(2004) analyzed data from 5,475 claims in the American Society of Anesthesiologists Closed Claims Project database between 19 1. This is mainly due to the facts that such complications are usually under reported, that there is limited statistical analysis of such incidences, and that only a small fraction of such complications ends up in litigation. It is difficult, however, to know the true incidence of complications. This requires an adequate appreciation of the risks and complications associated with the procedures. Consequently, prevention of complications should be one of the most important aspects of interventional pain management. The practice of chronic pain management has grown steadily in recent years. We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the procedural techniques with a clear understanding of the relevant anatomies. Other complications include spinal cord injury and peripheral nerve injuries, pneumothorax, air embolism, pain or swelling at the site of injection, chemical meningism, granulomatous inflammation of the synovium, aseptic acute arthritis, embolia cutis medicamentosa, skeletal muscle toxicity, and tendon and fascial ruptures. These infections include spondylodiscitis, septic arthritis, epidural abscess, necrotizing fasciitis, osteomyelitis, gas gangrene, and albicans arthritis. The most common complications appear to be infections that have been associated with virtually all of these injections. We found over 35 relevant papers in forms of original articles, case reports, and reviews. We conducted Medline research from 1966 to November 2006 using keywords complication, injection, radiofrequency, closed claim, facet, zygophyseal joint, sacroiliac joint, shoulder, hip, knee, carpel tunnel, bursa, and trigger point. The objective of this study is to review documented complications in medical literature that are associated with interventional pain management, specifically those associated with joint, tendon, and muscle injections. The doctor will call you back.Prevention of complications is one of the most important aspects of patient care in pain management.
Leave your name and phone number with the area code. Ask for the rehabilitation doctor on call. Poliak-Tunis call:Ĭall your referring MD for follow up visit two weeks after the injection. Increased redness, swelling, or pain around the siteĬall if you have any concerns or signs of infection.įor Dr. Together, we will review this record to decide the next step in your treatment plan.įever greater than 100.4° F by mouth for 2 readings, taken 4 hours apart Mail the form back to us in the pre-paid envelope we gave you. We will give you a pain log to complete for the next 14 days. It is fine to take a shower.Īfter the procedure, you may take your routine medicines and any prescribed pain medicines. No baths or soaking the injection site for 24 hours after the procedure. You may feel weak for the next 3-5 hours due to the medicine we gave you. Make sure your primary doctor adjusts your medicine to keep your blood sugar within your normal range. If you have diabetes, steroids may cause your blood sugar to increase. These symptoms do not require any treatment. These symptoms often occur within the first 24-48 hours and go away within a week. Some patients have facial and neck flushing, anxiety, nervousness, mood swings, or trouble sleeping with the use of steroids. Think about taking the pain medicine you were prescribed. This is called a pain “flare.” If this happens: When the local anesthetic wears off, you may have more pain. Some patients do not notice a change in their pain for up to 2 weeks. We then gave you a steroid that may not start working for 2-5 days. We first gave you a local numbing medicine that only works for a few hours. Your pain may take up to a couple of weeks to improve.
After 24 hours, you may also use heat if needed. For the first 24 hours you may apply ice to the site (20 minutes on and 20 minutes off) to decrease pain.
You may have a sore hip for the next 2-4 days. The doctor gave you a hip injection to decrease pain and inflammation in the joint.
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