Q & A

QUESTIONS ABOUT YOUR PROCEDURE

Q: What types of procedures do you perform at PainCare?
A: Our interventional specialists perform minimally invasive, needle “band-aid” procedures. In general, these procedures do not require surgical incision or general anesthesia. Ample local anesthetic and in some cases intravenous sedatives help make treatment procedures well tolerated.

Q: Where are the procedures performed at?
A: Most of the procedures are performed on-site at PainCare Surgicenter, a fully AAAHC and Medicare accredited facility . PainCare Surgicenter performs only pain treatment procedures – unlike other mixed-use surgery centers and hospitals, where various types of cases, both clean and dirty, are performed daily and in adjacent suites.
PainCare utilizes the most advanced equipment (including GE’s OEC imaging equipment) optimized for interventional pain treatment. The combination of our specialized equipment and staff help us provide the safest, most convenient and effective treatments for our patients.

Q: How long will the procedure take?
A: Most of the procedures take less than 30 minutes, depending on the type of procedure and the patient’s specific condition. In general, most of the patients are in and out of our facility within one hour.

Q: Will I need a ride?
A: Yes and no. We encourage our patients to have a ride available, especially the first time. The only time we do require a ride home is if the patient receives an IV sedative, or if the procedure will produce temporary numbness or weakness in the legs.

Q: Are the procedures painful?
A: With local anesthesia, most patients find the procedures easily tolerated. A sedative is infrequently needed. However, if a patient is anxious or is unusually fearful of needles, a sedative is given.

Q: Should I stop my blood thinner?
A: Blood thinners such as Plavix, Coumadin, Warfarin and Ticlid are given to patients at risk for forming blood clots. Please make sure to inform your PainCare doctor if you are taking a blood thinner. You will be instructed on what to do based on your individual situation. Do not stop your blood thinner on your own prior to receiving instructions. While most physicians do not think it is necessary to discontinue non-steroidal anti-inflammatory medications such as Motrin and Naprosyn, some may require you to stop aspirin products for up to 14 days before a procedure. Again, you will be instructed by your doctor.

Q: What should I do with my other medications?
A: You may continue to take the rest of your medications as you normally do.

Q: What should I wear?
A: You should wear loose and comfortable clothes.

Q: Is the procedure covered by my insurance?
A: Almost all procedures are covered by insurances. In addition we are providers for Monarch Healthcare, Mission Hospital Affiliated Physicians, Memorial Care Medical Group, COMP and other health plans and groups. Health plans vary greatly in terms of deductibles and co-pays; our office will assist you in determining your insurance coverage.

Q: What can I do following my injections?
A: You will receive complete post-discharge instructions from our nurses after your procedure. In general, we advice rest and minimal physical activity for the rest of the day. In general, patients may return to baseline activity within 24 to 48 hours after the procedure.

Q: How often can I have a steroid injection?
A: In general, steroid injections are quite safe when given less than 3 times every 6 months.

Q: How long does the relief from injection procedures last?
A: While most patients do well, some patients, especially those with severe degenerative or post-traumatic conditions, may not experience much improvement. The results can vary widely, ranging from temporary relief to long-term complete pain resolution. Unfortunately, there is as yet no definitive way to predict how each individual patient will respond to treatment.

Q: What if the procedure doesn’t help?
A: PainCare is a full service pain center that offers multiple treatment options. Medications and rehabilitation treatments are some of the alternatives.
PainCare physicians maintain staff privileges at local hospitals and work closely with specialists in Neurology, Neurosurgery, Orthopedics etc. – consulting with each other as needed. If surgery is needed, and inescapable, you will be referred to the most qualified specialists in the community, or elsewhere in the country.

QUESTIONS ABOUT EPIDURAL CORTISONE INJECTION

Q: What is Epidural Cortisone, or Epidural Steroid Injection (ESI)?
A: ESI is a procedure that places a small amount of powerful anti-inflammatory steroid medication, cortisone, around inflamed spinal nerves, in the epidural space. It reduces the swelling, irritation, and pain caused by the pinched nerves.

Q: Why is ESI helpful?
A: ESI is used to treat pain caused by inflammation of the spine that may involve herniated discs, pinched nerves, and injured soft and connective tissues.

Q: Is ESI similar to labor epidural?
A: ESI and labor epidural are similar but different. Labor epidural uses anesthetics while ESI uses cortisone. ESI is performed with a smaller needle with the patient lying flat on the abdomen. A moving x-ray machine (C-arm) is usually used to precisely place the needle.

Q: How many injections will I need?
A: ESI is performed as a series of 2 to 3 injections over several weeks. The series can be repeated in the future, or later in life, if the problem returns.

Q: Does cortisone just cover up my pain? Will I injure myself without knowing?
A: Cortisone is neither a pain medication nor an anesthetic. It is an anti-inflammatory drug. It is a compound similar to what the body normally produces at times of stress, except longer-lasting. Cortisone helps the body recover. All of your faculties and sensations will remain intact, thus you will not injure yourself without knowing.

Q: Is steroid bad for you?
A: Problems with ESI are rare. Cortisone is a steroid, but it is not the performance-enhancing anabolic steroid you’ve heard so much about. Cortisone is more likely to cause problems when it is used chronically, such as for treating rheumatoid arthritis or for asthma. A short series of ESIs rarely causes problems.

Q: Is ESI used only for back and leg pain?
A: ESI can be used to treat nerves along the entire spine but lower back and neck are the most common locations for the procedure.

Q: Do you do ESI under X-ray?
A: Precise medication delivery to the injured areas is essential for good response. Training and equipment do affect how some physicians in the community practice. Our specially designed interventional suites, with the most advanced GE C-arm and multi-directional x-ray tables, set the standard. Our facility is fully accredited by AAAHC and Medicare for meeting high quality standards. The information contained here is not intended as a substitute for professional medical evaluation and management.  It should be used only as a starting point for further research.  A physician should always be consulted for any health problem.