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Why have I been advised to come in 30 minutes before my first appointment?
During your first appointment you will have to fill out a questionnaire about your health problems. This provides information to the physician about your complete history and is necessary to make a diagnosis and treatment plan. This is done only during the first visit.

What should I expect on the first visit?
It's better if you download the form from this website and fill it before you come for the appointment; otherwise you will need to fill it out on the day of your appointment. A medical assistant will go through the form with you. The physician will review the form, acquire a history of your primary problem, review your old medical records including imaging, and perform a targeted physical examination. After those steps, a detailed plan of care will be formulated and discussed with you. Usually procedures are not performed during the first visit.

If you are taking any blood thinners including Aspirin, Plavix, Coumadin, Pradaxa, Eliquis, Xarelto, etc. please let the physician and/or staff know.

Will I have a procedure during my first visit?
Usually procedures are not done on the first visit.  It is almost always necessary to acquire prior authorization from your insurance.  Most procedures are done in the office in our procedure suite on a separate day utilizing imagine guidance, including both a fluoroscope (x-ray) or ultrasound, depending on the type of procedure planned.

I am on a blood thinner, can I have a procedure?
Let your physician know that you are on a blood thinner. Some procedures can be performed with blood thinners, but most require a period of discontinuation in order to minimize the risk of dangerous bleeding.  Sometimes it is necessary to get clearance from your primary care physician to stop the blood thinner for the required period of time (this can be as short as 2 days, or as long as 7).

Does the procedure hurt?
During the procedure, the area to be treated will receive local anesthetic (numbing agent).  When the local anesthetic is injected, this can cause a brief, intense burning sensation, but will make the rest of the procedure more comfortable.  Furthermore, you have the option of receiving "conscious sedation" via medications administered through an IV.  You will remain fully awake, but the medications administered improve pain and anxiety related to the procedure.  Some procedures require the placement of an IV even if you do not receive conscious sedation.

Do I need to bring a driver on the day of the procedure?
Yes. A number of procedures may leave your leg or arm numb for a few hours. If you are getting sedation, you will not be able to drive back home by yourself. So we require you to bring a driver on the day of the procedure.

Should I come with an empty stomach on the day of the procedure?
If you are planning to receive sedation, we require that you are fully fasting for at least four hours (this includes both food and water). As mentioned earlier, local numbing medicine is given to everyone irrespective of fasting status.  Fasting is necessary as a safety precaution.  In the rare instance that you become over-sedated, you are at an increased risk of an event called aspiration that can be life-threatening.  This risk is minimized if you are fasting.

I am pregnant. Can I still get the procedure?
It depends upon the procedure, but if you pregnant or trying to get pregnant please let the physician know immediately.  


You may not be able to get a procedure that requires X-ray guidance.

What insurance plans do you accept?
We accept most insurance plans. Please feel free to call us and ask about your insurance plan.

I am looking for more information on the procedure?
The details of the procedure, including rationale, goals of the procedure, as well as risks and benefits, will be discussed during the visit in which the procedure is ordered.  But, if further information is needed, there is more information provided under the procedures and educational sections on this website. You are also welcome to call and talk to our trained staff.   


Can a friend or family member stay with me during the procedure?
Our clinic and hospital policies do not allow friends or family members to come into the procedure room. Your friends or family members can accompany you to the preparation area, but are not allowed to come into the procedure room itself.

How long will the benefits of the injection last?
The duration of benefit varies from patient to patient, the underlying medical condition, and the procedure itself. Please discuss this with your physician.

When will I feel relief after the injection?
There are several stages of benefit.  The local anesthetic part of the medication injection begins working within 30 minutes of completion of the procedure. Pain usually comes back after the local anesthetic wears off in 6-8 hours. But, the main component of the procedure, the steroids usually begins working with 48 to 72 hours with gradual improvement thereafter.

How many procedures can I have?
It varies from patient to patient. Usually the procedure can be repeated. Please talk to your physician to discuss this.

How soon must I let you know that I want IV sedation?
Anytime.  You can decide this at the time of procedure. But, as noted above, you have to be fully fasting (food and water) for at least four hours prior to the receipt of the sedation.

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