Back Pain: Is It Nerve Damage After Steroid Injection?

Back pain

I previously experienced back pain due to a sports injury and visited an orthopedic specialist.
I received a steroid injection at the site of pain in my left upper back, which alleviated the discomfort.
However, since the injection, the injection site has been painful, and I have also been experiencing pain, numbness, and tingling throughout my entire left arm.
It's difficult to pinpoint the exact location of the pain.
Could this be nerve damage? Which specialist should I consult? Thank you.

Yang Yafeng, 40~49 year old female. Ask Date: 2022/01/16

Dr. Huang Weiqing reply Rehabilitation

It is generally uncommon for local injections to cause nerve damage; most cases are exacerbations of pre-existing cervical nerve issues.
It is recommended to follow up with a neurosurgeon or a rehabilitation specialist for treatment, and to arrange for magnetic resonance imaging (MRI) or nerve conduction/electromyography studies.

Reply Date: 2022/01/16

More Info

Back pain following a steroid injection can be concerning, especially when accompanied by symptoms such as pain, numbness, or tingling in the arm. It is essential to understand the potential causes of these symptoms and the appropriate steps to take for diagnosis and treatment.

When a steroid injection is administered, particularly in the spinal region, it is intended to reduce inflammation and alleviate pain. However, there are instances where patients may experience increased pain or new symptoms following the injection. This can occur for several reasons:
1. Inflammatory Response: After a steroid injection, some patients may experience a temporary increase in pain due to an inflammatory response. This is often referred to as a "rebound effect," where the body reacts to the injection, leading to heightened discomfort before the intended anti-inflammatory effects take place.

2. Nerve Irritation or Damage: If the injection inadvertently irritates or damages nearby nerves, it can lead to symptoms such as pain, tingling, or numbness radiating down the arm. This is particularly possible if the needle inadvertently touches or punctures a nerve during the procedure.

3. Post-Injection Complications: In rare cases, complications such as hematoma (a localized collection of blood outside of blood vessels) or infection can occur, leading to increased pain and neurological symptoms.

Given your symptoms of pain and discomfort in the injection site, along with pain and tingling in the left arm, it is crucial to seek further evaluation. Here are the recommended steps:
1. Consult a Specialist: You should consider seeing a neurologist or a pain management specialist. A neurologist can assess for any potential nerve damage or irritation, while a pain management specialist can evaluate your pain and recommend appropriate treatment options.

2. Diagnostic Imaging: Depending on your symptoms, your doctor may recommend imaging studies such as an MRI or CT scan to visualize the spine and surrounding structures. This can help identify any issues such as herniated discs, nerve compression, or other abnormalities.

3. Physical Therapy: Engaging in physical therapy may be beneficial. A physical therapist can provide exercises and treatments aimed at reducing pain, improving mobility, and strengthening the muscles around the spine.

4. Pain Management: If your pain persists, your doctor may suggest various pain management strategies, including medications, nerve blocks, or alternative therapies such as acupuncture.

5. Monitoring Symptoms: Keep track of your symptoms, including any changes in pain intensity, the nature of the pain, and any new symptoms that may arise. This information will be valuable for your healthcare provider in determining the best course of action.

In conclusion, while it is possible that your symptoms may be related to nerve irritation or damage following the steroid injection, a thorough evaluation by a specialist is necessary to determine the exact cause and appropriate treatment. Early intervention can help manage your symptoms effectively and improve your quality of life.

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