An epidural injection is given into the space that surrounds your spinal cord (called the epidural space). A spinal injection is given directly into the fluid that surrounds your spinal cord (called the cerebrospinal fluid). The injection can be a local anaesthetic or a medicine to relieve pain.
What are the symptoms of nerve damage?
Nerve damage is a rare complication of spinal or epidural injections. A single nerve or a group of nerves may be damaged. Therefore, the area that is affected will vary and may be small or large.
The symptoms will depend on the nature of the nerve damage and which type of nerves have been affected. Nerves may be sensory nerves, which help you to feel light touch, pain or whether something is hot or cold. The other main type of nerves are the motor nerves, which take nerve impulses to the muscles in your body and so control movement.
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.
Most people with this type of nerve damage make a full recovery over a period of time, usually between a few days and a few weeks.
Permanent nerve damage resulting in loss of the use of one or more limbs (paralysis) and/or loss of control of your bladder or bowel is very rare.
What causes it?
The main ways in which nerve damage can be caused by a spinal or epidural injection are by:
- Injury caused by the needle or the catheter.
- Blood clot (haematoma).
- Inadequate blood supply.
Read more about the causes of nerve damage after a spinal or epidural injection.
How do anaesthetists prevent it?
Epidural and spinal injections are performed by anaesthetists, who are very highly trained at performing these procedures. They are also trained to be aware of nerve damage and the steps that are required to prevent nerve damage.
If you have an epidural or spinal injection, the nurses in hospital will make regular checks until everything returns to normal. This should help to spot any possible nerve damage very early so treatment can be started immediately if needed.
Find out more about how nerve damage after a spinal or epidural injection can be prevented.
What are the treatment options?
If you are concerned you may have nerve damage then you will be seen by a doctor, who may refer you to see a doctor who specialises in nerve problems (a neurologist). Tests may be done to try to find out exactly where and how the damage has occurred. These tests might include:
- Nerve conduction studies (very small electrical currents are applied to the skin or muscles and recordings made further up the nerve. This shows whether the nerve is working or not).
- Magnetic resonance imaging (MRI): a form of body scan.
- Computed tomography (CT): a form of body scan.
If any treatment is needed then this may include physiotherapy and following any advice about regular exercises that will help. If you have any pain then medicines can be used to relieve the pain. See separate leaflet called Neuropathic Pain for more information.
Occasionally an operation is necessary, either to repair a nerve or to relieve the pressure on a nerve.
Find out more about the treatment options for nerve damage after a spinal or epidural injection.
How likely is permanent nerve damage?
Permanent damage to nerves is very rare. The risk of longer-lasting problems after a spinal or epidural injection is:
- Permanent harm occurs between 1 in 23,500 and 1 in 50,500 spinal or epidural injections.
- Nerve damage to both legs (paraplegia) or death occurs between 1 in 54,500 to 1 in 141,500 spinal or epidural injections.
These figures can only give you a rough idea of the risks. The risk may be higher or lower depending on your general health and the reasons for you having the spinal or epidural injection.
Further reading and references
Nerve damage associated with a spinal or epidural injection; Royal College of Anaesthetists, last updated February 2017
Cook TM, Counsell D, Wildsmith JA; Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists. Br J Anaesth. 2009 Feb102(2):179-90. doi: 10.1093/bja/aen360. Epub 2009 Jan 12.
Hi there, I am just wondering if anyone else has suffered with bladder numbness following a spinal Anaesthetic. I had my right hip replaced last year and my bladder has been virtually numb ever...shirley84100
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