Pre Procedure Guidlines

Cervical Epidural Steroid Injection             Lumbar Epidural Steroid Injection               Thoracic Epidural Steroid Injection         
Cervical Facet Joint Injections                      Lumbar Facet Joint Injections                        Thoracic Facets Joint Injections                
Cervical Medial Branch Blocks                     Lumbar Medial Branch Blocks                        Transforaminal Epidural Injection               
Cervical RFA                                                           Lumbar RFA                                                              Caudal Epidural                            
Cervical SCS Trial                                                 Lumbar SCS Trial                                                   Sacroiliac Joint Injections


  Please call our office if you have any questions or need to change your appointment.

The instructions below may be changed according to each patient’s clinical history and pain management needs.

IF you are scheduled for  an Epidural procedure or  Spinal Cord Stimulator (SCS) trial you will need to discontinue taking your blood thinners and must follow the instructions below:

For your safety, you will have to be off of any blood thinning medications for a certain number of days before the pain procedure. However, do not stop this medication without getting permission to do so from the physician who prescribed it. You must do this before each pain procedure, as your medical situation can change over time. If the prescribing physician will not authorize you to stop this medication, please contact us to discuss alternative treatment options.

General guidelines are as follows:

  •  For Coumadin, you will need to stop taking this for 5 days before having your procedure.
If you are on Coumadin, a PT/INR should be ordered by your primary care physician. You can have your blood work drawn on the day  before your scheduled procedure and bring the results with you to your appoinement.

  • For Plavix, Persantine, Aggrenox, Trental or Arixtra, you will need to stop taking them for 7 days before having your procedure. For Lovenox, you will need to stop 48 hours before having your procedure.

  • For Heparin, you will need to stop 6 hours before having your procedure.

  • For Ticlid, you will need to stop 14 days before having your procedure.
  • For Pradaxa (Dabigatran), you will need to stop 4 days before having your procedure.

      On the day of your appointment for your procedure:

  • If you were prescribed Valium to take for your procedure, you may take only 1 valium tablet 1 hour prior to the procedure. (You will be required to bring a driver if you take Valium)
  • You may take your diabetic, blood pressure and pain medications as normal.
  • You must be off antibiotics for 2 days and free of infection before the procedure.
  • If you are pregnant, please inform the Pain Clinic staff.
  • Discharge instructions will be explained and given to you after the procedure.