- How do I contact the Pain Center?
- What are your hours?
- Where are you located?
- How do I make an appointment?
- What kinds of insurance do you accept?
- Do I need a referral?
- What should I bring to my appointment?
- What happens at the first appointment?
- Will I be treated on the first visit?
Can I get an injection at my first visit?
Your first visit is an initial clinic evaluation. The purpose of this evaluation is to review your medical history as well as your medications, imaging studies, treatments already tried, and any other pertinent information. Please bring your records if at all possible. A physical exam will be performed and a plan of care will be formulated. If more information(such as records, imaging studies etc..) is required, we will assist you in obtaining it. If an injection is found to be an appropriate treatment it will be scheduled as soon as possible. Injections can only be done on the first visit if you provide payment for services or if your insurer authorizes both an initial clinic evaluation and a procedure on the same day.
Why do I need a ride home after a procedure?
If local anesthetic(“numbing medicine”) spreads to nearby nerves you may have weakness or numbness of your extremities that can last for 1 – 2 hours. If this happens you may have noticeable weakness of one or more extremities and you should not walk, drive or operate any machinery until this resolves. If you received sedation at a surgery center/hospital, your judgement, alertness and coordination will be impaired and you will not be permitted to drive.
Do you use x-rays to do your procedures and are they safe?
For most of our procedures, we utilize fluoroscopy(“xrays”) over the area(s) of injection. This increases safety because it allows us to visualize the injection under real-time imaging. We minimize the dose of xrays to the lowest required for our patients’ and staff safety. Our xray machine and safety monitoring protocols are regulated by the state of California and our contracted physicist(s). Radiation in any form can be potentially harmful and so we recommend you limit your exposure to radiation only when required.
Do you do “_____” procedure?
Chances are we do if the pain management procedure is supported by medical evidence. Click here to see some of our most common procedures.
What can I expect on my first visit?
Your first visit is an initial clinic evaluation. The purpose of this evaluation is to review your medical history as well as your medications, imaging studies, treatments already tried, and any other pertinent information. Please bring your records if at all possible. A physical exam will be performed and a plan of care will be formulated. If more information(such as records, imaging studies etc..) is required, we will assist you in obtaining it. If an epidural steroid injection is found to be an appropriate treatment it will be scheduled as soon as possible. Injections can only be done on the first visit if your insurer authorizes both an initial clinic evaluation and a procedure on the same day.
What is an injection?
Most pain management procedures consist of an injection of long-lasting steroid and local anesthetic placed under xray guidance into the area(s) of pain. The goal of an injection is to provide pain relief by reducing the inflammation (swelling) of the nerves, muscles and/or joints. An injection will not cure the pre-existing medical problem (i.e. herniated or bulging disc, arthritis, spinal stenosis etc…) but it may improve the level of pain for a significant period of time and in many cases reduce the need for costly and invasive surgery. The injections are classically done in a series of three injections about 2-4 weeks apart if needed and generally can be repeated periodically to maintain pain relief. If the pain is significantly improved no further injection is needed unless the pain returns.
Are there any restrictions before the injections?
You should bring an adult to accompany you to/from the procedure. If you are having the procedure done in Odyssey Pain Center, we recommend that you do not eat/drink for at least 6 hours prior to the injection. If you are having the procedure done under sedation in a surgery center/hospital, we require that you not eat or drink for at least 8 hours. You should not be on any blood thinners(including but not limited to aspirin, ibuprofen, naprosyn, relafen, plavix, ticlid, coumadin, heparin, lovenox, fondaparinux, argatroban) before this procedure! If you are on such medications or you are unsure if you are taking a blood thinner, you must alert all of your physician(s) and you should NOT undergo the procedure until it has been approved by your physician(s). If you have fevers or an infection, we do not recommend undergoing the procedure until well after your infection resolves. The procedure will be cancelled if any of the above restrictions are not followed.
What are the risks of the injection?
Risks are very rare but may include bleeding, infection, headaches, nerve injury, joint injury, ineffectiveness and allergic reactions to the medication(s). Even rarer are possible organ, blood vessel injuries.
Other side effects may occur. If local anesthetic(“numbing medicine”) spreads to nearby nerves you may have weakness or numbness that can last for 1 – 2 hours. If this happens you may have noticeable weakness of one or more extremities and you should not walk, drive or operate any machinery until this resolves. You may have increased pain at the injection site as well as your usual area of pain for the first few days after the injection. Patients with diabetes may have a short-term rise of blood sugar. Some individuals may have increased fluid retention and hypertension. Overly frequent usage of steroids can lead to long-term complications such as premature bone/muscle/tissue degeneration, cataracts, infections, hormone imbalances or deficiency.
Does the injection hurt?
Most people agree that the stinging/burning of the initial numbing medicine is the most uncomfortable portion of the procedure although individual response to the procedure will vary.
What happens during the injection?
The pertinent area is cleansed with an antiseptic to sterilize the area. The skin is “numbed” with a local anesthetic by a very small needle. The needle itself is then advanced into the relevant area(s). You may feel pressure throughout the procedure–if pain is felt, more local anesthetic will be given. Once in the correct location, the steroid and/or local anesthetic is deposited and the needle is removed. Your skin will be cleansed and a bandage may be applied. You will be allowed to leave with your ride after the doctor authorizes it.
What will I feel after the injection?
Most people do NOT notice any improvement immediately after the injection and, not uncommonly, the pain may actually be temporarily worsened. This is because the steroid, at a minimum, takes at least two or three days to start to have an effect in most individuals. Therefore, it may be quite some time before you feel a change in your pain level!
Some local tenderness in the site of the injection should be expected for a couple of days afterwards. Using an ice pack three or four times a day may help this. You may take your usual pain medications as well after the injection.
Are there any restrictions after the procedure?
You should not drive or operate any machinery for the remainder of the day after your procedure. An adult should be present to drive you home.
No tub bath or soaking in water (i.e. pool, jacuzzi, etc.) for the remainder of the day.
You may eat, drink and take your medications as usual after the procedure unless told otherwise by your doctor.
You should contact your primary care physician to discuss when/if you should resume your usual medications(including blood thinners) if any.
For what reasons should I call Odyssey Pain Center after the injection?
If you experience severe pain, new numbness or weakness of your extremities, loss of control of your bladder or bowels, fevers or signs of infection in the area of the injection, you should call the Pain Management Center right away at 949-207-7650. If it is after hours or the center is closed, you should seek medical help immediately through your primary care physician or the nearest emergency department.