Expert: Ronald Levy, M.D. - 10/13/2007

Question
I gave birth 2 weeks ago, and had problems occuring when given the epidural and had no freezing in my left thigh to knee.  I was topped up three times and still felt unbearable pain with each contraction.  The pain did subside after giving birth.  Today, I still experience burning, discomfort in the left leg, have difficulty walking and sitting for prolonged times, and can't sleep on my left side.  I am taking ibuprofen, alleve and extra strength tylenol.  I am breastfeeding.  I am using cold packs and heating pads to the area. Can you tell me what I am experiencing and if there is anything I can do to heal faster?  I have tried stretching and massaging the area but only receive short term relief. I realize that you cannot tell me how to deal with the pain management but if I knew a little more about what I am experiencing and the length of time this will take would be helpful.  
My family doctor is away until next week and I will hopefully get in for an appt then.

Thank you for your time,
Lucy

Answer
It is not unusual to have a patchy block as you describe but the post preocedure problems are rare. Your problem could be related to three possibilities. 1) During delivery, the head of the baby pushed down on your pelvic nerves causing injury that is usually self-limiting. 2) If your legs were in stirrups, there could have been pressure on the nerves from this which is also usually self limiting. 3) The epidural needle hit a nerve on the way in (did you feel a tingling down your leg when they placed it). While all of these are generally self-limiting, they can rarely progress to Reflex Sympathetic Dystrophy Syndrome (also called Complex Regional Pain Syndrome). This is a chronic problem that is difficult to treat. I would recommend going to see either an anesthesia pain specialist or neurologist for evaluation to rule out this possibility. I would not wait for your family doctor.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston