Frequently Asked Questions
Frequently Asked Questions Regarding Pain Management Procedures
How Long Does The Procedure Take?
Depending upon the areas to be treated, your procedure can take between twenty minutes to an hour.
Where Is The Procedure Performed?
Pain Management procedures are performed in the Short Stay Unit of St John of God Hospital, Subiaco
How Is It Actually Performed?
Since nerves cannot be seen on x-ray, the needles are positioned using bony landmarks that indicate where the nerves usually are. Fluoroscopy (x-ray) is used to identify those bony landmarks. A local anaesthetic is injected to minimize the discomfort. After confirmation of the needle tip position your doctor will proceed with the procedure.
Will The Procedure Hurt?
Nerves are protected by layers of muscle and soft tissues. The procedure involves inserting a needle through the skin and those layers of muscle and soft tissues, so there is some discomfort involved. However your Anaesthetist will numb the skin and deeper tissues with a local anaesthetic.
Will A General Anaesthetic Be Used For This Procedure?
Your Anaesthetist will not use a General Anaesthetic. We usually use intra-venous sedation, so the procedure is quite comfortable.
How Is The Procedure Performed?
Patients are monitored with EKG, blood pressure cuff, and blood oxygen-monitoring devices. The skin at the treated area is cleaned with antiseptic solution and then the procedure is carried out. X-ray (fluoroscopy) is used to guide the needles. Fluoroscopy uses x-ray technology to produce real-time video images.
What Should I Expect After The Procedure And What Are The Side Effects?
Initially there will be muscle soreness for up to a week afterwards. Ice packs will usually control this discomfort. After the first three weeks are over, your pain may be gone or lessened considerably. Some patients may develop hypersensitivity or a burning pain or numb areas for a few weeks. Pain relief is noticed in about 2 to 3 weeks, not immediately. You may use over-the-counter analgesics if necessary.
You may also experience hot and cold flushes for a few days after the procedure.
You should contact your Pain Medicine Consultant if you experience any of the following:
- Marked swelling and redness at the site of your procedure (some minor swelling is common and requires no treatment)
- Prolonged weakness (greater than 24 hours)
What Should I Do After The Procedure?
Make sure you have someone to take you home. We advise patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform your normal activities as tolerated by you.
If you have had Facet Joint Injections you should be able to resume normal activities immediately.
You will be given a Pain Relief Chart on discharge from the Short Stay Unit – please make sure you complete this form and bring it to your next appointment. If you need a copy of this form then please go to our Helpful Links And Resources section in the For Patients menu where you can print / download a copy.
Can I Go To Work The Next Day?
After Radio Frequency or Epidurals you should rest the following day. Sometimes soreness at the injection site may cause you to be off work for a day or two. If you have had Facet Joint Injections, you should be able to return to work the next day.
How Long Will The Effects Of The Procedure Last?
For Radio Frequency procedures, the effects can last from 3-18 months, usually 12 months, occasionally for years. Facet Joint Injections and Epidurals start working in about 5 to 7 days and the effect can last for several days to a few months.
What Are The Risks?
Generally speaking, Pain Management procedures are very safe. However with any procedure, there are risks, side effects, and the possibility of complications. The risks and complications are dependent upon the sites that are treated. Any time there is an injection through the skin, there is a risk of infection. This is why sterile conditions are used for these procedures. The needles used have to go through skin and soft tissues, which will cause some soreness. The nerves to be treated may be near blood vessels or other nerves and therefore there is the potential for these nerves to be damaged, although every effort is made to avoid this. Please discuss any specific concerns you may have with your Pain Medicine consultant.
Who Should Not Have This Procedure?
If you are on a blood thinning medication (e.g. Warfarin or plavix), or if you have an active infection, you should not have the procedure. If you have not responded to local anaesthetic blocks, you may not be a candidate for a facet rhizotomy.
What Time Do I Have My Procedure?
You will be contacted the day before your procedure by the Doctor’s rooms with your admission time. Please allow approximately four to five hours for your stay at the Short Stay Unit.
Do I Take My Medications Prior To The Procedure As Usual?
- Prednisolone – Yes
- Diabetic Medications – Yes
- Karvea – Yes
- Natural Medications – Yes
When Do I Stop Taking My Anti-Coagulants?
- Plavix / Aspirin/ Cartia / Iscover / Clopidogrel – one week before the procedure
- Warfarin – take the last tablet five days before the procedure
For patients having a Facet Joint Injection, please do not take your medication on the day of your procedure.
Should I Bring my Medications With Me To Hospital?
When Do I Start My Medications Again After The Procedure?
Straight away after the procedure
Do I Bring My X-Rays & MRI’s To Hospital?
No, not if the doctor has already seen your films in his rooms