Epidural Steroid Injection / Selective Nerve Root Block
| An injection performed under fluoroscopy (x-ray) to confirm a specific diagnosis and to decrease nerve root pain. The pain is relieved as the corticosteroid decreased inflammation of the nerve roots. An anesthetic agent is injected with the corticosteroid into the epidural space and/or the neural foramen where the nerve root exits the spine. |
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An I.V. will be started in your hand or arm and local anesthetic will be given at the site of injection.
Interlaminar Epidural Steroid Injection: The epidural space is inside the bony canal of the spine and outside the dura (covering of the spinal cord). This space runs the length of the spine. A needle is inserted into the epidural space of the cervical, thoracic, lumbar or caudal spine. The steroid medication is then injected into this space.
Transforaminal Epidural Steroid Injection & Selective Nerve Root Block: A specific spinal nerve root is located under fluoroscopy. A needle is then introduced into the foramen of the nerve root. Steroid medication is then injected into the area bathing the nerve root.
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| A prolonged decrease in or relief of pain can occur. The steroid medication may be unable to overcome the inflammation and pain if the inflamed area is significant. Onset of relief is usually within 2-days, but may take up to 2-weeks to reach full effectiveness. |
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| The injection takes about 30 minutes, plus approximately 30 minutes recovery time. Please take your usual medications with small sips of water unless otherwise instructed. |
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| Risks include increased pain, headache, bleeding, infection, a reaction to any medications used, nerve damage, paraplegia/quadriplegia, discitis (infection of the disc) or death. |
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- Mild back or neck ache lasting a few days
- Bruising of the skin and tenderness at the injection site
- Short-term headache, salt retention with temporary weight gain
- Rare emotional changes: elation, hyperactivity, anger, depression
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- YOU WILL NEED SOMEONE TO DRIVE YOU TO AND FROM THE SURGICAL CENTER
- NO FOOD OR DRINK FOR 6-HOURS PRIOR TO THE SCHEDULED TIME OF YOUR INJECTION
- No driving for the rest of the day.
- Apply ice to the area every 15 minutes as needed.
- Continue exercises and stretches as before and as tolerated by pain.
- Drink extra fluids for the next 24 hours.
- Take pain medication if needed as prescribed.
- Monitor your level of pain or pain relief from the time the injection is completed.
- Guard the affected area if numbness is present.
- Follow up as directed
- IF YOU HAVE PROBLEMS CALL 303-788-9322 OR 303-423-8334
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Medial Branch Blocks / Medial Branch Nerve Injections
| An injection that is performed to confirm that a specific nerve branch is responsible for pain experienced in the facet joint area. It is often done as a precursor to Radio-Frequency Neurotomy. Usually a series of two Medial Branch Blocks are done using two different anesthetic agents. |
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An I.V. will be started in your hand or arm. A local skin anesthetic is given. A needle is then inserted using Fluoroscopy (x-ray) down to the medial branch nerve(s) supplying the facet joint or facet capsule. An anesthetic is then injected onto the medial branch nerve.
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| A decrease in, or relief of, pain. A specific pain diary needs to be kept for the fist 48 hours following the injection. |
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| Thirty minutes plus approximately thirty minutes recovery time. Please take your usual medications with a small sip of water unless otherwise instructed. |
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| Risks include increased pain, headache, bleeding, infection, a reaction to any medications used, nerve damage, paraplegia/quadriplegia, or death. |
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- YOU WILL NEED SOMEONE TO DRIVE YOU TO AND FROM THE SURGICAL CENTER
- NO FOOD OR DRINK FOR 6-HOURS PRIOR TO THE SCHEDULED TIME OF YOUR INJECTION
- HOLD ASPIRIN FOR 7 DAYS AND HOLD NSAID’S (Naproxen, Ibuprofen) FOR 3 DAYS PRIOR TO INJECTION.
- FOR BLOOD THINNERS (Coumadin, Heparin, Plavix) SPEAK TO YOUR DOCTOR FOR SPECIFIC INSTRUCTIONS.
- No driving for the rest of the day.
- Apply ice to the area every 15 minutes as needed.
- Continue exercises and stretches as before and as tolerated by pain.
- Drink extra fluids for the next 24 hours.
- Take pain medication if needed as prescribed.
- Monitor your level of pain or pain relief from the time the injection is completed.
- Guard the affected area if numbness is present.
