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Relieving Pain. Restoring Hope.

Before and After Your Procedure

doctor holding a patient's hand, mental help


Instructions Before Your Procedure

  • An appointment will be scheduled for your procedure. Please be prompt. Please bring your insurance cards, your ID, and a list of your current medications with you.
  • Please have someone to drive you to and from your procedure. You should also have someone stay at your home with you following your appointment. Inform your physician if any other arrangements need to be considered.
  • Please do not eat or drink at least 6 hours prior to your scheduled procedure.
  • Check with your physician regarding prescription medications the morning of your procedure.
  • Stop blood thinners and aspirin products at least 5 days prior to your injection. Please verify with prescribing physician prior to stopping any medication. If you are taking blood thinners, you may require pre-procedure lab work. Please contact the office staff for lab orders.
  • If you are diabetic, please make your physician or nurse is aware of your condition and medications.
  • Wear comfortable clothing and low-heeled shoes.
  • If you are unable to make your appointment, please call the office to reschedule 24 hours prior to your arrival time. If you are late, your appointment may be delayed or rescheduled according to the physician’s schedule.


  • You will need to sign a consent form that explains the procedure, its risks, benefits, and complications.
  • An IV will be started to administer relaxing medication (Optional).
  • You will have an opportunity to speak with your doctor before you are transported to the procedure room.
  • After you are placed on the procedure table, monitors will be applied to observe your heart rate, blood pressure and oxygenation during the procedure.
  • IV sedation will be administered if applicable. The intention of the sedation is to make you relaxed and more comfortable. This is not general anesthesia. You will be able to converse with the physician if needed.
  • The physician will mark the area to be injected then cleanse the area with an antimicrobial solution.
  • A local anesthetic will be injected into the skin and muscle above the injection site.
  • You may feel pressure as the doctor inserts the small needle into the appropriate location.
  • X-ray may be used to guide the needle and verify correct placement. Please alert staff if you are or think you may be pregnant.
  • Medications used in pain procedures may include one or more of the following:
  • DepoMedrol/ Celestone- injectable steroid that reduces inflammation.
  • Marcaine/Lidocaine- local/injectable anesthetic that numbs the area.
  • Isovue- radiopaque dye to allow the physician to see placement of the needle with x-ray.
  • Fentanyl- IV narcotic pain medication used for sedation.
  • Versed- IV sedative to relax the patient for procedure.
  • Once the medication has been injected, you will be transported to the recovery area and monitored for 30-45 minutes. You will then be able to drink fluids and provided a small snack to eat. A follow up appointment and discharge instructions will be provided prior to discharge home.



  • You may have numbness and weakness to your extremities due to the local anesthetic administered during the procedure. This is temporary and should wear off in 6-8 hours.
  • You may experience muscle tenderness at the injection site for 24 hours following the injection. Apply ice to the area for 20 minutes every hour for the first 24 hours.
  • Once the numbing medication wears off, your pain may return at its original intensity. This is normal. It may take up to 72 hours for the steroid to reduce the inflammation. Depending on the amount of inflammation, a second injection may be needed before a reduction in pain is noted.
  • Temporary swelling of the hands and feet due to water retention may occur in some patients. An increase in appetite is also possible and can be attributed to the steroid.
  • If you experience headaches that cause sensitivity to light and subside only when lying down, inform the physician immediately. Increase fluid intake to include beverages which contain caffeine and lay down flat.
  • Continue all medications as previously prescribed unless specific instructions to alter or stop medications have been given to you.



  • Rest the remainder of the day. Advance your activity as tolerated. If soreness persists, continue to rest.
  • You may experience numbness or tingling in the affected area for up to 8-12 hours.
  • Do not drive or operate any dangerous machinery for 12 hours after your procedure.
  • Do not perform tasks that require much skill or fine finger work. Do not use kitchen appliances, knives and other potentially dangerous household equipment.
  • We suggest you do not make any important decisions (such as legal or financial decisions) on the day of the procedure. Your ability to concentrate, maintain balance and coordination and decision making may be impaired the remainder of the day.


  • Advance your diet as tolerated to previous diet, unless instructed otherwise.
  • Ice chips or clear liquids (apple juice, water or Sprite) for the first 4 hours. If no problems, may advance to soft diet (ice cream, mash potatoes, etc.) for the next 4 hours. If no problems, may advance to regular diet.

Special Instructions:

  1. Do not drive for 12 hours following the procedure.
  2. Do not drink alcoholic beverages for 12 hours following the procedure.
  3. If you have soreness at the injection site, apply ice for 24 hours, followed by heat. Do not put ice or heat directly on your skin.
  4. Please take notice of the changes in your pain characteristics and report changes at your next appointment. You may want to keep a diary or notes to help you remember.
  5. Continue to take all your medications ordered by your physician.
  6. If a dressing or band-aid is applied, you may remove it in 12 hours (unless otherwise instructed).
  7. Avoid prolonged immersion or bathing for 24 hours. You may shower after the procedure.

Symptoms/Problems- Notify Your Doctor:

  1. Persistent or increasing pain.
  2. Severe headache that decreases when lying down flat.
  3. Any redness, warmth or drainage at the injection site.
  4. If you have any fever or chills.

Call your physician at (210) 582-6600 for any problems or for an appointment.
If you cannot reach your physician and feel you have a medical emergency, call 911 or go to your nearest Emergency Room.