Pain Management - Therapeutic

About Therapeutic Pain Management

Pain management therapy is an outpatient treatment that uses image guided injections to treat the specific area that is causing pain.

It provides a conservative treatment method that may prevent the need for surgery.

Experienced spine interventional radiologists perform our procedures. These physicians have been specially trained to perform therapeutic spine and joint injections. They work with your treating physician to help identify the anatomic cause of your pain and also treat the cause. We use steroids to help reduce inflammation and break the cycle of pain, inflammation, decrease in mobility, and progression of symptoms. The steroids that we use are potent therapeutic anti-inflammatory agents. These steroids are not the same drugs that are abused by some athletes.

Invision Sally Jobe also offers diagnostic pain management services. Diagnostic pain management is used to determine the precise source of pain and for surgical planning.

Risks Involved in Therapeutic Pain Management

Risks involved in pain management treatments include the following:

• Infection, bleeding, nerve injury, and injury to adjacent structures. These are uncommon.
• Risk of x-ray exposure; however, it is well below the level that generally causes adverse affects.
• Reaction to the contrast medium or medications used. This is rare.

Scheduling, Insurance and Preparation

• Medical Center of Aurora
• Sky Ridge Hospital
• Swedish Medical Center
• Porter Adventist Hospital
• Littleton Adventist Hospital.

Insurance Coverage

Pain management procedures are usually covered by insurance when ordered by a physician. Check with your insurance company to be sure. Please bring your insurance card with you to your exam.

Conditions to Let Us Know About

In advance of your procedure, let your scheduler, radiologist, or technologist know if any of the following circumstances apply to you:

• Currently pregnant
• Any allergies
• Any chronic medical conditions
• Using aspirin or anticoagulants such as Coumadin or Warfarin
• Dental work performed within the week prior to the procedure (this increases your risk of infection)
• Sick, taking antibiotics, or finished taking antibiotics less than a week before the procedure (we may need to reschedule your procedure)

Preparation Guidelines

Following are the general preparation guidelines for therapeutic pain management treatments. You may receive additional or differing guidelines based on your specific situation. A technologist or nurse will contact you before your procedure as a reminder and to answer your questions. You may also contact the facility where you will have the procedure to have any questions answered.

• Stop taking blood thinning medications (such as aspirin, Coumadin, Warfarin) between 72 and 96 hours prior to the procedure. Contact your doctor first to make certain that you may safely stop these medications. If you cannot stop them, then a spine injection may not be the best procedure for you.
• Bring any prior imaging studies such as x-rays, MRI, or CT scans with you for your procedure. The radiologist will review these studies to make certain that the procedure is safe and determine the exact site for injection.
• Bring a list of your medications and allergies with you.
• Wear comfortable clothing.
• If you are receiving conscious sedation, arrange for someone to drive you to and from the procedure.

What to Expect

During the Procedure

Here is generally what will happen during a therapeutic pain management treatment:

1. A technologist will obtain a medical history and ask you some questions.
2. If your physician requested that you receive conscious sedation, a small IV will be placed in your hand. Conscious sedation will help you relax; however, you will remain awake for the procedure.
3. The technologist will position you on the exam table.
4. The technologist will sterilize and anesthetize the area to be treated.
5. A fluoroscope will be moved into position above the area to be injected.
6. Using the fluoroscope images, the radiologist will carefully guide the needle to the correct location. He or she may inject a small amount of x-ray contrast media to confirm the location of the needle.
7. After the needle is properly place, the medication will be injected. You may feel pressure during the injection, but most procedures are relatively painless.

Therapeutic pain management procedures usually take about 30 minutes. If you received conscious sedation, you will be observed until you are alert.

After the Procedure

Recovery

After any pain management procedure, please follow these instructions:

• Rest at home for 24 hours
• Refrain from any strenuous activity or impact exercise for 48 hours
• Do not take aspirin products for 48 hours
• Do not apply any direct heat to the injection site for 48 hours, including hot tub, hot bath, or heating pad. A shower is okay. Ice is fine.

Rarely a steroid flare can occur. These symptoms include:

• Facial flushing
• Headache
• Increase in pain
• Difficulty sleeping
• Rapid heart rate

These symptoms are temporary and rarely last longer than 24-48 hours.

If you are given a pain journal, please complete and return it to your referring physician.

Call Invision Sally Jobe at 303-741-1501 or your referring physician if you have any questions or problems.

Procedure Results

Your doctor will receive a written report from a Radiology Imaging Associates spine interventional radiologist. Please follow-up with your referring doctor. Your feedback is important to your treatment plan. If a diagnostic procedure is performed, the radiologist will dictate a report which will be provided to your physician. In turn, your physician will pass the results onto you.

During the exam, our radiologists and technologists will be happy to answer questions about the exam itself; however, they will not immediately provide you with the results of your exam.

Jump to a Service