Back Pain and Epidural Shots: How They Work, Risks, and Legal Implications

Back pain can be debilitating, and since we use our backs in almost everything we do on a daily basis, if our back hurts, we can experience almost constant pain with every move. Doctors recommend epidural steroid injections (ESI) when back pain is caused by inflamed nerves in the spine. Spinal nerves become inflamed when they are under pressure from conditions caused by illness or injury. Epidurals relieve pressure on nerves and help reduce the inflammation that is causing pain.

An epidural shot is generally considered a safe procedure without serious side effects. However, there are risks of injury if the procedure is not properly performed. Complications can arise requiring immediate medical treatment to avoid serious neurological impairment. The doctor who performs an epidural procedure that results in injury to a patient may be liable for medical malpractice.

How Epidurals Affect the Body

The epidural space between the inside surface of the spinal canal and the spinal cord contains things like fats, veins, and, in particular, spinal nerve roots. An ESI is primarily a shot of synthetic cortisone into the epidural space. It works like the body’s own cortisone but is much more concentrated and more effective at reducing pain for longer periods.

Epidurals have an anesthetic effect on spinal nerves and are therefore given for pain during medical procedures as well as used for the management of chronic pain. The effects of an epidural can last anywhere from a week to several months, depending on individual circumstances.

When Your Doctor May Recommend an Epidural for Back Pain

Epidurals are not an appropriate treatment for all types of back pain. When your back pain results from strained or sore muscles, an epidural is not an effective treatment. Epidurals target inflamed nerves and reduce inflammation near the location of the painful area.

EPIs are often used to help manage back pain from chronic or degenerative conditions such as:

• Herniated discs
• Spinal stenosis (narrowing of the spinal column)
• Bone spurs
• Sciatica
• Spinal arthritis

Medical professionals who deliver epidurals use X-rays to determine where to insert the needle and sometimes a contrasting dye to make sure the shot goes in the right place. By using a numbing agent before the shot, doctors can provide Immediate relief. The effects of the actual steroid do not take effect for several days.

The duration of relief provided by an EPI depends on a number of factors, including the type of injection, the medications used, where the pain is located, and the accuracy of the injection. The patient’s follow-up care and adherence to doctor’s orders can also affect how well the EPI helps their pain.

Potential Injuries From Epidural Shots

The normal side effects of receiving an EPI are fairly minor and do not usually result in any lasting problems. However, some people may experience more serious reactions to the procedure. Any of the following can result as a consequence of an epidural:

• Allergic reaction
• Infection
• Bleeding
• Nerve damage
• Paralysis

An infection at the injection site can result in an epidural abscess (buildup of pus). It is critical that caregivers and practitioners discover and treat infections quickly to minimize potential nerve damage. These infections can also spread to the brain and spinal cord. Meningitis is a potentially life-threatening infection that can develop in the tissues surrounding the brain and spinal cord.

Drug Makers Are Required to Warn Consumers of Rare Adverse Events from Epidurals

Despite being a widespread practice, injecting synthetic steroids into the epidural space of the spine for pain relief has not been approved by the Food and Drug Administration (FDA). In 2014, the FDA required manufacturers to warn medical practitioners and other consumers that epidurals can have extremely adverse consequences, including:

• Loss of vision
• Stroke
• Paralysis
• Death

How Doctors Can Be Held Liable for Patient Injuries from Epidural Injections

When a patient opts to have an ESI to relieve back pain and the treatment causes further injury, it doesn’t necessarily mean the medical provider administering the procedure is liable for the injury. There are known side effects that may accompany an ESI, such as tenderness around the injection site or a temporary drop in blood pressure. There may also be some other noticeable changes that accompany introducing a steroid into the body such as water retention, flushed skin, and sleeping disturbances.

Medical malpractice is a specific type of personal injury that occurs when the person providing a medical service fails to adhere to the appropriate standard of care, and the failure results in injury to a patient. When a doctor performs an epidural injection, an established procedure must be followed to ensure the right medication is used and the injection is delivered to the appropriate area without causing collateral injury.

If a patient experiences an injury consistent with an improperly given ESI, the person administering the shot may be liable for the resulting damage. There are two primary types of mistakes a healthcare provider can make with regard to an epidural shot: improperly placing the needle and failing to diagnose resulting conditions.

Improper Needle Placement

A healthcare provider administering an epidural shot has to be extremely careful about needle placement and where the contents are delivered. The only acceptable injection site is the fluid-filled area surrounding the spinal nerves – the epidural space. A misplaced needle can injure delicate surrounding tissue or deliver the contents to the wrong place, which can lead to the development of life-threatening complications.

Failure to Diagnose a Resulting Condition

Some pain and other discomfort are not unusual during and after an epidural injection. However, severe pain or headache, loss of sensation, weakness, or a decreased ability to move or use a part of the body are all potential warning signs that there may be a serious complication. Some common conditions include:

• Spinal Epidural Hematoma (SEH) – Blood can accumulate in the epidural space, putting pressure on the spinal cord. Without immediate treatment (drainage), neurologic damage progresses, and death can result.
• Spinal Epidural Abscess – The epidural space may become infected, and pus can accumulate, compressing the spinal cord or interfering with the blood supply. Both situations present a medical emergency and can result in permanent neurological damage and death.
• Cauda Equina Syndrome – A rare condition caused by extreme pressure and swelling of the nerves at the bottom of the spinal cord (Cauda Equina). Paralysis, loss of bowel and bladder control, and lower body weakness, numbness, or radiating pain can become permanent without immediate surgical intervention.

Where to Go for Help if You Were Injured From an Epidural Shot

A properly given epidural steroid injection can deliver welcome relief for someone suffering neurological back pain. Though complications are relatively rare, when they do occur, the resulting damage can be severe and permanent. If the complications are due to a mistake made by a healthcare provider, an injured patient may have a claim for medical malpractice.

The nationally recognized New Jersey-based personal injury law firm of Lopez McHugh has been obtaining justice for clients injured by consumer products, healthcare institutions, and medical professionals for over 30 years. Our experienced hospital negligence lawyers understand how devastating it can be for patients who entrust their well-being to doctors and then suffer injury as a result. If you were injured by a healthcare provider’s mistake, contact Lopez McHugh for a free consultation.