Spinal Injections

Spinal Injections

Chronic pain can affect all parts of the body, but is especially prominent in the lumbar or cervical regions of the back. Pain management injections involve the direct delivery of steroids and anesthetic to nerve, joint or epidural space. Injections are typically prescribed after a course of medications and/or physical therapy is completed, but before surgery is considered. Also referred to as blocks, injections are useful for providing pain relief and as a diagnostic tool for identifying the source of back pain.

There are a variety of such treatments based on the different sources of pain in the neck and back, almost all of which are done under X-ray guidance to ensure medication is delivered to a very focused location. Our physicians have been specialty trained in the latest medical science has to offer with regards to such therapies at some of the top teaching hospitals in the country.

Some of the conditions we treat include:

  • Lumbar Radiculopathy/Sciatica
  • Cervical Radiculopathy
  • Herniated Discs
  • Facet Syndrome
  • Spinal Stenosis
  • Spondylolisthesis
  • Degenerative Disc Disease
  • Post Surgical Pain Syndromes
  • RSD (Reflex Sympathetic Dystrophy) / CRPS (Chronic Regional Pain Syndrome)

Some of the procedures we perform include:

  • Lumbar Epidural Injections
  • Lumbar Transforaminal Injections
  • Caudal Steroid Injections
  • Cervical Epidural Injections
  • Facet Blocks
  • Piriformis Injections
  • Sacroiliac Joint Injections
  • Stellate Ganglion Blocks
  • Discography
  • Facet Medial Branch Radiofrequency Neurolysis
  • Spinal Cord Stimulator Trial and Implant
  • Platelet Rich Plasma

General Guidelines for Different Steps

This is a sampling of some things to expect before, during, and after a procedure. More detailed instructions will be provided once you have scheduled your appointment.Initial Visit Instructions
For us to best treat your spinal condition or injury, we need to have a comprehensive understanding of your current health status. When you come in for your initial consult, please bring all of the items listed below. Please be advised, if we do not have all of your relevant medical records and films at the time of your visit, your appointment may need to be rescheduled in order to ensure we can deliver the best care.

Information to bring:

  • Previous X-rays, CT scans, or MRI scans: films AND reports must be provided
  • Medical records of previous testing or treatment (EMGs, physical therapy, etc.)
  • Any brace or support that you are using
  • Referral(s) and pre-authorization(s)
  • Insurance card and applicable co-payment

Pain Injection Instructions - Before the Procedure

Please follow the instructions below if you are scheduled to have an epidural injection or any spine procedure.

Pre-Injection Instructions

You should stay NPO (nothing by mouth) after midnight before the procedure the next day. You may take sips of water for your medications the morning of your procedure. DO NOT stop taking your regular medications EXCEPT as follows:

If you are Diabetic and taking either oral diabetic medications or insulin:

1. If your procedure is scheduled before 12pm, then stay NPO and do not take your diabetic medications.

2. If your procedure is scheduled after 12pm, then eat a light breakfast around 6am and take your diabetic medications.

3. You may eat a light early morning breakfast if your procedure is in the afternoon.

4. There are certain medications that you may need to discontinue prior to the procedure. Our pain management staff will review these prior to your procedure.

5. As a precaution, make arrangements for transportation to and from our office.

Note: If you have an allergy to any anesthetic medications, contrast dye, IVP dye, shellfish, or iodine, please notify the doctor prior to the procedure.
More detailed instructions will be provided once scheduled.

Pain Injection Instructions - After the Procedure

  • On the day of the procedure, you should rest. Ask a responsible adult to keep you company for the remainder of the day. You may resume your normal daily routine the next day. However, be careful to avoid strenuous activity or any activities that cause pain or discomfort.
  • The anesthetics used during the procedure may remain in your body for up to 24 hours. Drowsiness, dizziness, and nausea are normal side effects during this period.
Refrain from the following for the 24-48 hours after your procedure:
  • Do not take a bath, swim, or sit in a hot tub. Showers are okay.
  • Do not drive, operate heavy machinery or use power tools.
  • Do not drink alcoholic beverages.
  • Do not make important or legal decisions, as your judgment may be impaired.
  • Do not sit for more than 1-2 hours in any one spot.
  • Do not exercise unsupervised.