Spinal Injections

For any injection near the spine complications can occur – but thankfully serious complications are very rare.

Common complications

  1. It is common to have pain after the procedure where the needles have been placed. Pain normally settles within 24-48 hours. Certain procedures such as radiofrequency neurotomy, can result in more prolonged pain flare-ups.
  2. Itching and skin reactions can occur from the antiseptic solution.
  3. If you are having sedation or anaesthesia for your spinal injection there can be anaesthesia complications as a result. As with any anaesthetic you should not drive, operate machinery or make important decisions for 24 hours afterwards.

Rare Complications

  1. Infections in the skin and surrounding tissues can occur at the injection site. Any infections following injections are generally easy to treat with antibiotics.
  2. Dural puncture headache. When an epidural injection is performed it is possible for the needle to pass into the fluid that surrounds the spinal cord. This can create a headache of fluid leaks out. The headache can normally be treated effectively with an epidural blood patch, which is where blood from the patient is injected into the epidural space to patch the hole. Dural puncture headaches are said to occur in about 1 in every 200 epidural injections.
  3. In rare circumstances a severe allergic reaction can occur to sedation medications, antiseptic, or the substances injected into the spine or near the spine.

Very Rare Complications

  1. Damage to the spinal cord and spinal nerves can occur, although it is very unlikely. This can occur as a result of direct trauma from needles or from bleeding within the spine or if an infection develops in the spine itself as a result of the injection. This is an extremely rare event.
  2. A deep infection within the spine can result in widespread infection throughout the body known as sepsis. This is a life threatening complication. This is an extremely rare event.
  3. Some spinal injections take place near the lungs. Punctured lung (pneumothorax) has been reported after spinal injections – generally those in the thoracic spine or the lower neck. This can be a life threatening condition and requires a tube to be inserted into the chest in some circumstances.
  4. Brainstem anaesthesia. A very rare complication where local anaesthetic spreads to and anaesthetises the upper part of the spine and the lower part of the brain, causing loss of consciousness and cessation of breathing. This condition normally resolves as the anaesthetic wears off, but whilst unconscious, patients need to be on life support in intensive care.

Conditions that make Spinal Injections unsafe:

Injections into and around the spine should not be performed in certain medical conditions. These conditions include blood clotting problems, low platelet levels, infection or problems with the immune system. Injections should not be performed if patients are taking strong blood thinners. Please contact your pain management doctor if you have any of these conditions or take blood thinners.

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