To strengthen your back after an epidural, start with gentle, low-impact activities like walking and swimming, focusing on core stability with exercises like pelvic tilts, bridges, and bird-dog, and incorporate gentle stretches for flexibility, all while maintaining good posture; always consult your doctor or physical therapist before starting any new exercise plan to ensure it's safe for your specific recovery. Avoid twisting or high-impact moves initially to prevent straining your healing back.
Staying active. Rest helps you recover right after receiving an epidural, but you should plan to reintroduce moderate activity fairly quickly. Gentle activities like walking or swimming can help maintain flexibility, strengthen your back muscles, and prevent stiffness as your epidural gets to work.
Though rare, improper needle placement during an epidural injection can lead to chronic back pain, numbness, tingling, and weakness. In these cases, the needle hits the spinal cord, a nerve, or a collection of nerves, leading to irritation and damage.
Post-Injection Care and Recovery
It is important to follow your doctor's instructions carefully regarding rest and physical activity. Avoid intense exercise or heavy lifting for at least 24 hours after the procedure, even if you are feeling better. This helps minimize strain on the epidural space and the injected area.
Physical therapy and other exercises should be postponed for three days following a spinal injection. The day after the injection, you can return to your usual daily activities including work. If needed, you may take anti-inflammatory pain medications, such as Advil or aspirin, following the injection.
Even though some people feel better within hours, the steroid's full effect may take a few days. Resuming exercise too soon can reduce the risk of the cortisone's effectiveness and may worsen symptoms.
After a cortisone shot, your care team might ask that you:
Reach out to your doctor right away if you experience any of the following: Severe or worsening pain not improving with rest or medication. Numbness or weakness in your legs. Loss of bowel or bladder control (a potential sign of nerve damage)
Epidural anesthesia can cause long-term back pain if nerves are damaged, an infection develops, or the spinal cord is injured during the procedure. Persistent pain may result from improper needle placement, epidural abscess, or cerebrospinal fluid leaks.
Risks of epidurals
Epidurals, like any pain medication, come with side effects – which is what most people worry about when they're making their decision. Epidurals are generally considered safe and complications are uncommon, but some individuals may experience things like headaches or nausea.
In its mildest form you can get a small numb area or an area of 'pins and needles' on your skin. There may be areas of your body that feel strange and painful. Weakness may occur in one or more muscles. and/or loss of control of the bowel or bladder.
A massage can help reduce muscle tightness around the lower back. After an injection, muscles sometimes become tight or tense to protect the area. This tension can make the pain worse. A trained massage therapist can press gently on nearby muscles like the glutes and hips.
Self-care: Do not drive oroperate dangerous equipment for 4-6 hours. Do not apply heat to injection site for 48 hours following your procedure (includes heating pad, hot tub, or hot bath -warm showers are okay).
Sleeping on your back with a slight elevation is often one of the most comfortable and doctor-recommended positions after an epidural steroid injection. Elevating the upper body helps reduce swelling near the injection site and improves breathing.
In rare cases, an epidural can lead to permanent loss of feeling or movement in, for example, 1 or both legs. The causes are: direct damage to the spinal cord from the epidural needle or catheter. infection deep in the epidural area or near the spinal cord.
The signs of nerve damage include the following:
Harlequin syndrome is a rare complication related to blockade of facial sympathetic input that can occur secondary to thoracic epidural anaesthesia. [3] This syndrome causes unilateral flushing, hyperhidrosis and occasional ipsilateral pupillary miosis.
Most guidelines suggest limiting these injections to around three or four per year, depending on the patient's condition and response. The cumulative exposure to steroids, especially over many years, is factored in when making long-term decisions, but there's no single cutoff.
3 Things To Do When Epidural Steroid Injections Don't Work
Consider physical therapy. You might need to enroll in physical therapy to strengthen some of the muscles and ligaments around your back. With extra support, your pain could start to wear off. Talk to your doctor about surgery.
Going on walks: Initial research suggests that going on a walk or brisk walking (Nordic walking) can help relieve back pain if done regularly – for instance, every two days for 30 to 60 minutes.
The most painful places for a cortisone shot are typically small, sensitive areas with dense nerve endings, like the palm of the hand, sole of the foot (plantar fascia), fingers, toes, or ankle joints, because they have less space for the medicine and more surface nerves compared to larger joints like the shoulder or knee. Pain is also worse if the tissue is already severely inflamed, and the needle size can play a role.
It's OK to shower. Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours. Infection is a rare side effect and usually takes several days to present.
Resting after your cortisone injection
This rest period is crucial because it allows the medication time to work without additional stress or strain on the area. During this time, avoid strenuous activities, heavy lifting, or any movements that could aggravate the pain or cause injury.