Contact and Hours:

1580 Valencia Street Suite 703
San Francisco, CA 94110
Phone: 415-642-0707
Fax: 415-648-7988

Monday through Thursday:
7:30 am to 4:30 pm

Friday 8:00 am to 3:00 pm

Closed Saturday and

Spinal Injections Instructions

Why Perform Injections?
Spinal injections can be an important part of your treatment plan. They provide two essential functions. First, they can relieve significant amount of pain. While fundamentally they do not change the pathology, they can often provide enough relief so that patients can successfully proceed with a rehabilitation program.

Secondly, since the injections are very precise, they have diagnostic value. For example, if an injection a level L4-5 in the spine relieves only 50% of the pain, then there must another structure that must responsible for the remaining pain. Knowing precisely what is causing the pain allows your physician to accurately treat the problems.

How do I schedule an appointment?
Typically, it could take up two weeks to receive authorization, although it can sometimes take longer. If you have not heard anything from our office after two weeks, please contact us. Once we have authorization from your insurance, we will contact you to schedule your procedure.

How do I prepare?
If you are having IV sedation, please do not eat or drink anything for six hours before the procedure. You can take your medications with a sip of water. If you happen to eat or drink before the procedure, it can still be done, but you will not be able to have sedation because of safety concerns.

You should continue taking your regular medication with a sip of water. Please contact the office for specific instructions if you are on any other blood thinner besides aspirin. Example of such medications include: Plavix, coumadin, warfarin, and lovenox. If you are a diabetic, please contact us for specific instructions.

If you are having IV sedation, you will need someone to take you home.
Please arrive two hours before the procedure in order to prepare.

Please contact us before the procedure if you develop symptoms of an infection like fever, chills, or night sweats.

Please wear comfortable clothing. Leave jewelry and valuables at home.

If you think that you are pregnant, please contact the office.

What type of medications are typically used?
Most procedures use a combination of a local anesthetic and a steroid. The local anesthetic provides some immediate relief. The steroid, which is designed to give the extended relief, can take anywhere between two days to two weeks to take full effect.

What are the risks?
Although most of the procedures are safe, there are always risks with every procedure. You will have a chance to discuss any specific concerns before the procedure with a physician.

Will the procedure be painful?
Most procedures can be done under local anesthesia with mild discomfort. IV sedation can help relieve some of the associated anxiety. However, “knocking someone out” for an injection is not done as that in itself carries significant risks. Certain diagnostic injections like discography are more painful and require active cooperation with the patient. As a result, less sedation is given before the diagnostic portion of the procedure.

What happens during the procedure?
After an IV has been established, you will be taken to the operating room, which is a sterile working environment. An x-ray machine will be used to direct medication to the appropriate location. Every step of the procedure will be explained to you before proceeding. If you feel discomfort, pain, or anxiety, please inform us so that steps can be taken to make you more comfortable.

What happens afterwards?
Most procedures take between ten and twenty minutes. Afterwards, you will be taken to recovery areas where your vital signs will be monitored for approximately thirty minutes. A nurse will be taking care of you and will give you specific instructions before your discharge.

What can I expect when I go home?
You will be given specific instructions corresponding to the procedure you had. In general, you can resume all previous medications. Do not drive the rest of the day. You can do any activity you wish. You can have soreness at the needle insertion site, which you can treat with an over the counter anti-inflammatory. Minor side effects from steroids include: flushing, upset stomach, headache, palpitations, anxiety, increased blood sugars, and flu-like symptoms.