Frequently Asked Questions

Someone should be referred to a pain management specialist when pain does not respond to usual conventional treatments (such as physical therapy, over-the-counter medications) within a reasonable period of time

At the initial visit, you will be evaluated by one of our pain management physicians. Prior to your appointment, one of our office staff may request that you complete an online questionnaire regarding your past medical, surgical, family, and social history as well as any physical symptoms you may be experiencing. If the questionnaire is not completed prior to your appointment, we kindly ask that you arrive 30 minutes early to complete this in the office. During your visit, you will be asked specific questions related to your pain and a thorough physical exam will be performed. We ask that you please bring all MRI, CT, X-Ray, or EMG reports to your initial visit with the accompanying CD or films if available. Also, make sure that you bring your insurance card and driver’s license.

You will receive a phone call the day before your procedure from the facility where you are having it performed to provide you with your pre-procedure instructions and to answer any questions you may have. Please wear comfortable clothing, as you will be asked to change into a gown. If you are having sedation, you will be required to bring a driver with you and you may not eat or drink anything after midnight before your procedure. Upon arrival you will be admitted by one of the nurses at the facility and you will talk to the physician performing your procedure (and anesthesiologist if you are having sedation) and operating room staff. Once in the operating room, you will be positioned on the table and pictures will be taken with an X-Ray machine. Your skin will be cleaned with a cold, wet solution and a sterile drape will be placed. During injection of the local anesthesia, you will feel a pinch and burning for a few seconds until the area is numb. If you are feeling any discomfort during the procedure, please inform your physician. Our goal is to make your procedure as painless and comfortable for you as possible. The X-Ray machine will be used intermittently throughout your procedure to ensure your safety. Once your procedure is finished, you will be accompanied back to the recovery area where you will be monitored for a few more minutes before you can change back into your clothes and be discharged from the facility. If you have sedation, please plan on at least 45 minutes of additional recovery time.

If you are having SEDATION for your procedure, you MAY NOT eat or drink anything after midnight. If you are having local anesthesia only, it is safe to eat and drink prior to your procedure.

If you are having SEDATION for your procedure, you MAY NOT drive yourself to and from the facility. You will be required to have someone available to drive you home afterwards.
Please consult with your physician regarding driving after your procedure if you are having local anesthesia only.

In most cases, sedation is not required for pain management procedures and is often not covered by insurance plans. A few of the more invasive procedures our physicians perform will require sedation and this will be discussed with you during your office visit.

We recommend that you take your regular antihypertensive medications and pain medications before your procedure. If you are diabetic and will not be eating prior to your procedure, please consult with your physician regarding your diabetic medications.

Coumadin (warfarin) for 4-7 days – please consult with your physician prior to discontinuation. An INR will need to be obtained the evening before or morning of your scheduled procedure.
Lovenox Injection (enoxaparin) for 24 hours
Plavix (clopidogrel) for 7 days
Pradaxa (dabigatran) for 3 days
Ticlid (ticlopidine) for 14 days

You may have some post-procedural pain at the site of your procedure, which often resolves quickly. You may use ice intermittently at the site or take over-the-counter medications like ibuprofen or acetaminophen as needed. It is also possible that your pain for which you had the injection may be increased for several days until the medication begins to take effect.

If you are taking a blood-thinning medication, we will request documentation faxed to our office stating that you have permission to stop taking your medication for the specified time period prior to your procedure.

If you are having a series of injections, you will be asked to call our office after each injection to schedule the next procedure. Depending on your response to your procedures, you may be asked to call and schedule a follow up appointment in one of our offices before proceeding with any further procedures.

If you are having a series of injections, you will be asked to call our office after each injection to schedule the next procedure. Depending on your response to your procedures, you may be asked to call and schedule a follow up appointment in one of our offices before proceeding with any further procedures.

You may resume your medications after your procedure. If you are having a steroid or cortisone injection and have diabetes or hypertension, please be aware that you will likely have an increase in your blood glucose levels or blood pressure after your procedure and this should be monitored and treated accordingly.

There are several classes of medications that are used to treat pain. The most common are:

• Anti-inflammatory medications like aspirin, ibuprofen or naproxen. These work by reducing inflammation caused by injury or irritation.
• Non-aspirin medications like acetaminophen. This medication is often combined with other medications to provide even greater pain relief.
• Corticosteroid medications like Medrol (methylprednisolone). These medications are typically used for a short period to treat more severe inflammatory conditions.
• Adjuvant pain medications – these include anticonvulsants, antidepressants, and muscle relaxants.
• Opioids like hydrocodone, hydromorphone, or oxycodone. These are used to treat acute pain related to injury or surgery and cancer-related pain. They are also sometimes used to treat chronic pain.

There are a variety of delivery methods of pain medications including oral, sublingual, topical creams, patches, or injections.

As a general rule, our physicians AIPM will not prescribe opioid medications on your first visit. However, other medications may be prescribed on a case-by-case basis.

We are unable to replace lost or stolen prescriptions. You will need to be evaluated in the office by a physician in order to receive an alternative medication. Certain medications can cause withdrawal-like symptoms if discontinued abruptly.

Non-controlled medications may be e-prescribed or called in to your pharmacy during regular office hours. Controlled medications (opioids) may not be e-prescribed or called in and require an office visit to obtain a refill.

If you feel that your medication is not working or you are experiencing side effects, we ask that you please call our office to speak with one of our physicians or schedule a follow up appointment. However, we recommend that you allow the new medications up to 2-4 weeks to take effect.