Many patients with pain can benefit from various types of injections. These pain injections are preformed by interventional pain physicians who specialize in managing pain and reducing chronic aches.
Training of interventional physicians is variable; they include those trained in Anesthesia, Radiology, and Physical Medicine and Rehabilitation. A good interventional pain physician will be board certified in their specialty and have years of experience.
Types of Pain Injections
The appropriate injection will be determined once the problematic area is assessed. Most injections can be performed with minimal discomfort and will take only a few minutes once the procedure begins.
Every injection has the same four risks. They are:
Risk of Infection – The first risk is infection. Cleaning off the skin, and using sterile techniques and medications reduces this risk.
Bleeding Risks – The second risk is bleeding. If the patient does not have a bleeding disorder or is not on anticoagulation medication, then this is not a problem.
Allergic Reaction – The third risk is an allergy to a compound used with the injection. The most common is an allergic reaction to the X-ray contrast, however this risk is very small, less than the risk of being hit by lightning, and can be treated.
Needle Damage – The largest risk is the possibility of a needle causing damage to the structure that is being treated. Damage during a spine injection to the spinal cord or to a vascular structure that may cause damage to a nerve, spine or the brain is always a concern. Risk is minimized by using real time X-ray guidance known as fluoroscopy, and by having an experienced and knowledgeable physician administer the injection.
Post-Injection Safety
Some pain clinics require all patients to have a driver for any procedure, but it usually depends on which injection you’re receiving. In the vast majority of procedures, the patient will feel the same or better shortly after receiving the injection. If the patient is nervous, I usually recommend they have someone drive them to and from the clinic, as there is little reason to compound the injection with fear. This is also a good piece of advice for anyone who will be receiving an injection for the first time. If you feel fine on the ride home from your first appointment, feel free to drive yourself to any follow-ups.
If you need help to move or drive before the procedure, it is unlikely the injection will give you the ability to do so in the immediate aftermath. In these cases, you absolutely should plan on having a driver. If you are sedated for your procedure, you’ll be required to have a driver since this definitely impairs the ability to make safe decisions behind the wheel.
After the injection is complete, the physician will likely use a local anesthesia to reduce discomfort around the injection site. This will make your drive home more comfortable, especially if you received an injection on your lower back or hips.
A good pain physician should be able to make you comfortable during the procedure. They can answer your questions and describe the procedure so you know what to expect. You should always meet the physician before the procedure so you can ask any questions you might have ahead of time.