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Epidural for chronic back pain Q&As

Published by Bupa's health information team, March 2009.

Answers to questions about epidural for chronic back pain

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Why do epidurals affect blood sugar levels?

Steroids can cause your blood sugar levels to rise. If you have diabetes, you should tell your doctor before you have the procedure.

Explanation

The side-effects of steroids can include high blood sugar levels (hyperglycaemia) and diabetes.

Any steroid treatment, including epidural injections, can cause a rise in your blood sugar levels. This is caused by an increase in the body's sugar production and a resistance to the effects of insulin, the hormone that controls blood sugar. This means your body isn't as good at dealing with the excess sugar in your blood. This could cause you to develop diabetes. You should see your GP if you:

  • are thirsty despite drinking plenty of water
  • are passing urine more often than normal
  • lose weight without trying

Your blood sugar levels will be checked after your epidural, but if you have diabetes you should tell your doctor before having the procedure. You should also check your blood sugar level when you get home.

The change in your blood sugar levels isn't usually large but you should make sure that you drink plenty of water and eat properly. If you have type I diabetes and you don't control your blood sugar well, you may be at risk of developing a condition called diabetic ketoacidosis. You should see your GP if you:

  • are passing urine more often than normal
  • are tired
  • are vomiting
  • have abdominal (tummy) pain

For more information about the effects of steroids on blood sugar levels, ask your doctor.

Further information

Sources

  • Joint Formulary Committee, British National Formulary. 56th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008:383-384
  • Longmore M, Wilkinson IB, Rajagopalan S. Oxford Handbook of Clinical Medicine, 6th ed. Oxford: Oxford University Press, 2004:294, 818
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How can I reduce stiffness in my back?

If your back is stiff or painful, you should try to control this with self-care, such as gentle exercise, before you try other methods of treatment.

Explanation

The best way to control acute low back pain is to stay active and to exercise. This can also help with chronic low back pain or stiffness after an epidural injection. The terms acute and chronic refer to the length of time a person has had a condition, not how serious it is.

A good way to relieve stiffness and mild pain is with gentle exercise to improve your strength and flexibility, such as walking, swimming or pilates. Even a small amount of exercise is better than none.

Alternatively, you can ask your GP to refer you to a pain clinic, sometimes called a back school. Specialists such as a physiotherapist (a health professional who specialises in movement and mobility) at the pain clinic will assess your back problem and give you a tailored exercise programme. He or she will also give you advice about improving your posture and relaxation techniques. For more information about pain clinics or back schools talk to your GP.

Bed rest isn't a good idea and can actually make your back pain worse.

If your back pain gets worse or lasts for more than a week or so, you should visit your doctor for more advice.

Further information

Sources

  • Effective health care: Acute and chronic back pain. NHS Centre for Reviews and Dissemination, University of York. 2000; Volume 6: Bulletin number 5. www.york.ac.uk
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I'm pregnant - how can I relieve my back pain?

Back pain during pregnancy is common. The best methods for relieving your back pain if you're pregnant are strengthening exercises, pelvic tilt exercises and water aerobics. You shouldn't do any heavy lifting while you're pregnant.

Explanation

As you go through pregnancy it's likely that you will have some back pain and this can get worse as your pregnancy progresses.

Back pain during pregnancy is caused by a number of things, including the following.

  • A change in your posture caused by balancing the increasing weight of your developing baby.
  • Loosening of the ligaments in your pelvic area - during pregnancy a hormone called relaxin is released, which makes ligaments more prone to strains.
  • Fluid retention within connective tissue.

Your back pain will generally be worse at night and can cause insomnia (an inability to fall asleep, or to stay asleep long enough to get a proper night's sleep).

Exercise programmes are the best way of relieving your back pain. You can do exercises to strengthen your lower back or pelvic tilt exercises to strengthen your pelvis. Water aerobics is also an effective method for strengthening your back. For more information about suitable exercises talk, to your GP.

It can help if you use a soft to pillow to support your back when sitting upright, or place a pillow between your knees when lying on your side in bed.

You can also try alternative methods of controlling your back pain such as acupuncture. Ask your doctor for more advice before having acupuncture, and check that the acupuncturist is fully qualified.

Further information

Sources

  • Pennick VE, Young G. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database of Systematic Reviews 1998, Issue 2. Art. No: CD001139.pub2. www.cochrane.org
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: March 2009

 

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