Frequently Asked Questions
Q: Is a cortisone injection painful?
A: For most of our procedures we give a local anaesthetic, like at the dentist.
Q: What can I do right after the treatment?
A: Except for an arthroscopic injection of the shoulder, most of the other techniques indicate stopping sports activities, physiotherapy, as well as occupational therapy for approximately 3 days – 2 weeks. All usual daily activities such as walking, working, shopping are allowed.
Q: Do I have to fast before these treatments?
A: No, fasting is not necessary for the treatments at our clinic.
Q: Are there any secondary effects after receiving these procedures?
A: It is extremely rare, but there could be sensitivity at the site of injection for a few days. Since we are injecting cortisone, there could be a small rise in glucose levels or a mild face rash lasting only a few days after the injection.
Q: Are there any medications that cannot be taken during my treatment at your clinic?
A: Yes, antibiotics cannot be taken at the time of injection; it is better to finish your prescription and schedule your injection after. Also it is important to note that all blood thinners are not permitted .If you are taking Coumadin, Plavix, Aggrenox etc., you must ask your prescribing doctor to authorise stopping this medication before the injection,(7 days for Plavix +Aggrenox) and ( 5 days for Coumadin).For patients on Coumadin, a blood test (INR) would be required a day before scheduled injection in order to confirm the possibility of the next days appointment.
Q: Can I take aspirin or anti-inflammatory medication before or after these injections?
A. Yes, common aspirin and anti-inflammatory medications such as Voltarin, Celebrex, Naproxy and Arthrotec are permitted.
Q: Do I need to stop work after an injection?
A: If your work is physically intensive you could be required to stop work for 2-3 days.
Q: Why do I need to be accompanied?
A: We are injecting an anaesthetic which can cause temporary numbness, therefore, for your protection, it is better not to drive. If you are taking public transport or taxi, it is not necessary to be accompanied.
Q: What if I have to leave the country after my treatment?
A: Ideally, we would like the patient to stay in the region for approxamately 15 days after an injection; however, we can still proceed with the injection if this is not the case.
Q: How long after the injection will I feel better?
A: The beneficial effects of these injections are not immediate and can take up to 2-3 weeks.
Q: If I have Hepatitis or AIDS can I still have an injection?
A: Yes, this is mentioned on the consent form you will sign before your procedure.
Q: When will my referring doctor receive the medical report?
A: The referring doctor will receive the medical report within 2 -3 weeks following the treatment.
Q: Can I receive treatment at your clinic if I am not a Canadian citizen?
A: Generally speaking no , except for special cases, for example if you are a permanent resident , foreign student, or have special work status, then you most likely could be treated at our clinic.
Q: What are the costs of our treatments?
A: Our prices range from 150$-$400$ depending upon the treatment.
Definitions
Définitions:
Facet Joint Bloc: This is an injection, comprised of a proportionate mixture of anti-inflammatory medicine and anaesthetic (cortisone and xylocaine) which is injected into the facet articulation (see definition).
The purpose of this injection is to administer the medicine with precision into the area of the spinal column causing the pain. In order to insure that the medicine is injected with pin-point accuracy and security, this procedure must be done under fluoroscopic guidance (see definition). These injections can be administered in cervical, lumbar or dorsal anatomical areas.
Facet articulation: Also known by the name zygapophyseal articulation, it is located in the posterior region of the spinal column (see drawing 1a) at every vertebral level there are two facet articulations (right and left) which comprises the posterior area of the spinal column.
These articulations, full of nerve endings, permit stability of movement between the vertebras in the posterior area of the spinal cord.
Neuroforaminal epidural: This is an injection comprised of a proportionate mixture of anti-inflammatory medicine and anaesthetic (cortisone and xylocaine) which is injected into the epidural space through the foramen (see definition). The purpose of this injection is to administer the medicine next to the nerve root responsible for sciatic pain. Using fluoroscopic guidance the specialist can achieve pin-point accuracy in administering the medicine into the area of inflammation, caused by a herniated disc(s), foraminal srenosis, or spinal stenosis. This is the technique most recommended at the 2009 International Spinal Intervention Society Meeting.
Foramen: This is known as the anatomical space where the nerve root leaves the spinal column, in the area of the inter-vertebral disc. This area containing many spinal nerve roots is susceptible to compression or irritation caused by herniated disc(s), foraminal stenosis or spinal stenosis.(see design 1b,1c,1d)
Fluoroscopic guidance*: This is a technique involving the use of a specialized radiological apparatus, in order to effectively administer pain medication to the appropriate anatomical region. This apparatus allows us to see bone structures and their articulations permitting precise injection positioning, for the many diverse types of infiltrations available to the patient. To aid in the visualisation and photo-imaging of this technique we use a contrast agent, an iodine based medication, in order to confirm the correct positioning of the injection, therefore providing the patient with a secure and effective treatment. (*see photo #10)
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