Previously on this blog, we've examined the impact that pregnancy can have on scoliosis
and discussed the ways in which we at Scoliosis SOS can help. However, there's one fairly common question that we failed to cover last time around: if you have a curved spine, can you have an epidural to help with the pain of giving birth?
What is an epidural?
An epidural is a type of steroid injection administered into the 'epidural space', which lies between the covering of the spinal cord and inside the bony spinal canal. The medication reduces pain by coating the nerve roots and the outside lining of the facet joints in the areas near the injection.
An epidural is administered by an anaesthetist, who will first insert a drip into your arm to administer fluids whilst you are having the epidural. You will then be asked to sit leaning forwards - or to lie on your side with your knees drawn up - in order to allow the anaesthetist to begin the procedure of inserting the epidural. First, an injection of local anaesthetic will be used to numb the skin where the epidural will be inserted; then, a needle will be used to insert a fine plastic tube between the bones of your back.
The needle is then removed, leaving the tube to be used for administering the pain relief drugs. While this will usually make it difficult to walk around and cause unsteadiness on your feet, some hospitals are able to offer mobile epidurals that allow you to walk around.
Scoliosis and epidurals
Cases of scoliosis vary hugely in their severity, and every spinal curve impacts the patient in different ways; the same is also true of undergoing an epidural. It is quite rare for back problems to prevent the use of an epidural during labour, but it may not be an option for some scoliosis patients, particularly those who have undergone surgery or have a curve in the lower (lumbar) spine.
Due to the fact that the epidural is placed in the lower spine, a spinal curve in this region may present difficulties for the anaesthetist, who may not be able to safely inject the epidural catheter in order to administer the pain relief medication. If the scoliosis impacts the patient's middle to upper spine, this should not present a problem, although it is still important for the patient to make the doctor/nurse aware of their condition beforehand.
If you have undergone spinal fusion surgery to correct a progressive curve, your doctor may not wish to risk disrupting the implant and/or giving you an infection, both of which can occur when administering an epidural. This may cause them to advise you against receiving an epidural.
If you are a pregnant scoliosis sufferer and you would like to have an epidural when you go into labour, the most important thing for you to do is to speak with your doctor and anaesthetist, who will be able to give you professional advice and guidance based on your individual circumstances. Not only will this provide you with a truly informed understanding of the possible risks involved (and the likelihood of success), it will also enable you to discuss alternative methods of pain relief in the event that an epidural is not possible or presents too much of a risk.