Expert: JM Starkman, MD - 8/28/2009

Question
Hello! I was in a car accident this past Feb and have 2 herniated discs and 1 bulging disc in my lumbar, my pain specialist also said I have an elevated ligament and "degenerative disc disease".  I don't know what exact discs but they are right above my buttocks.  I have had numerus procedures done: tp shots, epidurals, freezing the nerves and most recently 3 cortizone injections through a catheter that my doctor puts it  in between the beginning of my buttocks. Unfortunatly, nothing has worked and I am still in a great deal of pain.  My doctor is hesitant to refer me to a surgeon since I am only 22.
  My question pertains to my last catheter injection.  I always go to the same one day surgery center to have my procedures done.  2 nurses informed me that I am having the injection by my neck.  I argued with them that all previous injections are on my lumbar, NEVER in my neck.  1 nurse said it is in my file that it is going to be done.  Upon further investigation, they realized they were wrong after they gave my anesthesiologist my report and he realized that the report was wrong because it still said my neck.  They later re-wrote it.  
My anesthesiologist also gives me general anesthesia through an IV.  I usually had problems with that because days after the procedure, I was still numb from the waste down.
This time, I woke up I believe during the procedure because I woke up screaming and struggling because of the horrible pain I felt in my back.  It felt like many needles were inside of me.  The staff told me to calm down and they helped me on my gurnee and rolled me back to my room.  I was still woozy and was dazing in and out. when I finally came, I felt a tremendous amount of pain in my back, but not where I usually feel pain, it was more towards the middle of my back.  I freaked out because this has never happened to me before and I know I woke up because I do not dream while I am under.  I asked the nurses if anything went wrong and they said no, it went smoothly.  I told them I was hurting in a place I never hurt before.  They told me it was "normal"  this is my 7th procedure altogether and I have NEVER felt pain elsewhere.  They gave me 2 vicodins (which they have also never given me pain pills before).  I also rest for only 15-30 mins, but this time I was resting for an hour there.  When I had to get dressed, I noticed that my underwear wasn't just stained with iodine (which i know is normal) but it was also drenched with blood (which I never had before).  It is also not that time of the month yet either. And they had to re-bandage where my catheter was (which was the first they have ever done that as well).  My back is still killing me, both where my bad discs are as well as the middle of my back.  I would like to know if something went wrong, or am I just over reacting?    
P.S. I am sorry for the long question, but I am trying to be as specific as possible.   Thank you

Answer
Thank you for providing me with the detail and specifics (age, time since accident, etc.) necessary to adequately attempt to answer your question.  What you left out though, was the length of time between your last injection (about which you're detailing) and the writing of this question (?day?week?month?)

First, your pain doctor is correct in trying to keep you out of surgery, which should be considered a last resort.  Surgery for this type of problem is laden with long term complications and is best reserved for serious bulging disc problems (e.g. legs becoming paralyzed, loss of bladder control).

The epidural space into which was injected the steroid medication is really very vascular.  That means that there are many blood vessels there, and since the injection that is done is always done without the ability to "see" the vessels, the injecting needle may puncture the vessel and cause bleeding.  If the blood accumulates, it can press on the nerves in the area causing compression instead of decompression---and make your pain worse.  As long as the blood drains out (as it did in your case) it rarely is a serious matter.  You're not over reacting--I wish your pain doctor had explained this to you.  If symptoms get worse instead of better be sure and contact your doctor directly.  Go to the ER if you lose control of your bladder function or your legs feel weak or increasingly dysfunctional.  

There are many options for the treatment of bulging discs.  Research these as much as you can to make the right choice about getting over this.  Thoroughly consider the complications to any "laser", "surgery", "non-invasive", "percutaneous", or other important-sounding options offered  you.  I am sorry to report that many of these are money-driven;  some will work, some won't.
I'm a big believer in less-is-more: passive exercises and gravity devices (you know, those slant tables where you sort of 'hang' inverted to stretch out your back) have helped many people.  If you're overweight lose it!.....take every bit of extra-weight-stress off your back.