- Follow up as directed
- IF YOU HAVE PROBLEMS CALL 303-788-9322 OR 303-423-8334
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Epidural Steroid Injection / Selective Nerve Root Block
| An injection performed to confirm/diagnose (treat) that the sympathetic nervous system is responsible for arm or leg pain. For example, pain caused with reflex sympathetic dystrophy or complex regional pain syndrome.. |
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An I.V. will be started in your hand or arm. A local skin anesthetic is given. A needle is then inserted using fluoroscopy (x-ray) down to the cervical (SGB) or lumbar (LSB) sympathetic nerve chain. Injectate will then be delivered to the region (Local anesthetic and corticosteroid).
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| A decrease in, or relief of pain. A specific pain diary needs to be kept for the first 48 hours following the injection. |
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| Thirty minutes plus approximately thirty minutes for recovery time. Please take your usual medication with a small sip of water unless otherwise instructed. |
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| Risks include increased pain, headache, bleeding, infection, a reaction to any medications used, nerve damage, paraplegia/quadriplegia, or death. |
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- Mild back or neck ache lasting a few days
- Bruising of the skin and tenderness at the injection site
- Short-term headache, salt retention with temporary weight gain
- Rare emotional changes: elation, hyperactivity, anger, depression
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- YOU WILL NEED SOMEONE TO DRIVE YOU TO AND FROM THE SURGICAL CENTER
- NO FOOD OR DRINK FOR 6-HOURS PRIOR TO THE SCHEDULED TIME OF YOUR INJECTION
- HOLD ASPIRIN FOR 7 DAYS AND HOLD NSAID’S (Naproxen, Ibuprofen) FOR 3 DAYS PRIOR TO INJECTION.
- FOR BLOOD THINNERS (Coumadin, Heparin, Plavix) SPEAK TO YOUR DOCTOR FOR SPECIFIC INSTRUCTIONS.
- No driving for the rest of the day.
- Apply ice to the area every 15 minutes as needed.
- Continue exercises and stretches as before and as tolerated by pain.
- Drink extra fluids for the next 24 hours.
- Take pain medication if needed as prescribed.
- Monitor your level of pain or pain relief from the time the injection is completed.
- Guard the affected area if numbness is present.
- Follow up as directed
- IF YOU HAVE PROBLEMS CALL 303-788-9322 OR 303-423-8334
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Facet Joint Injections / Z-Joint Injections
| An injection that is performed to confirm that a facet joint is the source of pain and provide pain relief. |
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| Facet joints or zygapophysial joints are located on the back of the spine on each side where one vertebra slightly overlaps the adjacent vertebra. These joints glide and allow movement of the spine. |
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An I.V. will be started in your hand or arm. A needle is then inserted using fluoroscopy (x-ray) into the joint or joint capsule. An anesthetic agent and steroid are injected.
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| This is usually a diagnostic and therapeutic procedure. A prolonged decrease in or relief of spinal pain can occur. A detailed pain diary needs to be kept for the first 48 hours following the injection. |
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| The injection procedure takes about thirty minutes, plus approximately thirty minutes recovery time. Please take your usual medications with a small sip of water unless otherwise instructed. |
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| Risks include increased pain, headache, bleeding, infection, a reaction to any medications used, nerve damage, paraplegia/quadriplegia, or death. |
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- Mild back or neck ache lasting a few days
- Bruising of the skin and tenderness at the injection site
- Short-term headache, salt retention with temporary weight gain
- Rare emotional changes: elation, hyperactivity, anger, depression
|
- YOU WILL NEED SOMEONE TO DRIVE YOU TO AND FROM THE SURGICAL CENTER
- NO FOOD OR DRINK FOR 6-HOURS PRIOR TO THE SCHEDULED TIME OF YOUR INJECTION
- HOLD ASPIRIN FOR 7 DAYS AND HOLD NSAID’S (Naproxen, Ibuprofen) FOR 3 DAYS PRIOR TO INJECTION.
- FOR BLOOD THINNERS (Coumadin, Heparin, Plavix) SPEAK TO YOUR DOCTOR FOR SPECIFIC INSTRUCTIONS.
- No driving for the rest of the day.
- Apply ice to the area every 15 minutes as needed.
- Continue exercises and stretches as before and as tolerated by pain.
- Drink extra fluids for the next 24 hours.
- Take pain medication if needed as prescribed.
- Monitor your level of pain or pain relief from the time the injection is completed.
- Guard the affected area if numbness is present.
