Although extremely rare, perineural or foraminal hematomas may occur as a serious complication of TFESI, even in the setting of a standardized procedure. Hematoma may cause worsening of symptoms in the acute and subacute phase following TFESI. Further investigation into the etiologies of such injuries is warranted and must be added to the considerations of pain physicians performing these procedures.
Current therapeutic options in the treatment of Dercum's disease have proven either ineffective or cumbersome. The use of transdermal lidocaine is a safe and non-invasive treatment modality that has been efficacious in alternate forms. The use of this medication might prove preferable to more invasive or risky treatment and warrants further investigation.
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