidural-steroid-injections
[3] Cleveland Clinic. (2021). Epidural steroid injections. [online] Available at: https://my.clevelandclinic.org/health/treatments/17143-epidural-steroid-injections
[4] Spine-health.com. (2021). Epidural steroid injections for back pain. [online] Available at: https://www.spine-health.com/treatment/epidural-steroid-injection/epidural-steroid-injections-for-back-pain
[5] American Academy of Orthopaedic Surgeons. (2021). Epidural steroid injections. [online] Available at: https://orthoinfo.aaos.org/en/treatment/epidural-steroid-injections/
- Obesity and COPD are examples of chronic diseases that epidural steroid injections (ESIs) may not effectively treat due to science's limited understanding of their complex relationship with back pain and health-and-wellness.
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- This new predictive science model allows medical professionals to identify potential risks for obesity and other chronic diseases, such as diabetes and heart disease, in patients based on their genetic makeup.
- In addition to relief from chronic diseases like back pain and osteoarthritis, epidural steroid injections are also proven to aid in the management of chronic obstructive pulmonary disease (COPD) symptoms in some cases, improving health-and-wellness overall.
- As part of a comprehensive approach to overall health-and-wellness, mental health is becoming an increasingly important factor in managing chronic conditions such as obesity, diabetes, and chronic pain, demonstrating the interconnections between mental and physical health.
