What can I expect to feel after my procedure?

Immediately after the procedure

Chronic pain is complex and not everyone will experience exactly the same sensations or feelings after a procedure.

Immediately after your procedure you may have numbness around the treatment area. This may sometimes be accompanied by weakness or heaviness. This is due to the use of local anaesthetic and this will wear off in a variable length of time, usually a few hours.

If you have significant sensitivity you may feel pain at the injection sites in spite of the local anaesthetic. This may sometimes be associated with stiffness or muscle tension. If you are feeling this please tell the nurse looking after you on day ward and you may take some of your normal pain medicines, or if required an additional pain medicine can be prescribed for you.

Occasionally you may feel sick or dizzy. Please tell the nurse on day ward if this is the case and you will have a check of your observations. This may include blood pressure and pulse rate. It may include blood sugar measurement. In most cases this will resolve rapidly without specific treatment. Occasionally you may need to have fluids prescribed, or medication, or be further reviewed by your doctor. Very rarely you may need to stay a little longer on day ward for observation.

Please ensure you are driven home by a responsible adult who will be able to ensure you are settled at home after your procedure.

 

At home after my procedure

After the local anaesthetic wears off you may experience an increase of pain. In almost all cases this will respond to regular use of your normal pain medicines. You should take these regularly as prescribed.

We would advise that you do not apply heat to the area on the first day as this will encourage bruising. Application of cold packs may be helpful.

 

Activity

In general it is important to maintain mobility. If you do have pain immediately following the procedure it may be advisable to reduce activity. However gentle paced mobility and muscle stretches should be maintained throughout.

 

Dressing

Please keep any dressings on for 24 hours after which you may soak it off in a shower or bath.

If you have had sacroiliac joint radiofrequency treatment you may have steristrips and a dressing – please keep this on for 5-7 days before removing these at home.

You may notice some bruising at the injection site. This will resolve in a few days.

Steroids are frequently used as part of the injection therapy. If you have diabetes then the steroid may sometimes alter blood sugar levels. If this occurs please contact your diabetic team at your local surgery or at the Trust for advice.

Steroids may sometimes cause irregularity of menstrual cycle, for up to 3 months.

If you are of childbearing age, we advise you to avoid conception of pregnancy for 3 months following treatment, and to use effective contraception.

Rarely, you may feel unwell after a procedure. If this is associated with fever and / or swelling and redness at the injection site please seek medical advice to exclude the rare possibility of infection.

Rarely, you may develop more unusual side effects. If this occurs please contact your GP or contact the pain clinic advice line for non-urgent advice.

Rarely, people feel unwell and do not feel able to await an appointment with the GP or a call back from the advice line, if this occurs please attend A and E.

 

Later after my procedure

Many procedures use depot steroid and this will take 2 weeks to be fully effective.

Most of the benefit you feel will be expected to be in the treated area, benefit for other pains are possible but less likely.

Some patients may experience flare up of their pain after injection treatment, in the majority of cases this will settle in a few days with normal pain medicines, and pacing of activity.

Some patients may experience flare up of other pain related to the position required to do the treatment procedure, this will also resolve with simple measures.

Radiofrequency denervation for spinal pain may cause a longer period of flare up, in the majority of cases this will be managed with normal pain medicines and pacing of activity.

You will gain most benefit from your procedure if you are able to enhance your activity levels.

Please maintain your normal pain medication regime after your procedure. When you have had time to fully recover from your procedure you may wish to consider changes to your medication. In the first instance please discuss this with your GP. Please make gradual changes only and do not stop your medication suddenly. It is best to make only one medication change at a time when managing chronic pain, and to then allow a period of stability before initiating further changes.

An appointment for follow up may be arranged in pain clinic.

If you have been given a graph to chart your pain level after treatment please bring this to your review appointment, or post it to the department prior to review.

 

Further Information

If you have any questions regarding treatment in the Chronic Pain Service, please call our Pain Clinic Advice Line on 01932 723998.

 

For questions regarding your appointment or any other administrative matter, please call the Surrey iMSK line: 01932 722730, select option 1 for procedure booking office or option 4 for pain clinic office.

Website: www.surreyimsk.com

 

Additional useful information in respect of the Chronic Pain Service at Ashford and St Peter’s may be obtained by logging on to the hospital website www.ashfordstpeters.nhs.uk.

From the drop down menu select:

A-Z of Departments - Chronic Pain Management

 

Leaflets

For patient information leaflets - Pain management (Chronic)

 

Alternatively the British Pain Society provides a comprehensive website which you may find useful www.britishpainsociety.org