FAQ - INTERVENTIONAL PAIN MANAGEMENT
FAQ: Interventional Pain Services
What is interventional pain management?
Interventional pain management is a medical specialty that uses targeted procedures, diagnostic testing, and coordinated treatment plans to help identify the source of pain, reduce symptoms, improve function, and support recovery. It is often used along with conservative care, medications, rehabilitation, and other medical or surgical evaluations when appropriate.
Why might my doctor recommend interventional pain services?
Your doctor may recommend a pain procedure, additional diagnostic testing, and/or other treatments to help reduce pain, improve movement, and support your recovery. These treatments are often used with conservative care, such as home exercises, physical therapy, chiropractic care, medications, activity modification, and follow-up with your treating doctors.
What is an occipital nerve block?
An occipital nerve block is an injection near the nerves at the back of the head. It may be recommended for headaches, occipital neuralgia, or pain that starts in the upper neck and travels toward the scalp.
What is a facet joint injection or medial branch block?
Facet procedures target the small joints of the spine or the nerves that carry pain from those joints. They may be recommended for neck, mid-back, or low back pain that worsens with extension, rotation, posture, or activity.
What is radiofrequency ablation?
Radiofrequency ablation, also called RFA, uses heat from radiofrequency energy to reduce pain signals from targeted nerves. It may be recommended when diagnostic facet or joint-related blocks provide meaningful temporary relief and longer-lasting relief is desired.
What is an epidural steroid injection?
An epidural injection places anti-inflammatory medication near irritated spinal nerves. It may be recommended for neck, back, arm, or leg pain caused by disc herniation, stenosis, or nerve-root inflammation.
What are joint and bursa injections?
Joint or bursa injections may be recommended for painful inflammation or injury involving areas such as the sacroiliac joint, hip, knee, wrist, shoulder, or bursa. These injections may help reduce pain, improve motion, and support daily activity.
What other diagnostics or treatments may be recommended?
Your doctor may also recommend additional testing or treatment options, depending on your symptoms, exam findings, imaging, and response to care. These may include EMG/NCT testing to evaluate nerve function, bracing for the neck, back, or joints, additional physical therapy and/or chiropractic care, lifestyle modifications, medication review, updated imaging, or consultation with other specialists.
What are the goals of these procedures?
Your doctor may recommend a procedure to help identify the pain source, reduce inflammation, decrease pain intensity, improve function, and help you participate more comfortably in rehabilitation. The goal is not always to cure the condition, but to improve pain control, activity tolerance, and quality of life.
What should I expect during a pain procedure?
Most procedures are performed using sterile technique and may use imaging guidance, such as fluoroscopy or ultrasound. Local anesthetic may be used to numb the area. Some patients feel improvement quickly, while others notice gradual improvement over several days. Relief may be temporary, partial, or longer lasting depending on the condition and treatment response.
What should I tell my medical team before a procedure?
Tell your medical team if you take blood thinners, have diabetes, have an infection, are pregnant, have allergies to medications or contrast dye, or have had a prior reaction to steroids or anesthesia. All procedures have risks, including bleeding, infection, increased pain, allergic reaction, nerve injury, medication side effects, or incomplete relief. Your doctor will review the risks, benefits, and alternatives before treatment.
What should I do after the procedure?
Follow your post-procedure instructions carefully. Avoid strenuous activity until cleared. Track your pain relief, activity tolerance, and any changes in symptoms. Contact the office or seek urgent care for fever, severe headache, new weakness, loss of bowel or bladder control, chest pain, shortness of breath, or worsening neurologic symptoms.
Why is follow-up important?
Your follow-up visit helps determine how well the treatment worked and whether additional care is needed. Your doctor may recommend continued conservative care, repeat injection, RFA, further testing, specialist referral, or other treatment options based on your response.
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INJECTION VIDEOS
CERVICAL FACET | CERIVICAL MEDIAL BRANCH BLOCK (MBB) -> CERIVICAL RFA
THORACIC = EPIDURAL HERNIATED DISC KYPHOSIS
LUMBAR FACET LUMBAR MEDIAL BRANCH BLOCK -> LUMBAR RFA
NERVE BLOCKS / TRIGGER POINT:
VIDEOS: PAIN | VIEWMEDICA VIDEOS | PAIN MANAGEMENT
KNEE:
HYALGAN® Injection for Knee Pain (Fluoroscopic Guided)
Talking to Your Doctor About Medications
Managing Pain After Surgery (At Home) Ibuprofen
MEDICAL MARIJUANA Using Opioids Safely Narcan® Nasal Spray (Naloxone)
Exercising With Chronic Pain Preventing Back Pain Diabetes and Exercise
Anti-Inflammatory Diet Intermittent Fasting Keto Diet Mediterranean Diet
Paleo Diet Vegan Diet DASH Diet Dietary Fiber
HANDOUTS [MEDICAL]
Other Healthy Foods ...
A
Almonds: Provide Vitamin E, magnesium, and protein.
Avocado: Pack healthy monounsaturated fats and potassium.
Asparagus: Deliver chromium, fiber, and folate.
B
Broccoli: High in sulforaphane, fiber, and Vitamin C.
Blueberries: Loaded with antioxidants and low-glycemic carbohydrates.
Black Beans (Dry/Boiled): Packed with plant protein, fiber, and iron.
C
Chicken Breast: Packed with lean protein and selenium.
Citrus Fruits (Oranges/Limes): Lactose-free choice providing Vitamin C to lower cortisol.
