What is a spinal injection/nerve block?
Most procedures involve the careful placement of a steroid and local anesthetic mixture into a joint or near a specific nerve to treat the symptoms directly at the site of an injury. Specific procedures will be considered depending on your particular problem area. You will not have the procedure on the same day of your clinic visit.
What is the purpose of the procedure and how does it work?
The injected medication reduces the inflammation and swelling of the tissues in the problem area. This blocks the pain cycle, which will hopefully decrease your medication requirement and make it easier to participate in physical therapy.
Will I be put to sleep for the procedure?
Many patients prefer a sedative medication which is administered intravenously (IV) to decrease anxiety and make the procedure more comfortable, unless you have a heart or lung condition that places your health at risk. Sedation is not required to complete the procedure and a local anesthetic (numbing medicine) is always administered to the skin to reduce pain before the injection. All patients should be NPO (nothing to eat or drink for at least 6 hours) before the procedure, except your routine medications with a sip of water.
How is the procedure performed?
Most require the use of an X-ray machine (Fluoroscopy) to more accurately identify the appropriate structure and ensure correct placement of the instruments prior to injecting the medication. After placing your IV, you will be transported from the pre-op holding area to the procedure room where a nurse will apply heart rate, blood pressure, and oxygen monitors for your safety. With sedation (if preferred) and monitoring in place, the skin over the site is cleaned with an antiseptic solution and local anesthetic is applied to the skin prior to injection.
How long does the procedure take?
Most procedures take less than 30 minutes to perform, but the entire process may take up to 3 hours to complete from sign-in to discharge. You will be monitored in the recovery room until you have met the defined discharge criteria and it is safe to go home.
What should I do after the procedure?
You will need someone to drive you home even if you do not choose to be sedated for the procedure. We suggest that you limit your activity on the day of the procedure and refrain from driving or walking without assistance for 24 hours unless approved by a physician. Most patients can safely return to work the next day without restriction
What are the potential risks and side effects of the procedure?
These will be discussed in detail at the time of your visit if a procedure is planned. All procedures carry common risks (bleeding, infection, nerve irritation/injury). It is important to us that you feel comfortable with your decision to proceed with a diagnostic/therapeutic procedure, and we encourage you to ask any and all questions your may have at your visit.
Can I have the procedure if I am on blood thinner?
In most cases the procedure can be performed safely if you are taking blood thinner or platelet medication. These medications may need to be discontinued for several days prior to the procedure, but you should not stop any medication unless instructed to do so by your treating physician. We will discuss this at the time of your visit.
Are there any other additional blocks or procedures available?
Yes, these options are available and will be discussed by physician at the time of your visit.
Can I go back to work the next day?
You should be able to return to normal activities the next day.
How long will the effect of the medication last?
The immediate effect is usually from the local anesthetic injected; this wears off in a few hours. The steroid starts working in about three to five days and its effect can last up to three months.
Can I have more than three injections?
Generally, we perform three to four injections in a period of one year. Giving more could increase the likelihood of side effects from the steroids.
What are the risks and side effects of an injection?
This procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is temporary pain. The other risks involve spinal puncture with headaches, infection, bleeding inside epidural space, nerve damage, worsening symptoms, etc. The other risks are related to the side effects of steroids, including weight gain, increase in blood sugar (mainly in people with diabetes), water retention, suppression of the body's own natural production of cortisol, etc.