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What Causes Excessive Sweating After Getting Diprophos Shots For Lower Back Pain?

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Posted on Fri, 24 Jun 2016
Question: Hi doctor, is it possible that after having been injected Diprophos in her lower back ( sacro-iliac) to try to stop local ( probably muscular rather than articular ) pain , and with various results she finds herself at night in intense sweat, needing two or even three changes of night clothes. Over the last years she's had at least three of these injections and she does remember the same sweat ............
Another question, how often is it wise to repeat safely this treatment ? XXXXXXX Low on behalf of spouse Helene.
doctor
Answered by Dr. Dr. Matt Wachsman (25 minutes later)
Brief Answer:
She DOES remember the sweats?

Detailed Answer:
This is the most important feature, and it is quite important. The complications of these injections are bleeding (technically everyone has some, about 10 to 15 milliliters and not significant), hitting a nerve (you would know), and infection. With infection being the worst. Signs of infection include sweats. If you "always have that" then I cannot say whether it is or is not infection, but generally we would recommend immediate evaluation anyway since spinal infection can cause permanent disability and pain. Besides the injection causing an infection, the steroids may also UNMASK one (such as tuberculosis) by lowering the resistance to an infection that is already there and allowing it to pop out.

Ah, while we do not have this medicine by that name in the United States, it is the best medicine for spinal injection and quite common. It is a modulator of the immune system, and while one would expect an anti-inflammatory steroid to BLOCK all signs of infection, night sweats occur after getting steroids by any means. Furthermore the trauma of a spinal injection itself can cause ONE sweating episode.

Yeah, it could be a serious infection and it needs immediate attention, even if it turns out to just be a reaction to the steroids.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (33 minutes later)
Thank you Doc, I translated your message to my spouse ( Belgian French) and we decided to follow your advice and get a serious blood test done asap, just to be sure to be sure.
Probably steroïds are causing the sweating as ( sorry that I forgot to mention it before ) my wife's older sister had a similar reaction with the same steroïds.
Thx again and regards from Brussels
B Low
doctor
Answered by Dr. Dr. Matt Wachsman (37 minutes later)
Brief Answer:
Tricky......

Detailed Answer:
Ok, steroids cause a change in many functions including immunity. One of these changes you must be aware of is in blood cell movement. While infection causes the body to plain put out a lot of infection fighting cells (increased white blood cell count), steroids cause a change in the movement of immune fighting cells (they sit around, and pile up) this ALSO causes an increase in the white cell count in the blood, even while the ability to fight infection decreases.
So, I'm not sure a blood test can be helpful. Not even as helpful as looking at the back. Spinal infections are notoriously tricky to spot. A spinal tap is nearly 100% effective at finding them and all other studies are so so. BUT, if the sweats go away (especially if they go away in 1 to 2 days) and if the white count is NOT abnormal, the likelihood of any infection is pretty small. Ongoing night sweats are going to need more of an investigation.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Matt Wachsman (14 hours later)
THANK YOU again. Your advices will be followed.
I had asked you an additional question : how often can this injection of
Diprophos be safely perfrmed ?
doctor
Answered by Dr. Dr. Matt Wachsman (4 hours later)
Brief Answer:
There isn't clear information on this.

Detailed Answer:
The physicians who inject it each make up their own guidelines. There are some core scientific principles that would put constraints on it. Injection of betamethasone into a closed space takes about 24 hrs to have an effect and the drug will be present in the closed space for a month unless it physically leaks out. A good result occurs when the inflammation in the area does NOT immediately return after the drug is no longer there. The effect often lasts for months. Injection does cause minor damage and has risks. Continuous exposure to steroids will likely cause some degeneration of bones/muscles/ cartilege / tendons.

So, if someone gets 6 months of benefit from each injection one might seriously give it twice a year forever, since for nearly all of the time the benefit is there and no harm. If someone gets less than one month of benefit one might repeat trying it for a total of three tries (there is no scientific basis for this other than we like the number three), and then not give it ever again. If someone gets 3 to 4 months of benefit from it, and this is a very common situation, it is a gray area and different doctors do different things after a full year of injections. Some stop, some just continue. But by 1 to 2 years, things change. The area of injection often gets worse in a year and joint replacement is strongly considered. The patient gets tired of the injections. etc.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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What Causes Excessive Sweating After Getting Diprophos Shots For Lower Back Pain?

Brief Answer: She DOES remember the sweats? Detailed Answer: This is the most important feature, and it is quite important. The complications of these injections are bleeding (technically everyone has some, about 10 to 15 milliliters and not significant), hitting a nerve (you would know), and infection. With infection being the worst. Signs of infection include sweats. If you "always have that" then I cannot say whether it is or is not infection, but generally we would recommend immediate evaluation anyway since spinal infection can cause permanent disability and pain. Besides the injection causing an infection, the steroids may also UNMASK one (such as tuberculosis) by lowering the resistance to an infection that is already there and allowing it to pop out. Ah, while we do not have this medicine by that name in the United States, it is the best medicine for spinal injection and quite common. It is a modulator of the immune system, and while one would expect an anti-inflammatory steroid to BLOCK all signs of infection, night sweats occur after getting steroids by any means. Furthermore the trauma of a spinal injection itself can cause ONE sweating episode. Yeah, it could be a serious infection and it needs immediate attention, even if it turns out to just be a reaction to the steroids.