Procedure Instructions

Prior To Your Procedure

• Continue all of your usual medications as prescribed unless you are taking blood thinners (such as Coumadin, Plavix, Lovenox). You may take your morning medications with a sip of water.
• If you are taking blood thinners such as Coumadin, Plavix, or Lovenox, ask the physician who prescribes this medication if they feel it is safe for you to discontinue them before your injection. Below is the number of days required to discontinue each medication prior to your procedure:
  • If you are taking Coumadin, you must stop this medication 5 days prior to your procedure, with approval of the prescribing physician.
  • If you are taking Plavix, you must stop this medication 7 days prior to your procedure, with approval of the prescribing physician.
  • If you are taking Lovenox, you must stop this medication 24 hours prior to your procedure, with approval of the prescribing physician.
• Your doctor may prescribe sedation to help reduce discomfort and anxiety. If your procedure involves sedation you MUST have a driver.  The only exception is if you have arranged transportation.
• Wear comfortable clothing and low-heeled shoes.
• Please leave jewelry and other valuables at home.
• If you arrive 30 minutes later than your scheduled procedure time your procedure may be delayed or cancelled.
• The entire process from checking in to being discharged takes approximately 1 hour.

After Your Procedure

• You will be given a light snack and a beverage and the medical assistant will go over the discharge instructions with you.
• Your driver will have to come and sign on the consent form acknowledging that your are being discharged with him/her.
• The office staff will inform you of your next clinic visit prior to your discharge.

After Discharge From The Clinic

Activity:

• Do not drive for 24 hrs hours if you received sedation for your procedure
• Blood thinners such as aspirin, heparin and Coumadin may by resumed 24 hours after the procedure unless otherwise instructed. You may resume your other medications.
• You may perform mild activity (leisurely walking) today. Gradually resume other activity after 24hrs.
• No heavy lifting (greater than 5 lbs.), twisting and bending movements for 3 days.
• Resume light diet and advance to regular diet as tolerated.

Comfort Measures:

• You may apply ice to the injection area for twenty minutes at a time every 1 – 2 hours for the first 24 hours.
• Do not place a heating pad to the area for the first 24 hours. Remove the dressing or Band-Aid after 4 hours.
• No baths, hot tubs or swimming for 24 hours. You may shower

Expected Effects:

• You may experience an increase in pain the day following your procedure.This is due to the local anesthetic/numbing agent wearing off. A few days of soreness after the procedure are normal.
• Pain relief may occur immediately after the procedure, but may also take several days. Steroid medication can take 1 to 3 days to start working.  It may take this long to feel a decrease in your pain.
• Some procedures may take several days, even weeks (e.g. radiofrequency ablation) to effectively relieve pain. Do not become discouraged if the pain does not subside right away.
• If your test was a diagnostic test (e.g. Facet block), you may not have lasting pain relief. Additional procedures may be necessary for long term pain relief.
• You may experience facial flushing from the steroid injection (cortisone medication), sleeplessness, or a restless feeling. These symptoms can last for 1 – 4 days and are quite normal.

Complications to watch for: Please call our office at 919-787-7246 if you experience any of the following:

• Numbness, weakness, or tingling in the arms or legs lasting for more than 24 hours
• Fever or temperature greater than 101 degrees. If you feel hot, take your temperature.
• Nausea, new or unusual headache or neck stiffness.
• Difficulty urinating or holding your urine.
• Bleeding or drainage from the injection site (more than 1/2 teaspoon).
• Unusual swelling or redness around the injection site.

If you have difficulty breathing, chest pain or any emergency, please call 911 or go to the nearest emergency room.