Chronic Pain Procedures Patient Education
Pre-Procedure Patient Information
What are procedures for Chronic Pain?
There are several different procedures for chronic pain. Some are injections that could use numbing medication and/or steroids. Sometimes the pain can be treated using a Radio Frequency Ablation.
Who should get procedures for Chronic Pain?
You will meet with a doctor that specializes in treatment of chronic pain for an evaluation. Based on your symptoms, they will recommend the procedure that they think will best treat your pain. They will explain the procedure in detail, including possible complications and side effects. The doctor will also answer any other questions you may have.
What conditions should I make sure my doctor is aware of?
Before your exam, you should notify the doctor or nurse if you:
- Have had a previous reaction to iodine/contrast
- Have any drug/food allergies
- Are taking any blood thinning medications (anticoagulants)
- Have any medical conditions
- Whether you are pregnant or may be pregnant
- If you have an active infection
- If you or your family members have had any problems with anesthetic medications
What are the risks and side effects of Chronic Pain procedures?
Chronic pain procedures are very safe, however risks include having an allergic reaction to the medications used during the procedure and the exposure to x-ray radiation. You should not have this procedure if you are allergic to any of the medications to be injected, or if you have an active infection.
You may experience any of the following side effects:
- Mild discomfort from the injection (usually temporary)
- Mild numbness, tingling, or weakness around the injection site caused by the numbing medicine used before or with the injection
- Allergic reaction (itching, hives, widespread redness, and swelling beyond the injection site).
- If you had an Epidural Steroid Injection (ESI) Inadvertent puncture of the “sack” containing spinal fluid (may cause headaches), infection, bleeding, nerve damage, or no relief from usual pain.
- If you had a steroid injected, side effects are rare, but may cause an increase in blood sugar (mainly in diabetics) and water retention.
About the Procedure
The time given to you for the injection is an estimate. You will be notified the day before your procedure to confirm or change the time you were given.
Before the injection:
- Please confirm with your provider if you will need to fast for your procedure. If you plan on receiving sedation, you will need to fast. When fasting, do not eat within eight hours of your appointment. You may have clear liquids up to 2 to 3 hours before your procedure.
- If you have diabetes and use insulin, you may need to adjust the dosage of insulin the night prior and the day of the procedure. Your primary care doctor can help you with this adjustment.
- If you are on blood thinning medications, check with your provider to see if these need to be stopped. Your primary care doctor will let you know when it is safe to stop blood-thinning medicine. Aspirin or ibuprofen are ok.
- Continue to take all other medications with a small sip of water.
- Do not discontinue any medication without first consulting with your primary or referring doctor.
- Do not take new dietary supplements or medicines during the week before your procedure unless your health care provider approves them.
- Check with your provider to see if you need a ride home after your procedure. If you are sedated you must bring someone with you to drive you home after the procedure and you should not drive or operate heavy machinery for at least 24 hours after the procedure.
- If you receive sedation, plan to have someone stay with you for the first 24 hours after you leave the hospital.
The day of the injection:
Make sure you shower on the day of your procedure, washing the anticipated procedure site with soap and water.
Please arrive and register at admissions in the lobby of the hospital at your scheduled time.
You will be escorted to the prep area, where you will be connected to a blood pressure machine that will take your blood pressure and your heart rate. You may also have electrocardiogram (ECG) leads placed on your chest to allow us to monitor your heart during the procedure.
A nurse may insert an IV into your arm if you need sedation. Most patients do not need IV sedation as the procedures are typically not painful. The nurse will also review your medical history and medications, listen to your heart and lungs and make sure you have followed all your pre-procedure instructions.
Your physician will obtain your consent for the injection. The physician will explain the procedure including possible complications and side effects. They will also answer any questions you may have.
During the procedure:
A local anesthetic will be used to reduce any discomfort during your procedure. You will be awake during the process to aid in properly assessing the procedure. Your blood pressure and oxygen will be monitored. The procedure site will be cleansed with a special solution. The doctor will begin by injecting a small amount of local anesthetic through a very small needle. It feels like a pinch and then a slight burning as the local anesthetic starts numbing the skin. After the skin is numb, the procedure feels like a bit of pressure at the procedure site. If you experience a little pain during the procedure, let your doctor know and your doctor will make adjustments to make you more comfortable.
After the procedure:
Immediately following the procedure, you may feel the area of chronic pain becoming slightly heavy or numb. You may notice that your pain may be gone or much less. This is due to the effect of the local anesthetic and lasts only for a few hours.
Following the procedure:
- Your pain may return and you may have some soreness at the injection site for a day or so. You may use ice for a few days after.
- You will start noticing pain relief starting about 1-2 days after the procedure.
- You will stay in the recovery area for observation, where medical staff may check your blood pressure and pulse.
- You will be asked about your pain.
- The medical staff will review your discharge instructions with you.
- Someone must drive you home.
You will then be discharged home.
Can I resume normal activities?
You will have a few restrictions immediately following the procedure:
- Check with your provider to see if you need someone to drive you home after your procedure.
- If you are sedated, do not drive or operate heavy machinery for 24 hours after the procedure.
- Do not engage in any strenuous activity for 24 hours following the procedure.
- You may resume your normal diet.
What do I do for follow up visits?
Please make a follow up appointment with your ordering physician or the Pain Management Clinic. If you need to change or alter this appointment, please call in advance.
Contact Information
Please feel free to contact the Pain Management Clinic with questions or concerns:
(307) 638-7757
In case of emergency including:
- Severe procedure site redness, swelling
- Increasing weakness in arms or legs
- Shortness of breath
- Chest pain
