If you have a serious side effect or complication and cannot contact the Helmcken Pain Clinic please call 911.
General Recommendations
Immediately after the procedure, you may notice that your pain is gone or quite reduced. You may also notice localized numbness around the injection site or a tingling, numb or heavy sensation in the arm or leg (depending on the injection site). This is due to the local anesthetic (“freezing”) medicine. These sensations will last a few hours at most. Your pain will return and you may have increased pain for a day or two. This is due to irritation from the needle and occasionally from the medications used. You should start noticing pain relief within the first week although some injections can take longer to have an effect. If you have not noticed some reduction in pain within 2 weeks please call the office for advice.
You may feel a scab or piece of plastic on your skin if skin glue was used. Do not pick at this. It will fall off naturally in a few days to weeks.
Exercise
We advise patients to take it easy for a day or so after a procedure. Perform activities as tolerated. Do not suddenly increase your activity if you feel better following the injection or you might injure muscles that are no longer used to hard work. You should resume stretching immediately. You can try some of these exercises.
Medications
Resume taking all your regular medications including blood thinners and pain medications unless told otherwise by a physician. Pain medications that are taken “as needed” can be taken if necessary.
Heat or ice?
You may apply heat or cold packs to the affected site as necessary. Ice is recommended in the first few days after RFN, CRYO, PRP or prolotherapy injections. After other injections use whatever you like better – heat or ice. If you have numbness be extra careful to ensure that the pack is not too hot. Do not apply ice directly to the skin, instead wrap the ice pack in a tea towel or similar thickness cloth. Apply ice or heat for 15 minutes intervals with 10-15 minutes in between applications.
Bathing
Do not submerge the procedure site in water for the remainder of the day. (No swimming, bathing, or hot tubs). You may take a shower unless otherwise told by a physician.
Driving after injections
Ability to drive following injections is determined on a case-by-case basis according to the BC Medical Fitness Information for Medical Professionals section 2.2.5 (Transient impairments)
If you have had sedation, general anesthetic or taken analgesics such as Codeine or Tramadol then you cannot drive for 24 hours after taking the medication.
If you have weakness in a limb, dizziness or other physical effects that impair your ability to drive then you cannot drive until those symptoms are absent. This most often comes up following nerve root or epidural injections but could also occur following other procedures.
You are safe to drive only if the above 2 conditions do not apply, the physician does not say otherwise and you feel safe to drive. The physician’s opinion supersedes all other advice or recommendations you have received.
SIDE EFFECTS & COMPLICATIONS
Cortisone (steroid) side effects
Common side effects of steroid medications (if used) include a temporary increase in pain, mild fever, mild headache, a red flushed rash across your chest and face (like you are embarrassed), insomnia, mood changes, water retention and temporarily increased blood pressure. If you are diabetic your blood sugar will be increased for up to 48 hours after the injection.
If your blood pressure goes up too high you may feel nauseated, confused, have a severe headache that keeps getting worse, blurred vision, difficulty breathing or chest pain. These are serious symptoms that should be immediately checked out by a physician or the emergency department. Call 911 if you are worried.
Infection
Infections can occur after any injection or break in the skin. Symptoms include severe localized pain, swelling, redness, localized warmth, fever or feeling generally unwell. Symptoms typically increase in severity until treated. Please contact our office immediately if you are worried about infection. If you can’t contact the office and are worried about an infection please go to a walk-in clinic or the hospital ER.
Nerve irritation or injury
Nerve irritation is manifest as skin sensitivity, burning, stabbing or other pain in the area that a nerve travels to. It can occur when a needle is placed close to a nerve during the injection. Symptoms typically go away in a few weeks. Please call the Helmcken Pain Clinic if you are worried this has happened – we can sometimes treat this.
Nerve injury is extremely rare and usually occurs if there is an infection or bleeding around a nerve. Symptoms include progressive numbness or weakness in the area that a nerve travels to (after the local anesthetic wears off). This can be very serious depending on the nerve involved and must be treated quickly.
Please contact the office immediately if you are concerned about nerve irritation or injury. If you can’t contact the office please go to a walk-in clinic or the hospital ER.
Collapsed lung
Pain procedures in the chest or neck can rarely cause pneumothorax or collapsed lung. Symptoms include shortness of breath, chest pressure or pain, fainting, rapid breathing, rapid pulse, a bluish tinge around the lips or confusion. You should call 911 or go to the nearest emergency department if these occur.
Botox
Botox injections can cause muscle weakness depending on where it is injected and how much is used. Let your doctor know if you develop weakness or other unusual symptoms after Botox injections. Botox in the face or forehead can cause a drooping eye. Sometimes this can be treated with eye drops. Botox in the neck can make it difficult to lift your head up and sometimes requires you to use a soft collar for a while. Botox in the front or sides of the neck can also cause difficulty swallowing if it leaks into the throat muscles. These symptoms may last up to 3 months. Please contact our office immediately if you are worried about weakness after Botox injections.