While an epidural seems like a better option for chronic back pain than opioids, there are risks involved, including paraylsis.
There’s a controversial treatment available for chronic back pain — an epidural. Using fluoroscopy for guidance, a physician can inject steroids and an anesthetic into the epidural space between the spine and the spinal cord in a simple outpatient procedure. However, what many not be discussed during a pre-procedure consultation is the risk this procedure carries with it – paralyzing the patient immediately after the needle is inserted.
When an epidural is used for nerve root blocks to help with back pain, however, lasting paralysis is always a risk. The proposed cause is the “abnormally low position of a particular artery” and “the need’s undetected penetration” of that artery. If there are any avenues for recovery, oftentimes doctors are reluctant to outwardly work with the patient to explore these because to do so would be an admission of fault and open the practitioner up to a lawsuit.
However, research has shown time and again that open communication with patients following a medical mishap reduces the possibility of the families pursuing the issue in court. If remain accessible after the event, apologizing when appropriate, there are fewer liability claims. According to a 2010 study, the U.S. annual medical liability system costs $55.6 billion, or 2.4 percent of total health care spending.
Not only are medical personnel at risk of a lawsuit, but significantly altering a patient’s life in a very negative way severing deflates the ego, too, and may cause the physician to question his or her ability to practice. Luckily, the landscape is changing, and some facilities are private practitioners are now pushing for full investigations and patient disclosure, as well as offering compensation for injuries. But progress around this issue has been slow-moving.
Nerve stimulation after paralysis has offered some promise to patients hoping to regain feeling in those with spinal cord injuries. “Electrically stimulating the neurons in the spinal cord in a pattern that recapitulates the brain’s control of walking,” state the authors of a journal study on form of therapy.
“One misunderstanding about spinal cord injury is that…the whole spinal cord is devastated. Really, it’s just a few thousand neurons at the site of the injury that are destroyed,” says Susan Harkema, a spinal cord researcher at the University of Louisville in Kentucky. “Yes, that’s devastating, but there are many more millions of neurons that are still healthy, alive, and communicating. [The] circuitry is there, and we can take advantage of it.”
An array of wirelessly controlled electrodes are placed into the space around the spine to reactivate healthy nerve functioning.
“The advantage of [this] approach that this group has used is that they are targeting specific levels of the spinal cord based on the area that the individual wants to activate,” says Edelle Field-Fote, a physical therapist and spinal cord researcher at the Shepherd Center in Atlanta explained, adding, “If I wanted to cook a pot of beans, I don’t turn on the entire stovetop. It wastes much less energy if just turn on the burner that I want. That’s kind of what they’re doing here.”
Unfortunately, medical mishaps still happen, and the spine is a delicate area. Injuries don’t always occur at home. Those considering epidurals for chronic pain should be notified up front about this risk.