FAQ - Procedures

Q: Do I have to be sedated for my injection?

A: Sedation for most procedures and injections is entirely optional. Some patients elect to be completely awake during their blocks while others may desire to be sedated due to anxiety they have about the procedure. In some cases, sedation is recommended for patient safety, based on the type of procedure, patient factors, and response to prior injections. If you elect to have IV sedation for your procedure, this will be provided by a highly qualified anesthesia team. If you have further questions about anesthesia for your particular procedure, and the types of sedation that we provide in our practice, please ask your physician or provider at your next visit.

Q: What is the difference between a block and an injection?

A: The terms block and injection are very general terms that people use. Any procedure we perform where we give medication through a needle is an injection. Some injections block specific nerves while others involve putting steroid into joints. A common type of injection is an epidural steroid injection which is typically performed for patients suffering from Degenerative Disc Disease. However, there are hundreds of different types of blocks and injections. Please see our home page for a listing of some of the procedures that we offer in our clinic.

Q: What are the major risks of injection procedures or blocks?

A: All medical treatments, from medications to surgery, have some risk. Injections and blocks have risks but they are usually minimal and vary according to the procedure. Most procedures are performed in our in-office procedure suite, with local anesthesia and possibly sedation, as a same-day procedure with a quick recovery. The risk of this type of procedure is usually very small. Prior to performing the procedure, our physician will review the potential risks of the procedure you are having.

Q: How long will the procedure take?

A: Most procedures take between 5 and 10 minutes. Most of this includes taking the time to obtain images that we use to guide the injection. However, you should expect to be at our facility between 30 minutes to two hours, based on the type of procedure, Preprocedure evaluation, admission paperwork, Recovery time and discharge.

Q: Does the procedure hurt a lot?

A: This really depends on the individual. Many patients can undergo procedures without sedation, but patients who are particularly anxious may benefit from having their procedure done with sedation. Whether the patient is awake or sedated, we do anesthetize ("numb up") the area with lidocaine which reduces procedural discomfort. Should you elect sedation, we will monitor your breathing, heart rate, oxygen saturation and other vital signs throughout and after the procedure.

Q: Which medications can I take before a procedure, and which ones do I need to stop?

A: This depends entirely on the procedure, and also depends on whether you will require sedation. Some of the more invasive procedures require that you stop a blood thinner or anti-inflammatories such as Mobic or Ibuprofen. Please inform our office if you are taking a blood thinning medication so that we can obtain permission to stop this medication if required. You should only stop taking blood thinners after we have obtained permission for you to stop. You should take all blood pressure medications, heart medications, stomach or acid reflux, and breathing medications on the morning of your procedure with a sip of water. Please bring your medications to the procedure. If you are a diabetic, And your blood glucose is greater than 250, You should take half of your morning dose of insulin if you are insulin-dependent. Please see the [Patient Instructions for OR Procedures] (**needs hyprlink to webpage on our homepage) for further details. You may Also choose to call our office at 205-208-9001.

Q: Why can’t I eat if I am scheduled for sedation for a procedure?

A: Undergoing IV sedation without an empty stomach puts you at risk of aspiration in which you can reflux your stomach contents and have them go into your lungs. Aspiration can cause serious lung issues including pneumonia and may be deadly. Not eating before IV sedation is the gold standard for anesthesia care.

Q: Why can’t I drive if I am scheduled for sedation for a procedure?

A: Having sedation puts you at risk of wrecking your car if you drive.

Q: What activity am I allowed to do after a procedure?

A: This depends on what type of procedure you have and whether or not you were sedated for it. There may be restrictions in driving, working, or bathing depending on the procedure type. This is discussed at the time of the procedure. You will receive discharge instructions after your procedure to further clarify. Typically, patients are able to return to normal activities and work within 24 hours of most procedures.

Q: What are the common side effects of steroids?

A: Steroids will typically improve inflammation and thus improve pain within a few days of injection. The common side effects that are observed include a temporary increase in energy, mild insomnia, a temporary increase in appetite, redness of the face, and swelling of the hands or feet in some patients. Should you have any of these side effects, you may call our office. Some patients may benefit from a short-term dose of an antihistamine such as Benadryl for some of these side effects.

Q: I am having some pain after a procedure. Is this normal?

A: Mild pain after a procedure is often normal. Some patients will experience pain at the injection site from the insertion of the needle. With a steroid procedure, it may take 4-5 days or more for the steroid to reach its peak anti-inflammatory effect. With radiofrequency ablation procedures, the needle may cause soreness for several days after the procedure. Patients who are concerned about symptoms after a procedure are encouraged to call us. You will receive discharge instructions after your procedure which more thoroughly explain what to expect after your specific injection procedure.

Q: My provider said the block is diagnostic. What does that mean?

A: A diagnostic block is designed to block a nerve or group of nerves temporarily to see if those nerves are responsible for the patient’s pain. A diagnostic block, or test block, is designed to help us figure out if another procedure may be useful for long term treatment.

Medical Branch Blocks (MBBs) are an example. This is a diagnostic block to help us determine if pain in the spine is coming from the joints rather than the discs. If the 2 of these test blocks are helpful we will bring the patient back for a Medial Branch Radiofrequency Ablation (MBRF or MBRFA) where we burn the nerve to get rid of it and reduce the pain long term.

Another example is a selective nerve root block. A surgeon may request a block of a specific nerve root in the lumbar or cervical spine (a cervical or lumbar selective nerve root block) in an effort to diagnose the painful area and to determine surgical staging. Even though these blocks are labeled as "diagnostic,", some of these procedures may end up relieving pain for days to weeks in some patients.

Q: What can I expect after having an ablation (Radiofrequency Ablation)?

A: You may be sore for several days afterward and it may take as long as 4-6 weeks to get full relief from the procedure.