Positive Outlook – May 2013 2-3

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Positive Outlook – Issue 2.0 – May 2013

SIGNIFICANT BACK PAIN FOLLOWING EPIDURAL INJECTION/PPIX Recommendations
The majority of epidural abscesses are missed on initial evaluation and frequently end up in litigation. If your patient presents with significant back pain following epidural injection or any invasive procedure, or they have a history of drug abuse, don’t hesitate to get an MRI with gadolinium. If the pain remains unrelenting despite conservative management, a repeat MRI may show startling changes.

Remember that drug addicts are not always seeking narcotics and are predisposed to epidural abscesses. If missed, the end result can be disastrous. Alert your staff that if a patient calls and states they are in extreme back pain, consider bringing them in for evaluation or sending them to the ER.