Cherries: Rich in anthocyanins to reduce muscle soreness and inflammation.
D
Dark Leafy Greens: Provide iron, magnesium, and nitrates.
Dark Chocolate (85%+): Supplies magnesium, antioxidants, and healthy fats.
E
Eggs: Ultimate source of leucine, protein, and healthy fats.
Edamame (Fresh/Frozen): Offers plant-based protein, iron, and fiber.
F
Fish (Fresh/Frozen): Supplies ultra-lean protein and omega-3 fatty acids.
Salmon: Boosts fat loss via omega-3s.
Tuna: High-density lean protein source.
Cod: Low-calorie, pure muscle-building protein.
Flaxseeds: High in lignans, fiber, and alpha-linolenic acid.
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DISCUSS WITH YOUR DOCTOR 1ST ( Blood thinners | English )
https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022307s002lbl.pdf
The half-life of Effient (prasugrel) is approximately 7 hours (range 2–15 hours), based on the elimination half-life of its active metabolite.[1] This is substantially shorter than the half-life of warfarin (36–48 hours), and also shorter than the half-lives of the direct oral anticoagulants previously discussed: dabigatran (12–17 hours), apixaban (9–14 hours), rivaroxaban (5–13 hours depending on age), and betrixaban (19–27 hours).[1-6]
**** Important Reminder - FOR REFERENCE ONLY
SEEK INSTRUCTIONS FROM YOUR DOCTORS ****
***For Spine AND HIP INJECTIONS - here are instructions to stop bloodthinners.
For SI joint injections - no need to stop your blood thinner.
Do not stop taking your anticoagulant until you have been cleared to do so by the medical provider prescribing that medication.
Anticoagulants
Coumadin (warfarin): Stop 5 days before procedure; INR must be obtained on the day of the procedure.
Pradaxa (dabigatran): Stop 4 days before procedure.
Eliquis (apixaban): Stop 3 days before procedure.
Xarelto (rivaroxaban): Stop 3 days before procedure.
Bevyxxa (betrixaban): Stop 6 days before procedure.
Antiplatelets / Platelet Inhibitors
Aspirin / Excedrin (any dose “baby” or otherwise): Stop 7 days before procedure.
Plavix (clopidogrel): Stop 7 days before procedure.
Effient (prasugrel): Stop 10 days before procedure.
Ticlid (ticlopidine): Stop 5 days before procedure.
Pletal (cilostazol): Stop 2 days before procedure.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Advil (ibuprofen): Stop 1 day before procedure.
Arthrotec (diclofenac): Stop 1 day before procedure.
Indomethacin: Stop 2 days before procedure.
Lodine (etodolac): Stop 2 days before procedure.
Mobic (meloxicam): Stop 4 days before procedure.
Aleve (naproxen): Stop 4 days before procedure.
Relafen (nabumetone): Stop 6 days before procedure.
Feldene (piroxicam): Stop 10 days before procedure.
Supplements
Fish oil: Stop 6 days before procedure.
Garlic: Stop 7 days before procedure.
Vitamin E: Stop 7 days before procedure.
Turmeric: Stop 7 days before procedure.
Again, confirm these timelines with the provider who prescribed your medication.
**** Recordatorio importante - SOLO PARA REFERENCIA
BUSQUE INSTRUCCIONES DE SU MÉDICO ****
Para inyecciones en la columna vertebral Y la cadera – aquí están las instrucciones para suspender anticoagulantes.
Para inyecciones en la articulación sacroilíaca (SI) – no es necesario suspender su anticoagulante.
No deje de tomar su anticoagulante hasta que haya sido autorizado por el proveedor médico que le recetó ese medicamento.
Anticoagulantes
Coumadin (warfarina): Suspenda 5 días antes del procedimiento; el INR debe obtenerse el día del procedimiento.
Pradaxa (dabigatrán): Suspenda 4 días antes del procedimiento.
Eliquis (apixabán): Suspenda 3 días antes del procedimiento.
Xarelto (rivaroxabán): Suspenda 3 días antes del procedimiento.
Bevyxxa (betrixabán): Suspenda 6 días antes del procedimiento.
Antiplaquetarios / Inhibidores de Plaquetas
Aspirina / Excedrin (cualquier dosis “baja” o normal): Suspenda 7 días antes del procedimiento.
Plavix (clopidogrel): Suspenda 7 días antes del procedimiento.
Effient (prasugrel): Suspenda 10 días antes del procedimiento.
Ticlid (ticlopidina): Suspenda 5 días antes del procedimiento.
Pletal (cilostazol): Suspenda 2 días antes del procedimiento.
AINEs (Antiinflamatorios No Esteroides)
Advil (ibuprofeno): Suspenda 1 día antes del procedimiento.
Arthrotec (diclofenaco): Suspenda 1 día antes del procedimiento.
Indometacina: Suspenda 2 días antes del procedimiento.
Lodine (etodolaco): Suspenda 2 días antes del procedimiento.
Mobic (meloxicam): Suspenda 4 días antes del procedimiento.
Aleve (naproxeno): Suspenda 4 días antes del procedimiento.
Relafen (nabumetona): Suspenda 6 días antes del procedimiento.
Feldene (piroxicam): Suspenda 10 días antes del procedimiento.
Suplementos
Aceite de pescado: Suspenda 6 días antes del procedimiento.
Ajo: Suspenda 7 días antes del procedimiento.
Vitamina E: Suspenda 7 días antes del procedimiento.
Cúrcuma: Suspenda 7 días antes del procedimiento.