Frequently Asked Questions
How will I feel after an ESI injection?
You may notice some relief in the first few hours following injection. However, the steroid usually takes two or three days to have its maximum effect in most people. You may experience some local tenderness at the injection site for a couple of days after the injection, typical of any injection that may go through muscular tissue. Using an ice pack three or four times a day will help alleviate this. You may take your usual pain medication after the injection, if needed. It is important that you keep track of the amount of pain relief you received, as well as how long the pain relief lasted, as this will be a consideration when consideration is given to future injections.
Do all patients require multiple ESI injections?
No. Some patients find considerable and long-lasting relief with a single injection. A plan of care is unique to each patient, and while injections were always performed in a series of three injections in years prior, the approach to scheduling is markedly changed. Many patients with chronic degenerative changes find a single injection every few months provides significant improvement in pain level and ability to perform daily activities. Studies have shown that up to four to six injections can be performed in a 12-month period in most patients, with very minimal risk.
Why is a facet block necessary prior to rhizotomy?
The nerves that supply the facet branches are variable and not necessarily predictable in the type and location of pain that they cause. The temporary block procedure allows the opportunity to test the facet joints to make sure they are the cause of the pain you are experiencing and identify which of the joints is most responsible for the pain. Almost all insurance plans now require two successful block procedures prior to rhizotomy, as multiple studies have shown a higher chance of successful rhizotomy and avoidance of “placebo effect” with a single block that results in perceived improvement but leads to a failed rhizotomy procedure.
Who is a candidate for vertebroplasty?
People who have suffered recent compression fractures that are causing them moderate to severe back pain are the best candidates for vertebroplasty. In some cases, older fractures may be treated, but the procedure is most successful if it is performed soon after the fracture occurs. The procedure is not used to treat chronic back pain or herniated disks.
Is a trial implantation really necessary for a spinal cord stimulator?
Undergoing trial stimulation before you commit to a full SCS system implantation is a good idea for two reasons. First, if it is carefully planned and conducted, a trial gives you and your doctor valuable information for determining which system is best for you and plays a major role in deciding the optimum area for electrode wire placement. Second, most health insurance plans require a trial in order to qualify the system as a covered benefit.
Do I need a referral to get an appointment with a physician?
We do ask for referral from your treating physician in order to optimize continuity of care between providers and determine the most appropriate comprehensive treatment plan for each patient. If you do have questions, please feel free to call, and we will be happy to assist you in facilitating a referral request as appropriate.