An epidural injection is the injection of a medicine into a space of the spine called the epidural space.  The epidural space is a thin layer between the outer ligaments of the spine and the nerves of the spine.  Injecting medicines into the epidural space allows the medications to spread to injured and painful areas of the spine and can provide pain relief.  When performed properly an epidural injection is an extremely  safe procedure.  Here are some potential problems that can occur with epidural injections:

  • When an injection is performed too frequently (more than twice or more often than once in 2 weeks) an accumulation of the injected medicine can cause side effects like high blood sugar, skin changes, thin bones and a rounded and bloated appearance to your face. The likelihood of this with properly performed injections is very low.
  • In diabetic patients an epidural injection will cause a transient elevation in blood sugars. This is avoided by checking sugars frequently and adjusting diabetic medications if necessary.  Diabetics should advise there diabetes treating physicians that they are undergoing an epidural injection.
  • In the past, infections have occurred because some pharmacies that mixed together the medications used in an epidural injection had not practiced safe and clean techniques. This resulted in a series of infections, some very serious.  This has led to much more stringent supervision of these pharmacies.
  • In the neck, nerve or spinal injury can occur if patients are too sedated during the procedure. This is avoided by using only light anesthesia, if any at all.
  • In the neck, performing an epidural injection can cause a seizure if the anesthetic in an epidural injection is carried to the brain by blood flow. This is avoided through the careful use of x-rays or by not using anesthetic medications in an epidural injection.
  • Injecting medications that contain small particles through a nerve opening in the side of the neck vertebra can cause a stroke in the spinal cord. This is avoided through the careful use of x-rays and by using medications that are pure liquids and do not contain particles.
  • An epidural injection can cause a leakage of the normal fluid that surrounds the spine. This can cause headaches.  This can be treated with rest and hydration.  Larger leaks may require more intensive treatment.
  • The medication contained in an epidural injection may contain preservatives. If the needle inadvertently punctures the fluid containing sac that surrounds the spinal cord, the preservative may cause an inflammatory reaction resulting in pain, stiff neck, nausea and other symptoms.