This is a rare complication that may occur if a small hole is made in the fibrous sac and does not close up after the needle puncture. These small holes are only made in less than 1% of epidural injections and usually heal on their own. The spinal fluid inside can leak out, and when severe, the brain loses the cushioning effect of the fluid, which causes a severe headache when you sit or stand. These types of headaches occur typically about 2-3 days after the procedure and are positional - they come on when you sit or stand and go away when you lie down. If you do develop a spinal headache, it is OK to treat yourself. As long as you do not feel ill and have no fever and the headache goes away when you lay down, you may treat yourself with 24 hours of bed rest with bathroom privileges while drinking plenty of fluids. This almost always works. If it does not, contact the radiologist who performed the procedure or your referring physician. A procedure (called an epidural blood patch) can be performed in the hospital that has a very high success rate in treating spinal headaches.
Your exercises are completely based on your diagnoses and the procedures you undergo to combat the pain. One prominently used, non-surgical method is epidural steroid injections . The steroid is injected into the epidural space and decreases inflammation around the spinal nerves. If you are undergoing epidural steroid injections, you will want to take the rest day off for a little downtime to not cause unnecessary inflammation. After your brief resting period, you will want to resume normal, but not overly vigorous activity. It is best to start with walking slowly. For every 30 minute sitting period, you should take 5 to 10 minutes to get up and walk around. It may be uncomfortable at first, but if you stick with regular slow activity for the first day, you can build up to more activity.
Radiculopathy occurs when something irritates a spinal nerve—say a “slipped disc” causing a pinched nerve. This is also called sciatica . There are resident stem and other cells in the local tissues everywhere in our body. Many live around blood vessels. These are obviously also present in the disc and nerves in the epidural space and they usually play an important role in suppressing inflammation and repairing damage. We know, based on a copious in vitro (lab) data, that the high-dose steroids used in epidural injections can kill these cells. So the progression of the series of epidural steroid injections looks a little something like this: