Expert: Dr Ian Jackson - please note UK based - 4/15/2007

Question
QUESTION: Is it possible to have tachycardia hours after a transforaminal epidural steriod injection?  I asked the question to my nurse and she said it was anxiety.  Thing was, I was watching a comedy movie, relaxed in my recliner, and I noticed the picture was pulsating.  Then my chest started pounding, I think it was about 130?  The only reason I ask, is because I had a second injection today and now the same thing is happening, it's just weird.  Same thing, watching a movie, relaxing, not anxious.
ANSWER: Sarah
It is difficult to see a link between the steroid injection some hours previously and this tachycardia. However I learned a long time ago never to say anything for definite when dealing with the human body!
If you are due to have any more injections then it would be worthwhile reporting this back to your doctor who is doing them.
Sorry I can't shed any further light on these episodes.
Kind regards
Dr Ian Jackson

---------- FOLLOW-UP ----------

QUESTION: Thank you for your honest answer.  The only reason it concerns me a little is that I regularly take a beta blocker for IST.  This is the first time I've had any break thoughs like that in a very long time and it caught me offguard and was really strange.  

Pardon me if I bother once more as well.  How long is the leg weakness suppose to last?  After my first injection I was up and about with no problems the next day.  Today I'm still wobbly and I don't trust my legs to drive.  Thanks for your time and expertise, I very much appreciate it!
ANSWER: Hi Sarah
I did wonder if you had a background problem with a tachydysrhythmia and nearly asked about this in my answer.
The leg weakness is very unpredictable as is the whole outcome after these injections (having said that it is important that you know I have willingly had a series of them over the years for my back problems!)
It should settle over a few days but if it continues to be a problem then you should contact your doctor to ensure nothing else is causoing problems.
Kind regards
Dr Ian Jackson

---------- FOLLOW-UP ----------

QUESTION: Because I do have what you called a tachydysrhythmia, did that predispose me to have one of those episodes so many hours after the injection?  And what would it be from, the local anesthetic?  Shouldn't my doctor have warned me about that?  

Did you have any luck with these injections?  I've had two sets (two each time) so far and I am hoping this second round will allow me to start PT without any problems.  This ongoing thing is really starting to put a crimp in my life and work.  Is there an end to it? By the way, my legs are past the wobbly heavy feeling and into the shakey area now.  Thank you again for your prompt reply, I very much appreciate it.

Answer
Hi Sarah
As you have a propensity to get a fast heart rate that is controlled by beta blockers then one can say you are more likely to get an attack due to breakthrough from some reason e.g. perhaps tummy upset so you don't absorb your drug as well. Other than this I still can't see the mechanism for this to happen so many hours after the injection. Absorption of local anaesthetic would have been maximal long before then.

I did have luck with my injections and got myself mobilised and to the gym as often as possible. Careful what I do but walking fast uphill on treadmill with a bit of running, cycling, cross training etc. I still have aches but it has worked for me.
All the best