Medial Branch Block

Post-Procedure Care Instructions
Pain Injections

9218 Kimmer Drive, Suite 101 Lone Tree, CO 80124
(P): 303-623-2680 (F): 303-623-2814

WHAT SHOULD I EXPECT FOLLOWING THE PROCEDURE?

Immediately after the injection you may experience temporary relief, or your pain may intensify temporarily before you notice an improvement. Soreness at the injection site (and IV site) is common and may persist for a few days. The degree of pain and onset of pain may vary from patient to patient. Steroids can take 5-7 days to take effect. Be patient, you may have increased discomfort before you feel better. 

If you experience discomfort, you may apply a wrapped ice pack intermittently for the first 24 hours then heat or ice packs thereafter. You may take analgesics such as Tylenol, but avoid any NSAID’s like Ibuprofen, Advil, Aleve for 24 hours following your procedure. Stretching may also be beneficial. Do not take extra opioid medications without permission from your physician.

Steroids can cause side effects. These are usually short-lived, but include sweating, insomnia, swelling, flushing, headache, fluid retention, palpitations, flu-like symptoms, nausea, increased heart rate, and menstrual changes. Diabetic patients may notice an increase in their blood sugar levels. Contact your diabetes doctor if your glucose becomes difficult to control or exceeds 300 mg/dl.

If you have had a Medial Branch Block:  Please remember this procedure is a diagnostic test to determine if you are a good candidate for a radiofrequency ablation.  During this procedure they will use ONLY numbing medication (NO STEROID), which is temporary. The numbing medication typically works for a few hours, and will then wear off, and your pain will return. We will provide you with a pain diary to fill out for the first 4-6 hours after your procedure. Carefully attempt to perform the tasks that typically aggravate your pain. Track your pain level and percentage relief following your procedure. Please refrain from taking any pain medications during the first 4 hours after your procedure. The physician’s office will contact you after the procedure to determine how the diagnostic test went. If you do not hear from the office within a few days, please contact them with your results.

If you have had a Radiofrequency Ablation: It will take 1-2 weeks before you start feeling relief from the RFA, with maximum effect occurring within 3-4 weeks of the procedure. No steroids have been used during this procedure. You may have a Lidocaine patch placed at the injection site, which you may wear for up to 12 hours. The patch is ineffective after 12 hours and should be removed. You may experience relief from this procedure lasting anywhere from 6-12 months, and in some cases years.

WHAT CAN OR SHOULD I DO AFTER THE PROCEDURE?

Diet:  Start with clear liquids, especially if you have had sedation. If your stomach tolerates liquids, slowly advance your diet as tolerated until you have resumed your normal diet. 

Sedation/Anesthesia: If you have had sedation/anesthesia the following applies for the next 12 hours. DO NOT drive, drink alcohol, or use recreational drugs, operate machinery, tools, or firearms, sign important or legal documents. You MUST have a responsible adult with you for 12 hours following sedation/anesthesia. 

Activity:  Following your procedure, please rest for the remainder of the day and then resume activities as tolerated. It is important to stay mobile as walking will prevent muscles from stiffening. Avoid lifting heavy objects > 20 pounds for 1 week.

Medications:  Please resume your home medications as indicated on your home medication discharge list. If taking any blood thinners, please refer to the discharge medication list to determine when you may resume your blood thinner. Please do not drive while taking narcotics or muscle relaxants. 

Shower:  You may remove your dressing and shower on the same day as your procedure. Please NO bathtubs, swimming pools, and hot tubs for the next 3 days to avoid submerging your injection site in water. 

Work:   If you were working up until the day of your procedure without complications, you may return to work the following day.

Pain diary:  If you had a diagnostic injection and were provided with a pain diary, please carefully attempt to perform the tasks that typically aggravate your pain. Please track your pain level and % relief following your procedure and bring this to your next appointment.

POST PROCEDURE PRECAUTIONS

Please call your physician’s office if you develop any of the following:

  • Local tissue swelling, redness, drainage or severe tenderness at the injection site or NEW onset of radiating pain to a different location of your body.
  • Fever > 100.4 °F
  • Severe headache occurring after the procedure that is worse when standing and/or sitting and is not controlled by medications. This may also be associated with nausea and/or vomiting. 
  • You may experience numbness or weakness immediately following the procedure, if this lasts more than 6 hours, please contact your physician.
  • In the event of any urgent problems or questions, call your physician’s office at the number listed below from 8:00 am – 5:00 pm, Monday-Friday. If you call after hours, the answering service will connect you with the on-call provider. For emergencies, call 911 or go to the nearest Emergency Room. 
  • VMD Pain: 303-750-8100
  • VThe Denver Spine and Pain Institute: 303-327-5511
  • VOrthopedic Centers of Colorado: 303-344-9090

GO TO THE EMERGENCY ROOM or CALL 911 IF YOU ARE EXPERIENCING:

    • Rapid development of bowel or bladder incontinence or inability to urinate within 6 hours
    • Loss of sensation in the groin/rectal area or loss of strength in arms or legs
    • High fever, sudden onset of substernal chest pain, or shortness of breath
    • Severe lethargy, weakness, inability to walk, seizures or onset of confusion

     

    PHYSICIAN: ___________________________________   OFFICE PHONE NUMBER: _______________________________

     

    INSTRUCTIONS GIVEN BY: ____________________ RESPONSIBLE PARTY SIGNATURE: __________________________________________________

     

    Date: ___/___/___   TIME: _____________ COPY PROVIDED TO PATIENT. 

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