Pain Intervention & Management

Before Your Procedure

Please arrange a ride from the clinic for injections performed on site.

Take your medications on the day of the procedure, especially blood pressure and diabetes medications.

If you are having sedation:

• Inform our scheduler
• Do not eat anything for 8 hours prior to the injection
• You can drink Gatorade or apple juice up to two hours before the injection

Please tell us if you have an infection, are on antibiotics, have a new rash, or have an open wound. We will reschedule your injection once the infection is resolved.

Blood Thinners

Please tell us if you take any of these:

1. Aspirin:

• If you are taking Aspirin for heart health and have NEVER had a heart attack, stroke, or blood clot, (ASPIRIN HAS NOT BE PRESCRIBED BY A DOCTOR), then you can stop it for FOUR days prior to the procedure. Also ask the doctor when you can restart the medications.
• If you are taking Aspirin because you have had a heart attack, stroke, or a blood clot, you will have to discuss stopping the medication with your primary care doctor, neurologist or cardiologist. We will need a note from your doctor documenting the plan for aspirin
  
  • There are some procedures we will do while you are on aspirin and others that we won't do. There is an increased of bleeding if these injections are done on aspirin. You should inform us if your doctor does NOT want you to stop the aspirin.
    • Cervical or neck injections cannot be done while on aspirin- Please discuss with your pain doctor
    • Lumbar or lower back injections can be done while on aspirin but may increase your risk of bleeding.
    • Sacroiliac joint injection and facet injections can be done on aspirin
    • Peripheral joint injections: Hips/knee/shoulder can be done on aspirin
  • Full dose Aspirin may be reduced to 81mg for injections except neck- Discuss with your MD
  • If there are any concerns, we should see you for a follow-up appointment after discussing this with your doctor

2.Ibuprofen

Ibuprofen should be stopped TWO days prior to the injection

There are some procedures we will do while you are on ibuprofen and others that we won't do. There is an increased of bleeding if these injections are done on ibuprofen.

• Cervical or neck injections CANNOT be done while on ibuprofen
• Lumbar or lower back injections can be done while on ibuprofen but may increase your risk of bleeding.
• Sacroiliac joint injection and facet injections can be done on ibuprofen
• Peripheral joint injections: Hips/knee/shoulder can be done on ibuprofen

3. Other Anti-inflammatories:

• Diclofenac, Voltaren, Cambia, Solaraze, Zipsor, Pennsaid, Cataflam, Flector - stop for 1 day
• Midol, Aleve, Naprelan, Naprosyn, Anaprox, Ec-Naprosyn, Select, and Naproxen:- stop for 4 days
• Meloxicam- stop for 4 days
• Etodolac (Lodine)- stop for 2 days

4. Coumadin, Lovenox, Ticlid, Plavix, Heparin, Fondaparinux, Xeralto, Pradaxa, Eliquis, Aggrenox, Persantin, Fragmin

• Make an appointment to discuss this with us before stopping the above medication
• We will NOT perform any injections while you are on any of the above medications