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.
With the numerous points we have to choose from for our steroid injections most will find the glutes and lateral (side) deltoid head to be the most comfortable and convenient points of administration. Injection sites such as calves and traps are highly warned against; although in terms of adequate injection sites they are fine, they can produce a fair amount of pain in the individual. No matter where you choose to inject always practice sanitary methods; do not reuse needles or syringes, clean the area thoroughly before injection and always sterilize with alcohol beforehand.
As a skilled and experienced Pain Medicine Interventionalist, Dr. Levin evaluates each patient very thoroughly and carefully to help determine appropriate treatment options in order to provide the most effective individualized care. These treatment options may include: Lumbar, Thoracic and Cervical Epidural Steroid Injections utilizing targeted transforaminal techniques, Lumbar and Cervical Sympathetic Blocks, Sphenopalatine, Facial and Head and Neck Procedures, Discography, Percutaneuos Discectomy or Disc Decompression procedures, precision joint and nerve injections, Radiofrequency Neuroablative procedures, Peripheral or Spinal Cord Stimulator trials and implants, Foraminoplasties and several patented and patent pending advanced interventional procedures.