Spinal injections are a common approach for managing back and neck pain. Patients considering these procedures often wonder about potential outcomes, particularly if pain might increase afterward. While the primary goal is pain reduction, temporary discomfort or increased pain can occur. This temporary experience is typically part of the healing process and usually resolves quickly.
Expected Post-Injection Discomfort
A temporary increase in localized pain or discomfort immediately following a spinal injection is common and anticipated. This sensation can stem from the needle’s insertion, similar to soreness after any shot, leading to mild bruising or tenderness. Some individuals might also experience minor muscle spasms in the treated area. When corticosteroids are administered, a “steroid flare” can occur, causing a brief increase in inflammation and pain before the medication’s therapeutic effects begin. This post-injection discomfort is generally mild, subsiding within a few hours to two or three days as the body adjusts and the medication starts to work.
When Pain Worsens: Causes and Warning Signs
While temporary discomfort is common, pain that significantly worsens or persists beyond the initial few days warrants closer attention. One potential cause is temporary nerve irritation, where the needle or medication briefly irritates a nerve root, leading to increased localized pain that generally resolves. Another possibility is a pronounced inflammatory response to the injected material, where the body reacts strongly to the medication itself. Though rare, an infection at the injection site or within the spinal canal is a serious complication, characterized by progressive pain, redness, and warmth.
An allergic reaction to the anesthetic or steroid medication can also cause increased pain, along with other symptoms like rash or difficulty breathing. Accidental dural puncture, where the needle penetrates the dura mater (the membrane surrounding the spinal cord), can lead to a spinal headache, often severe and worse when sitting or standing. In some instances, a hematoma (a collection of blood) can form around the injection site, causing pressure and increased pain. The injection might also temporarily aggravate an underlying spinal condition if the procedure stresses sensitive tissues.
It is important to recognize specific warning signs that suggest a serious issue requiring immediate medical evaluation. These include severe, unremitting pain that does not improve with typical pain relief measures, or new onset of weakness, numbness, or tingling in the legs or arms. Other concerning symptoms are a fever, chills, or significant redness and swelling at the injection site, which could indicate an infection. The sudden loss of bowel or bladder control is an urgent neurological symptom requiring immediate medical attention. A severe headache that worsens when upright and improves when lying down, particularly if accompanied by nausea or neck stiffness, should also prompt immediate contact with a healthcare provider.
What to Do if Pain Worsens
If pain significantly worsens or persists beyond the expected initial discomfort after a spinal injection, communicate promptly with your healthcare provider. Immediately contact your doctor if you develop any of the warning signs discussed previously, such as severe or escalating pain, new or worsening weakness, numbness, fever, chills, or any loss of bowel or bladder control. When contacting your provider, describe the nature of your pain, including its location, intensity, and how it has changed. Also report any associated symptoms, such as changes in sensation, motor function, or body temperature.
For mild, expected post-injection soreness, apply ice packs to the injection site for the first 24 to 48 hours to reduce swelling and discomfort, followed by moist heat if pain persists. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be used as directed to manage discomfort. Do not self-diagnose severe symptoms or delay seeking professional medical advice for any concerning changes. Your medical team can assess your symptoms and determine the appropriate course of action, ensuring your safety and optimal recovery.
Optimizing Recovery After an Injection
Following a spinal injection, specific post-procedure practices can support healing and minimize discomfort. Rest and modify your activity for the first 24 to 48 hours after the injection. During this period, avoid strenuous activities, heavy lifting, or any movements that place excessive strain on your spine. Limit prolonged sitting or standing to prevent increased pressure on the injection site.
Staying well-hydrated by drinking plenty of fluids can also support your body’s recovery. Adhere to any specific post-procedure instructions provided by your physician, as these are tailored to your injection type and medical history. A gradual return to your normal daily activities is advisable, increasing your activity level as comfort allows. Attending all scheduled follow-up appointments is important, as these visits allow your healthcare provider to monitor your progress and assess the injection’s effectiveness.