This resolves in 10 minutes with pumping the legs and gentle twisting of the spine (by the patient). Was the OP using fluoro? Was this a virgin spine? Have had increased LBP with ESI (5cc injectate, 5 cc contrast) in stenosis patients. I've never had new onset back pain with blood patch. My buddy is working today and she has not come in to see him so I'm hopeful that means she is better. I like the idea of giving her a call to check on her - I'm back at work tommorrow so maybe I will call then. In residency we were trained to inject until the patient felt fullness and relief or to max of 25 or 30 cc.

Point taken about the volume - next time I think I will use 10-15 cc (I try to avoid this procedure anyway if possible). I don't remember seeing back pain this significant after this procedure before, but I figured like several have stated it was pressure on the nerve roots and would resolve. This lady actually seemed pretty responsible, but I was a little nervous about her sxs. She had her mom and husband to take care of her that evening and the next day, and I told her if there was no improvement to return the next day, and if at any point she felt she was getting worse to return immediately. So - I talked to her about problem signs to look for (neurologic sxs etc) and I let her go. I considered giving her a little fent or maybe some toradol for the pain, but she said she was ok and really wanted to go home.

While I appreciate noy's point about the versed helping anxiety - this didn't seem to be an issue with this particular patient.

T pain epiphany alternate cover