Hitting a nerve during an injection causes immediate, sharp, shooting pain, tingling, or a "pins and needles" sensation that can radiate, signaling the needle touched a nerve; if the needle isn't moved, this can lead to temporary (neurapraxia) or, rarely, lasting nerve damage, pain, numbness, or weakness, requiring immediate repositioning and sometimes further treatment.
Unlike some veins, nerves are not visible from outside the body, although you will definitely know if you've hit one while injecting because you'll experience extreme pain and no blood will enter the syringe when you pull back to register. You may feel an electric “burn” along your limb.
But here's the thing: nerves are everywhere. They run throughout your body, carrying messages between your brain and muscles. If a needle touches one, it can cause a little drama—like a sudden jolt, tingling, or weird shooting pain. That's your body's way of saying, “Hey, something touched a live wire.”
Nerve damage is usually temporary. In its mildest form the nerve damage may cause just 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. You may also get some weakness in one or more muscles.
With intramuscular injections, there is a risk that you could hit a nerve if you inject in the wrong place. This can produce more blood than usual, and may also cause lasting damage and paralysis in extreme cases.
Concomitantly, upon injection of the agent, the most frequent presentation included severe radicular pain and paresthesia, with almost immediate onset of variable motor and sensory deficits.5,16) The patient usually experienced a severe pain, described as the occurrence of burning, searing, electricity, or numbness ...
EMG tests and nerve conduction studies can help find out if you have a health condition that has damaged your muscles or nerves or how they work together. These tests can be done separately, but they are usually done at the same time.
Warning Signs You Should Not Ignore
Persistent numbness, tingling, or weakness in an arm or leg. Sharp, radiating pain that doesn't improve. Increasing redness, warmth, swelling, drainage, or fever. Limited mobility or loss of function near the injection area.
If a nerve is hit by a needle going in, it causes a sharp pain, often likened to an electric shock; the procedure must be stopped if this happens, as repositioning is required. [ 5 ] Both nerves have accompanying blood vessels, creating a bigger target for injury.
The signs of nerve damage include the following:
> Nerve damage occurs in less than 3 out of every 100 nerve blocks (<3%). The risk varies between the different blocks. The vast majority of those affected (92–97%), recover within four to six weeks. 99% of these people have recovered within a year.
In rare cases, the contact between the needle and the nerve causes irritation or nerve damage. The symptoms of nerve damage include irritation, pain, and numbness. If the symptoms persist long, you must consult your healthcare provider immediately.
Nerves are very fragile and can be easily damaged. They can be damaged by physical injury to the nerves, a viral infection, or due to drinking too much alcohol, for example. There are different severities of nerve injury ranging from mild bruising to a complete cut of the nerve.
Nerve damage – If the needle penetrates a nerve or blood vessel, it can cause severe pain, tingling, numbness, or even paralysis in extreme cases.
Injections can also be administered in the wrong site. The most common error is steroid injections (for example, Kenalog) administered into the deltoid or thigh instead of gluteal muscle. Deep intramuscular steroid injections must be given into the large muscles of the buttock.
When a needle grazes or “hits” a nerve during dry needling, you might feel a quick, sharp sensation. It's often described as a zapping or shooting feeling that travels along the nerve pathway. This happens because nerves are essentially your body's electrical wiring—they're designed to send signals to your brain.
Your treatment is based on the extent and cause of your injury and how well the nerve is healing. If your nerve is healing properly, you may not need surgery. You may need to rest the affected area until it's healed. Nerves recover slowly, and maximal recovery may take many months or several years.
If you experience weakness, tingling, numbness or a total loss of feeling, see your healthcare professional to find out the cause. It's important to treat peripheral nerve injuries early.
In the intramuscular injection group, perineural scarring involving the radial nerve was a common intraoperative finding, whereas in the sciatic nerve, contusion and neuroma formation were found in 54.3% of the patients. This finding demonstrates the nature of injury in these nerves.
Adults: Inject approximately 1cm away from the belly button if using a 4mm or 5mm pen needle length. Children: Insert the needle 2 adult fingerbreadths away from the belly button, and avoid any protruding bones. If using a longer pen needle consult your healthcare professional.
When to call your health care provider. Call your health care provider right away if you have: A fever of 100.4°F (38°C) or higher, or as directed. Severe pain at the injection site.
Errors when administering injections can cause abscesses and infections. In some cases, people may develop nerve damage. Hematoma or clotted blood pooling outside of the vein can also be an issue. In extreme cases, injection errors might even cause compartment syndrome.
The rule of 3's for nerve injury: Sharp, clean nerve injuries should be explored and repaired within 3 hours. Ragged, contusion injuries should have the ragged ends bound to a nearby anatomical structure immediately, then be repaired within three weeks. Closed injuries should be repaired within three months.
A nerve that is cut will grow at 1mm per day, after about a 4 week period of 'rest' following your injury. Some people notice continued improvement over many months. Sensory nerves are more resilient than motor nerves and can recover sensation months or years after injury. Motor nerves have a time limit for healing.
This can be especially useful for nerve-related pain, like sciatica, where both swelling and muscle tension are involved. Neither heat nor ice is universally “better” for nerve pain. Heat often helps ongoing nerve-related discomfort, while ice may help during sudden flare-ups.