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At Virginia Spine Institute, our unique treatment model provides several options for spinal injections for our patients all under one roof. Injections of medications are used to decrease pain and inflammation and have long been used in pain medicine as additional treatment options. Spinal injections use steroid medication; the steroid acts to interrupt the inflammatory cascade that leads to pain and swelling. We have two dedicated fluoroscopy suites and an ultrasound suite to perform injections. Our elite team is comprised of physicians, physician assistants, a registered nurse and medical assistants to ensure that your experience is positive.

Read on for many common questions and a step-by-step process for spinal injections.

Can I continue over-the-counter or prescription medication before my injection?
  • You should continue all of your routine medications as usual.
  • When your injection is ordered, inform your provider if you are on any blood thinners and/or anti-inflammatory drugs. These include but are not limited to: Aspirin, Coumadin/Warfarin, Plavix, NSAIDs (Ibuprofen, Advil, Motrin, Naproxen, Aleve, Voltaren, Celebrex, etc.) or any other blood thinning agents. If you aren’t sure, ask.
  • If you are on blood thinners for a specific medical condition, such as a heart condition, we will directly communicate with your prescribing doctor for permission for you to come off necessary medications 5 days prior to the procedure. Do NOT stop these medications until you receive permission from your prescribing physician. We need a signed consent form from your doctor.
  • If you are on an antibiotic for an infection you may need to reschedule as this can increase the risk for infection. Please call our office to discuss. 
Am I allowed to eat or drink before my injection?
  • Eat a light meal 2 hours prior to the procedure. If you are diabetic, DO NOT alter your normal food intake.
Should I arrive early for my appointment?
  • Please arrive 15 minutes early to fill out necessary paperwork and review any changes in your medical health.
What do I wear to my appointment?
  • Wear comfortable and loose clothing. For most procedures, you will be wearing your own clothes. Betadine or other cleaning agents that are used during the procedure may stain your clothes.
I have a contrast and/or latex allergy, what do I do?
  • Some procedures use contrast dye. Let the staff know if you have a contrast/iodine allergy before your injection appointment.
  • If you say or think that you are allergic to latex, we will send you for a blood test to confirm. FOR YOUR SAFETY, we cannot perform injections until we are certain that you are not allergic to latex.
Do I need someone to drive me to and from my appointment?
  • You need to have someone drive you home if you take an anti-anxiety medication or muscle relaxer. Please discuss this prior to your injection for instructions.
Step-by step process:
  • One of our medical assistants will bring you back and take your vital signs. Vitals are taken before and after all procedures. You may have a blood pressure cuff and pulse oximeter attached to you throughout the procedure and in recovery for continuous monitoring if needed.
  • The fluoroscope x-ray machine will be placed above your procedure site for guidance. This machine is flexible and rotates in different angles to allow your provider to locate the exact area of the injection site. Your provider usually uses a very small needle for local anesthesia and then performs the injection. You should not feel any pain, however, you may feel pressure.
  • After the injection, pressure will be applied to your entry site to prevent bleeding. Your vital signs will be taken post-procedure and you will be discharged home once stable. Most patients after spinal injections walk out without ever needing recovery services.
What should I expect after my injection?
  • You will likely resume your normal activities, but remember to take it easy. The most common complaint is soreness at the injection site. Ice can be helpful to relieve soreness.

Seek medical help immediately if you experience the following:

  • If you develop severe headaches, weakness, bowel or bladder incontinence, or a fever, notify your doctor or go to the nearest emergency facility IMMEDIATELY.
  • For Diabetic patients - it is essential that you monitor your blood sugar and take your medications accordingly. Steroids used in injections can elevate your glucose level.
When should I NOT get a spinal injection?

Medical reasons for not performing spinal injections may include:

  • If you are on antibiotics for an active infection or have a fever
  • Uncontrolled bleeding disorder
  • Uncontrolled blood sugar
  • Very high blood pressure on the day of the injection or overall uncontrolled hypertension
  • If your cannot stop Coumadin/Warfarin, Plavix, or other blood thinning medications
  • If you complain of chest pain or other worrying symptoms
Can repeated spinal injections over time cause further disc degeneration?
  • There is no data that suggests any correlation between repeated spinal injections and further disc degeneration. There is a limit on the number of steroid injections you should have over a period of time to limit any possible adverse effects from accumulation of injectable steroids.

Ask your doctor if you are a candidate for spinal injections. We are always here to answer your questions and determine if a spinal injection is appropriate for you based on your physical examination, clinical evaluation and diagnostic imaging.