International Pain Specialists in Napperville, IL

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Pre-surgical center instructions for those undergoing I.V. Sedation for the following procedures:

  • Transforaminal Epidural Steroid Injections
  • Facet Joint Injections
  • Sympathetic Ganglion Blockade
  • Radiofrequency Rhizotomy/Neurolysis
  1. You may not eat ANY FOOD after midnight the night before your procedure, if you are receiving I.V. Sedation.
  2. You may have CLEAR liquids, such as black coffee, tea, water, soda or apple juice (no citrus juices or milk) until 3 hours prior to scheduled arrival time. Do not have ANYTHING, including water, after that time.
  3. If you have any kind of sedation, you will not be allowed to drive for 24 hours after your procedure. You will need a driver and must make arrangements for a responsible adult companion to take you home from the surgery center.
  4. Please bring your insurance card or worker's compensation information with you to the surgical center.
  5. Medications:
    • You may take your morning dose of blood pressure medications.
    • Anticoagulants, Antiplatelet drugs, or Blood Thinners must be discontinued prior to interventional spinal procedures to minimize the risk of bleeding. You must consult with your cardiologist, primary care physician or prescribing physician prior to discontinuing any of these medications AND to obtain approval and clearance for you to stop these medications temporarily.  (CLICK HERE FOR BLOOD THINNER INSTRUCTIONS)
    • If you take insulin, please contact your primary care doctor for instructions. Please bring your insulin along with you.
    • If you use an inhaler, please bring it with you.



Back pain or neck pain accompanied by radiating pain to the legs or arms is most often caused by inflammation at the nerve roots located in your spine.  Epidural Steroid Injection is performed to place steroid (anti-inflammatory) medication directly at the source of inflammation and irritation to relieve the pain or radicular symptoms you are currently experiencing.  Strengthening abdominal muscles, weight loss, and exercise or physical therapy may also be important to your pain management program.

“What about steroid side effects?”  The purpose of this injection is to avoid those side effects.  A small amount of steroid medication is placed at the exact spot it is needed – as opposed to giving a large dose orally and hoping it gets to your back.  Common side effects include tenderness at the injection site, increased water retention, leg cramps, increased appetite, and an increase in blood glucose levels.  If you are diabetic, you should monitor these levels closely.

This is an outpatient procedure, typically performed in the office.  If IV Sedation is required for an individual, the procedure is performed at an outpatient surgery center.  Duration of the procedure is approximately 10 minutes.  Prior to the injection, the skin is cleansed with an antiseptic solution and numbed with an injection of local anesthetic.  Fluoroscopic guidance is used to confirm correct placement into the epidural space and steroid solution is injected.  A small bandage is placed over the injection site, which you should remove within 24 hours.  A maximum of three injections spaced about a week to two weeks apart have typically proven to be effective in providing long lasting pain relief.


These instructions are for procedures done at our office, not the surgical center.

  1. Medications:  
    • Anticoagulants, Blood Thinners (Coumadin, Plavix, Lovenox, etc) should be discontinued prior to the procedure according to the following guidelines.  (CLICK HERE FOR BLOOD THINNER INSTRUCTIONS)
    • If you use an inhaler, please bring it with you.
    • You may take regular strength Tylenol for any discomfort associated with the injection.  Continue to take your prescribed pain medications as necessary.
  2. You may drive yourself to and from the office procedure. 
  3. It is not necessary to fast prior to this procedure 
  4. You should go home and lie down for approximately 2 hours following the injection.  After this time you may resume your normal activities.


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