There is some controversy over whether epidural injections cause long-term back pain. A 2002 randomized study published in BMJ reports finding no significant distinction between long-term back pain in women who received epidural injections during labor and those who followed other pain management courses.
However, back pain and mothering forums are full of questions from concerned mothers who suffer severe back pain at the site of their injection for months or even years after the procedure. One woman writes:
“I had epidural 11 weeks ago when I had my daughter. The injection site was sore for several days, but it went away. Few weeks later I started experiencing sharp pains at the injection site, almost like having it done again. Instead of getting better, it has only gotten worse. I feel that pain even if I lean forward only slightly, and it’s very bad when I bend over.”
How Epidurals Work
Your spinal column houses a bundle of nerves that transport signals from the brain to all parts of the body and back. This nerve bundle is called the spinal cord. Between the vertebrae of the spine and the spinal cord sit the dural sac the epidural space. The dural sac surrounds the spinal cord. The epidural space, consisting of fat and blood vessels, surrounds the dural sac.
During an epidural procedure, steroids are injected into the epidural space, bathing the spinal cord in a steroid that reduces inflammation and an anesthetic that helps to reduce pain . A needle pierces the epidural space, and a catheter is slipped through to allow the steroid to flow into the area. At this point, the needle is removed and the tube remains in place until the medicine is no longer needed or cannot be administered anymore.
See Spine-Health.com’s animated video of an epidural injection at Spine Health.
What Can Go Wrong
While a properly-administered injection is highly effective in relieving pain, an improper injection can wreak havoc on the body.
There are a number of possible complications with epidural injections, from severe headaches to nerve damage. Nerve damage can cause back pain, but this is generally only a complication for people who have blood disorders. Bleeding in the epidural space can place pressure on the nerves of the spinal cord and eventually damage them completely, resulting in pain and loss of function. This is why epidurals are not administered to people with blood disorders.
A more likely complication of the injection is resulting with infection. This problem is called an epidural abscess and involves the buildup of pus between vertebrae and the spinal cord. The infection can occur directly from contact with the needle or catheter. Unfortunately, the exact cause of this type of infection is often not identified.
The pus in the spinal column can cause compression of the nerves and severe back pain. As an infection, it carries other dangers like permanent paralysis and even death, though these are rare.
What You Can Do
If you have severe back pain in the site of your epidural injection, it should not be taken lightly. Long-term pain goes far beyond the typical post-injection soreness that is to be expected. Giving birth can result in long-term back pain, so you must find out which is actually causing your pain.
Understand that pain is your body’s way of telling you that something is wrong. If you suspect that your epidural procedure went wrong, insist on an MRI test. If you find out the injection was not the cause of your pain, then you’re one step closer to finding what is.