Be sure to be adequately fed and hydrated prior to any injection procedure, especially a spinal injection, to minimize the chance of vasovagal response. (A vasovagal response is when stress or anxiety triggers your blood pressure and heart rate to drop suddenly, which may cause you to feel dizzy, nauseated, or clammy.)

If you are an anxious person, it may be necessary to take something for anxiety. If you do take something for anxiety on the day of your procedure, be sure to arrange for a competent driver.

After the procedure you may experience fluctuating levels of pain as the local anesthetic takes effect, then wears off. Anti-inflamatories tend to take effect within 12-24 hours after injection, or possibly sooner. You should plan to take it easy for the rest of the day.

• Prolotherapy injections will produce increased pain the next day or so and then return to baseline.
• Ablation procedures also may increase pain initially until the anti-inflamatories begin working.

Additionally, we advise against submerging in water for 48 hours to reduce the risk of infection at the injection site, but showers are okay.

The medications that are used in pain management injections may include:

• local anesthetic (ex: lidocaine, Marcaine)
• corticosteroid anti-inflammatories (ex: dexamethasone, triamcinolone)
• sodium bicarbonate (decrease the sting of acidic medications)
• non-steroid anti-inflammatory (ex: Sarapin, Traumeel/Zeel)
• Normal saline solution
• dextrose solution

The exact mixture will be determined based on your specific procedure and health risks.

• Reduce pain and inflammation
• Improve range of motion
• Enhance overall physical function
• Prevent chronic pain and long-term complications 

• Prevent minor injuries from becoming severe
• Reduce the risk of chronic pain
• Speed up the healing process
• Provide documentation for insurance claims

Having a driver is always a good idea after an injection procedure, if only for moral support. If you took medication for anxiety, you would need to arrange for a driver.

However, you will be given time to recover in the clinic after the procedure and should not be prohibited from driving afterward for other types of injections.

In general, you should abstain from heavy lifting or extreme use that will stress the area treated for a few days, ideally 2 weeks.

• Normal activity is encouraged.
• You should not submerge in water for 48 hours.

You should wait at least 2 weeks to resume weighted exercises that stress the spine. Stretching and body-weight exercise is OK.

• If you have herniated discs in your spine, you should avoid forward bending which may exacerbate pain.
• When you resume weighted exercise, start with low-weight, high-rep intensity and progress slowly.

Lifting too heavy, too quickly can stress the injured or painful area and cause the pain to recur.

You should always be aware that when a needle is piercing the skin to deliver medication, there is risk of infection and bleeding. These risks are minimal since we always choose the smallest needle size possible and disinfect the area thoroughly before injections.

When receiving any medication for the first time it is always possible to experience side effects from the medication. We use medications that have a low side effect profile to minimize this risk to you. Corticosteroids have the most reported side effects of all the medications we use; however we routinely use dexamethasone, which has the lowest side effect profile within the drug class. We also have multiple safe corticosteroid alternatives with no significant reported side effects available upon request.

We take every precaution to ensure your safety starting with personalizing a plan for your specific needs. All procedures are governed by protocols derived from industry standards which dictate everything from proper disinfection techniques to execution of injection techniques.

At this clinic, we use fluoroscopy guidance for our spinal procedures. This is a type of motion x-ray imaging that allows us to take frequent pictures throughout the procedure to ensure accurate needle placement. This type of image-guidance is appropriate for paraspinal procedures as well as other deep targets, like the hip joint. By using image-guidance, we minimize the risk of hitting an unintended target, thereby increasing safety and effectiveness of the injection procedure.

Having said that, no one can guarantee a “no-risk” procedure. With all injection procedures, there is a risk of infection or bleeding from the needle puncture. Also, there is a chance that an unintended target could be injected or injured. This is why our skilled proceduralists have been through extensive training to learn the landmarks of the intended targets as well as being trained to avoid vital structures like nerves and blood vessels, minimizing the risk to you.