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What Causes Fast Heart Rate And Anxiety After Getting Epidural Shots?
Question: Exactly 4 weeks ago, I had two epidural shots in my spine for two herniated disks. At that time, apart from some serious nerve pain due to the injections, I had no other problems and was feeling almost good by the next day. Unfortunately, within a few days, the pain had returned and I had my second round of shots earlier today.
This time, things didn't go nearly as well. I was in more pain from the shots, had burning and numbness all in the lower part of my body, numbness and tingling in my legs, and became extremely dizzy. Now that I'm back home, I'm having trouble with a rapid heartbeat and a generalized feeling of anxiety.
I should note that when I first had the sudden spine problems, which was around Thanksgiving, I was given the 6-day super-pack of tapering Prednisone doses. I initially did fine, as I've always done when given lower but steady doses of Predisone, but I was having seriously fast heartbeats and near-fainting by the time I was almost done with the pack. I went to the ER, where we initially suspected it was an allergic reaction, though subsequent testing at an allergy clinic indicated this wasn't the case. It was probably just a bad side-effect from the cumulative dosing. Now I'm wondering if I'm having more side-effects, this time from the shots. Still, I'd think a localized couple of shots spaced four weeks apart wouldn't have much of a cumulative effect. I'm not (yet) at the point I feel I should get to the ER - which is good as I'm an hour's drive from the nearest hospital and the road conditions are very where I live due to a sudden snowstorm.
My questions are: Is this normal? Should I be concerned? I'm trying to manage it by doing deep breathing and trying to rest. Thank you.
Brief Answer:
Also consider repeating thyroid check...
Detailed Answer:
Hi,
I went through the details provided with diligence. Systemic side effects from intrathecal steroid shots are not common. But I agree with your doctors opinion that cummulative effects from three prednisolone shots may be a reason why you have fast heart rate + anxiety.
However if I were to be evaluating you, I would also check your thyroid hormone levels. Overactive thyroid hormones can also explain fast heart rate and anxiety. Since you are on 150mcg synthroid, I would make sure your hormones are perfectly in euthyroid state and not overacting before pointing my fingers on intrathecal shots. Hence it makes sense to check your thyroid function tests again if wasn't tested at the ER.
Hope this helps. Let me know if you need clarifications.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My thyroid levels were recently checked and still solidly good for that dosage, to the point I'm about to have a refill called in at the same dosage. My vitamin D levels are still low, though I'm certain I haven't been on the correct dosage long enough to appreciate the benefits. Otherwise, I might have been worried that my D levels were too high, causing some of the problems. My blood pressure tends to stay low, even very low (94/60 is fairly common for me, and it can drop), though it had gone "up" to normal after having these shots. My temperature also stays a bit low, at around 97F.
I've had absolutely no flushing since these last shots, nor have I had any hives. I have had a bit of a headache, in addition to the feelings of anxiousness and being jittery. Now that it's late (midnight) my time, the feelings have subsided somewhat, though I've started having some tingling in my arms. It seems rather stubborn and won't diminish, even when changing positions and doing some arm exercises.
It strikes me as odd that I never had any similar problems with the low doses of Prednisone, even when taken for very long amounts of time. Since the high-dose tapering pack of Prednisone, I've become aware that I can have some serious side-effects due to a cumulative effect. At the same time, the doctor who preformed these injections insisted that if I could take low doses of Predinsone, I shouldn't have any problems with these shots as they are low dose and only given to the problem areas, rather than throughout the whole body.
At this point I won't head to the ER unless the problems get worse during the night or tomorrow. I'm hoping the worst is over, but I'd still like to know what's happening. I've even found myself wondering if a stronger dose was given accidentally (or deliberately, while failing to tell me), or if the injection fluid might have affected other areas besides the one being treated. I can say I feel that something went wrong today, in ways that didn't effect me last month when I had the first round of shots. I'd be loathe to get another shot, even if I continue having crippling problems with my back.
I sincerely appreciate your input and would love any further advice you might be able to offer.
Brief Answer:
I don't feel you need to visit the ER...
Detailed Answer:
Apologies if I disturbed your sleep again. I didn't realize it was late midnight. Before I proceed to comment further, first I would want to point out that this condition doesn't require ER visit.
Now getting back to your query,
1. It's good to know that thyroid hormones are stable. However if the last test was before you had these fresh symptoms, it would be worthwhile to repeat the test and make sure they stayed in euthyroid limits. I insist on repeating the tests as both anxiety, jittering as well as numbness are strong indicators of overacting thyroid.
2. It is very uncommon to find vitamin D toxicity unless you are on particularly very high vitamin d units. Further the complaints are unrelated to hyervitaminosis D, hence you need not be worried about that.
3. A low vitamin D can explain tingling sensation, but since you are diagnosed with osteopenia long time ago and are on supplements it is fairly unlikely to be related to deficiency.
4. Steroid is the mainstay of allergy treatment. And it is very rare to find steroid allergies. Moreover symptoms of allergy are expected to be masked when one is on steroids. Therefore unless you have severe skin manifestations, it is less likely that these are steroid induced allergy.
5. Systemic effects following steroid is dose dependent. It also depends on the type of steroid used and the route of administration. Unless some of the injected steroid got into the blood circulation it is fairly uncommon to see those causing systemic effects. Presuming you had a decent procedure, cummulative effects of prednisolone has most likely led to these unwanted effects.
Nevertheless I don't feel you need to consider ER visit. I don't find any conditions that would delay the rate of metabolism; so you should feel better in a day or two.
6. Chances of accidental prednisolone overdosage is exceedingly low. The preparations before administering injections is double checked and verified.
Hope this helped you. Good luck and sleep well!!!
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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