- Follow up as directed
- IF YOU HAVE PROBLEMS CALL 303-788-9322 OR 303-423-8334
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Sacroiliac Joint Injections / SI-Joint Injections
| An injection that is performed to confirm that the SI joint is the source of pain and provide pain relief. |
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| Sacroiliac (SI) joints are located on the back of the pelvis where the sacrum and ilium bones form two large ear-shaped joints These joints glide and allow movement of the pelvis and lower spine. |
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An I.V. will be started in your hand or arm. A needle is then inserted using fluoroscopy (x-ray) into the joint or joint capsule. An anesthetic agent and steroid are injected.
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| This is usually a diagnostic and therapeutic procedure. A prolonged decrease in or relief of spinal pain can occur. A detailed pain diary needs to be kept for the first 48 hours following the injection. |
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| The injection procedure takes about thirty minutes, plus approximately thirty minutes recovery time. Please take your usual medications with a small sip of water unless otherwise instructed. |
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| Risks include increased pain, headache, bleeding, infection, a reaction to any medications used, nerve damage, paraplegia/quadriplegia, or death. |
| |
- Mild back or neck ache lasting a few days
- Bruising of the skin and tenderness at the injection site
- Short-term headache, salt retention with temporary weight gain
- Rare emotional changes: elation, hyperactivity, anger, depression
|
- YOU WILL NEED SOMEONE TO DRIVE YOU TO AND FROM THE SURGICAL CENTER
- NO FOOD OR DRINK FOR 6-HOURS PRIOR TO THE SCHEDULED TIME OF YOUR INJECTION
- HOLD ASPIRIN FOR 7 DAYS AND HOLD NSAID’S (Naproxen, Ibuprofen) FOR 3 DAYS PRIOR TO INJECTION.
- FOR BLOOD THINNERS (Coumadin, Heparin, Plavix) SPEAK TO YOUR DOCTOR FOR SPECIFIC INSTRUCTIONS.
- No driving for the rest of the day.
- Apply ice to the area every 15 minutes as needed.
- Continue exercises and stretches as before and as tolerated by pain.
- Drink extra fluids for the next 24 hours.
- Take pain medication if needed as prescribed.
- Monitor your level of pain or pain relief from the time the injection is completed.
- Guard the affected area if numbness is present.
- Follow up as directed
- IF YOU HAVE PROBLEMS CALL 303-788-9322 OR 303-423-8334
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Discogram
| A diagnostic test performed to view and assess the internal structure of a disc and determine if it is a source of pain. |
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| An I.V. will be started in your hand or arm and local anesthetic will be injected into the patient’s skin in the area that is being examined. A needle is inserted into the disc under fluoroscopy (x-ray). A saline solution and radiopaque dye are injected into the disc or discs if more than one disc is being examined. A CT scan may be performed on the painful disc after the dye is injected to obtain images of the dye distribution. This will demonstrate annular tears, scarring, disc bulges and changes in the nucleus of the disc. |
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| Re-creation of painful symptoms if the disc(s) is abnormal. Confirmation of a diagnosis and/or determination of which disc(s) is the source of pain. |
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| The test takes about 30 minutes, plus approximately 30 minutes recovery time. If a CT is requested, this may take an additional 30 minutes to complete. |
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| Risks include increased pain, headache, bleeding, infection, a reaction to any medications used, nerve damage, paraplegia/quadriplegia, discitis (infection of the disc) or death. |
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- YOU WILL NEED SOMEONE TO DRIVE YOU TO AND FROM THE SURGICAL CENTER
- NO FOOD OR DRINK FOR 6-HOURS PRIOR TO THE SCHEDULED TIME OF YOUR INJECTION
- HOLD ASPIRIN FOR 7 DAYS AND HOLD NSAID’S (Naproxen, Ibuprofen) FOR 3 DAYS PRIOR TO INJECTION.
- FOR BLOOD THINNERS (Coumadin, Heparin, Plavix) SPEAK TO YOUR DOCTOR FOR SPECIFIC INSTRUCTIONS.
- No driving for the rest of the day.
- Apply ice to the area every 15 minutes as needed.
- Continue exercises and stretches as before and as tolerated by pain.
- Drink extra fluids for the next 24 hours.
- Take pain medication if needed as prescribed.
- Monitor your level of pain or pain relief from the time the injection is completed.
- Guard the affected area if numbness is present.
- Follow up as directed
- IF YOU HAVE PROBLEMS CALL 303-788-9322 OR 303-423-8334
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