Black Widow Spider Bite Signs Symptoms and The Management Approach

Please read and agree to the disclaimer before watching this video.
. Black widow spiders usually do not bite humans until provoked. It is not necessary that all bites cause pain. Some bites go unnoticed. Toxin injected by the spider affects the nervous system. After some time the bitten area shows signs of inflammation. Pain and swelling can be accompanied by tremors, muscle weakness, nausea, vomiting, and mild to severe abdominal discomfort. To the provider, the abdominal pain may seem like appendicitis or pancreatitis. The abdomen may be rigid like a board but non-tender on palpation.

Treatment is as follows
Clean the bite area with soapy water.
Apply cold compresses to the bite; it will limit the swelling and reduce the pain.
In case of a bite on a limb, elevate this limb.
Over the counter pain reliever, acetaminophen (Tylenol, others) or ibuprofen (Advil, Mortin, etc.) can be taken. Antihistamine (Benadryl) can be taken as well.
Tetanus immunization should be checked and updated if necessary with a booster.
Basic or advanced life support may be needed in case of severe symptoms.
Nitroprusside may be needed for hypertensive episodes due to envenomation. (Venom injection process.)

Antivenin can be given; however, it can cause a severe allergic reaction as it contains whole immunoglobulin G from horses. Deaths have been reported in the patients of asthma receiving antivenin. So, don't rush to antivenin as the other medications usually perform very well without endangering the patient's life.

Calcium gluconate used to be the treatment for abdominal pain. However, studies have shown that it is ineffective. IV opioids with or without benzodiazepines (usual diazepam) have proved to be the most effective. 55% of patients felt better with the IV opioids, 70% felt better with IV opioids plus benzodiazepines. 100% of the patients on antivenin felt better.

General approach

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Disclaimer:
This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only.
Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional. ...
Disclaimer:
This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only.
Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional.

[Planktonn-pj]

I recently was bitten by a presumed black widow. I live in Southern California and I think the bite happened in my garage. I had a terrible headache my eyes were swollen and I felt like I had I high fever but when temperature was taken it was normal. I vomited off and on for 3 days and and all symptoms stated lasted off and on for 2 weeks peeking for 6 days. I visited the emergency room and was given iv fluids and ibuprofen. This was awful and I will not soon forget it. I had 6 puncture marks so we think she got me 3 times. It’s been 2 months and I still have marks on my upper arm at bites location. I am 48 6ft 220 so if you are light in size or older with other Heath issues I could definitely see it being fatal. I also lost about 15 ponds. This is my black widow story. Peace

[debbieburns]

I’m still recovering 6 days later. Extremely painful, tremors, sweating. Two days in ICU. Biggest challenge was getting them to give pain meds. I am a 65 year old woman with zero previous dx, no meds, healthy. Recovery much slower than expected. Hospital staff not much help, lack of knowledge was disconcerting.

[Hedgeflexlfz]

I've always wondered about these bites, very interesting.

[teddyroberts]

This is great information. I had an encounter with a black widow and was worried about an ER visit, if I was bitten. Which it didn't try. It just crawled on me just like any other spider. This happened just yesterday. I'm not afraid of spiders but it was still unnerving, once I realized I was handling a black widow.

[liquidbraino]

Love this guy's accent! I just came here for the info because I got bit by a black widow spider about a week ago but I LOVE the Indian accent. Yes, it's painful, yes it sucks; you're not going to die from it. There hasn't been a death from a black widow in the US in ten years.

"Provoked" can mean you accidentally climbed through their web without knowing it; the spider went down your shirt and bit you seventeen f***ing times (what happened to me). I climbed under a fence at night, didn't see the spider but felt it's web on my face.

The thing about a black widow spider bite is you don't feel the sting but an hour later you feel the pain which in my case felt like somebody hit me in the chest with a baseball bat. It took me a while to figure out that I got bit by a black widow.

At first I thought I'd pulled a muscle but it started to hurt way more than you'd expect from a pulled muscle. It was a deep pain and the skin surface was numb. But then after about a week the deep pain started to go away and there was pain and itching on the surface and there were red spots in each place where the spider bit me. I counted about seventeen individual bites.

About a week and a half into it now and the red spots have turned into scabs, some of which have already fell off. I'm still in pain but I'm not going to hate black widow spiders for the rest of my life. I'm definitely going to be careful about crawling under fences; at night; in the dark; where I can't see what I'm climbing through.

Thanks for the info doc. Subscribed.

BTW, I didn't get any of the abdominal discomfort or pain; no nausea. Just felt like I got hit by a baseball bat in my chest/shoulder area and I have seen black widow spiders previously in the area I climbed through. It's amazing how fast they can put up a web (within just a few hours).

The fence I climbed under is on the North side of the Sepulveda Veterans Administration in North Hills CA (the Lassen gate). They lock the gate after 10pm so if it's later at night I have to climb under it.

There are lots of eucalyptus trees in this area and I've heard that eucalyptus trees attract black widow spiders. Not sure if that's true but there ARE lots of eucalyptus trees and LOTS of black widow spiders in the area.

[maria]

great video! short, brief and to the point. Thanks so much

[TheWheatHead]

Wonderful video, at least you get straight to the point.

[matteusgreyling]

Here in South Africa in the very temperate and almost tropical province of KZN we have a ton of black widows crawling around

[dhardy]

I am most greatful for your informative videos Doctor. Thankyou

[kittywampusdrums]

When i was a kid I started having trouble breathing and then it felt like my diaphram just quit working. It sucked. Nobody knew what happened. I couldn't breathe and blacked out for half a minute before I regained consciousness and slowly started breathing again. I always wondered if it was a spider bite or something.

[EfraHeemzCorral]

Thanks for the info! Great video straight to the point. Thanks again!

[generalahmed]

Why does a spider bite cause stomach pain/cramps?

[awaismehmood]

New interesting information thank you sir

[zachmalkemus]

I have severe arachnophobia and the refresher of how one would treat the bite. Was just not sure if their had been any change in procedure and immunization process.

[MISSUNIVERSE]

Hello I noticed my jaw started hurting, 3 hrs later I noticed pain and tingles on my left upper leg were a red circle is about 2inch in diameter with a lil bit of pain to touch or walk, but my jaw hurts, could this be black widow bite or just a house spider bite

[presouz]

I have a snake bite venom extractor mini pump. Orange one off Amazon, you can pump up the area. I use in regular bites. Has saved me before, I am very sensitive to insect/spider bites. Catch it in time & get some venom out ASAP.

[lauriestephens]

I disagree on the Calcium Gluconate. 1960ish bit twice. Original doctor said not black widow. My mother (she read encyclopedias back in the day) felt differently. After 4 or 5 days pain settled in my lower back. Doctor in larger town would have had me in the hospital but he administered the Gluconate I immediately felt relief. He sent another dose home so we could have someone closer to administer 2nd dose. I'll swear by it.

[jothishbalachandran]

Hi Sir

I got spider bite 4 years before, now also not completely gone. Please tell any medicine.

[thebulldog]

Very interesting video. Since there has been advises to seek medical attention if the bite is from brown recluse and/or black widow, I always thought death occurs if a black widow bite occurred 2 weeks ago or so, even though soap and water was the treatment for the bite, and no trip to emergency room, even though feelings improves. Maybe venom goes away within time, idk.

[bevturquoise]

I disagree that a tetanus injection is needed. This is not tetanus. Othewise, very informative. Thank you.