Procedure Policies

Spinal Injection Information

There are many different kinds of injections, including epidurals, nerve blocks, facet or sacroiliac joint injections. Each type of injection targets a different location in the spine. Your doctor recommends your specific type of injection based on your history, physical exam, X-rays, and MRI’s.

A spinal injection is a steroid injection, similar to a knee or shoulder injection, but in order to get the medicine to the correct place in the spine, X-ray guidance is used. The steroids are meant to decrease inflammation and swelling, and therefore reduce pain. The steroid medication generally begins working after 2-7 days, gradually reducing the inflammation and pain over the first 2 weeks. It may take a full 2 weeks to take effect.

The steroids usually stay in the area for 3-6 months. Sometimes one injection is enough to feel much better, but it may require a series of up to 4 injections, spaced out over time, to be most effective. Instructions for before your procedure:

• Someone must accompany you home after your procedure. You may not drive.
• Wear comfortable clothing.
• You cannot eat any solid foods 6 hours prior. A clear liquid diet is to be followed (water, coffee without creamer, tea).
• You may take your normal medications as prescribed. If you take pain medications on a daily basis, continue to take them on the day of the procedure.

Medication Restrictions

Stop taking aspirin 24 hours prior to the procedure. If you are currently taking a blood-thinner such as Coumadin, Plavix, or Aggrenox, you must stop taking this medication 7 days prior to your injection. Non Steroidal Anti-Inflammatory Drugs (NSAIDs) will have to be stopped 3 days prior to the procedure. This includes ibuprofen, Naproxen, Advil, Aleve, Motrin, as well as certain prescription anti-inflammatories. Certain diabetic medications, such as Metformin, will have to be stopped 3 days prior to the procedure.

NOTE: Your prescribing doctor must be notified before you stop taking any of these medications. Please let us know the name of the medicines you take, as well as your prescribing doctor. Our office will contact your doctor and get approval before we have you stop taking the medicine.

Illnesses

Your procedure cannot be done if you have any kind of active infection (bacterial, viral or fungal), if you are currently taking an antibiotic, or if you are running a fever.

Procedure Details

During the procedure, you will lie on your stomach and your skin will be cleansed with an antiseptic soap. Your skin will be numbed with a local anesthetic, and a small needle will be passed under fluoroscopy (X-ray guidance) to reach the target area (such as the epidural space, a specific nerve, or joint). Once the needle is in the correct position (this may be confirmed by using a small amount of radiopaque dye), the steroid medicine along with an anesthetic is injected. The entire procedure usually takes about 15 minutes. Once your procedure is completed, you will need to stay an additional 15-30 minutes for recovery time. You should be prepared to be there for up to 2 hours.

Clear Liquid Diet

If you are having a spinal injection or other procedure, you may have a clear liquid diet up to 3 hours prior to your procedure. If you have any questions in regards to this list, please call our office at (804) 249-8888.

Beverages

• Coffee or tea (without creamer, sweetener, or milk)
• Clear Juices (apple, white cranberry, white grape, lemonade)
• Liquid gelatin
• Mineral or bubbly water
• Soft drinks that are clear (Sprite, 7UP, ginger ale, club soda)
• Sports drink
• Water

Soup

• Clear broth or bouillon

Desserts

• Popsicles
• Hard candy
• Honey (you may put these in your hot drinks as sweetener)
• Flavored Jell-O

Post Procedure Instructions

You should limit your physical activity the day of your procedure. You can resume physical activity the following day, as tolerated. You may experience some bruising or tenderness at the injection site(s) and/or your pain may be worsened for a day or two after the procedure, this is normal, but rare. You may ice the injection site, but heat should not be used for two days. Please call our office if you experience any unusual pain symptoms, persistent weakness in your arms or legs, headache that doesn’t go away with your usual headache medication, or if you develop a fever greater than 100.5 degrees.