Over the years, our patients have asked very perceptive questions and turn to us for assistance and answers about their pain, their conditions, treatments and their use and many other topics related to managing and recovering from chronic or debilitating pain.
Frequently asked questions
We provide these questions and answers to help you. If you have a specific question and don’t see it here, please contact us for assistance.
Questions about our Practice
Who is treating my pain?
Since 1999, we have earned the trust not only of thousands of Charleston area patients, but also our area spine surgeons and doctors, by providing advanced, safe and cost-effective injections in a compassionate environment. We are anesthesiologists, certified by the American Board of Anesthesiology. We have completed an additional one-year fellowship in pain management, accredited by both the American Board of Anesthesiology and the American College of Graduate Medical Education (ACGME). (The ACGME is the governing body for all medical residencies.) Following the one-year fellowship, a written examination is offered for the candidate. We have completed and passed the written pain management examination, achieving full board certification.
Pain is a complex process, and we feel it is in your best interest to see a physician who can not only perform the injection or nerve block, but who can also treat your pain with many additional options – ranging from A to Z. Your pain physician should have knowledge of all of them. To get the most effective treatment available for your pain, we strongly suggest you seek your injection and/or treatment from a fellowship trained pain management specialist who is board certified by the American Board of Anesthesiology. We have these qualifications, and only physicians with these qualifications will practice within InterveneMD
What do I need to bring with me the day of my appointment?
Insurance cards and a picture I.D. are required. Please bring a list of your current medications. Prior diagnostic films, reports and medical records are also useful if they are available. For your convenience, we recommend you print and complete our new patient paperwork prior to your appointment. Completing these forms in advance and taking them with you to your appointment will minimize your wait time.
Will I be seen on time?
At InterveneMD, we value your time, and we run on time. If you find yourself running more than 10 minutes late for your appointment, please call us so we can try to reschedule your visit.
How long before I can get an appointment?
We try to get our patients in to see the doctor within 5 days of insurance being verified. If you are in severe pain, please let our staff know. We strive to be as accommodating as possible.
Questions about Pain Treatment
Why do you insist on evaluating all patients before a procedure?
Interventional Pain Medicine is a sophisticated, highly specialized field. Even though a primary care physician or specialist may recommend a specific procedure, we want to evaluate you before your procedure. While this evaluation may confirm the diagnosis and the suggested treatment, it is not uncommon for this evaluation to shed light on different aspects of the problem, resulting in different treatment options. It is important for the patient to ask questions and explore all alternatives prior to consenting to any procedure.
Recently, I’ve heard about platelet rich plasma (PRP) and stem cells to treat spinal pain. Does it work?
We have had success treating various spine related pains in the neck and back using regenerative therapies (platelet rich plasma and stem cells). These treatments are a breakthrough way to help jump start your body’s own healing process using cells from your own body, giving your body a great chance to heal without steroid injections or surgery. We were the first clnic in Charleston to integrate these treatments into our epidural steroid injection treatment for disc bulges, arthritis, stenosis and degenerative disc disease.
My primary doctor or spine surgeon has recommended that I get a spine injection at a facility owned by a hospital – can I come to you instead?
Yes, it is very easy to do so – just ask. We have developed great relationships with Charleston area physicians and surgeons – we’ve been seeing them, their families, and their patients since 1999.
Where are the procedures performed?
All of our procedures are performed in our office, using our specifically equipped and staffed procedure rooms. Our staff understands patients’ pain problems and are experienced in doing everything possible to provide comfort. Using our specially equipped office procedure rooms allows us to save you and your insurance hundreds of dollars.
How long will my procedure take?
Each procedure is different, but the typical time is ten to twenty minutes.
Will I be pain-free?
Treatment is very individualized and a positive outcome is achieved in the majority of cases. Many people are permanently cured with treatments offered by our physicians. The goal is to offer efficient specialized pain relief procedures that are alternatives to other treatments, such as back and neck surgery.
When can I resume exercise or sports?
Remember Aesop’s Fable “The Tortoise and the Hare” — when you resume your exercise regimen, be the turtle. Mild exercise such as walking, stationary bike, and water aerobics are encouraged as soon as possible. It is generally acceptable to resume activities such as jogging, golf, tennis, weightlifting, within 2-3 days after your treatment, but discuss your unique situation with your InterveneMD physician.
How long will I be off from work?
This will be determined by the doctor, but most patients return to work the day after the procedure.
How long will I benefit from the procedure?
It depends on your condition. Some patients report permanent pain relief, others find temporary relief. Usually, after a series of nerve blocks or other treatments, you can experience relief from months to years. Our goal is to provide as much pain relief to our patients as possible with the least amount of side effects. Sometimes nerve freezing, heating or other advanced pain therapies are utilized.
Are epidurals the only option I have for pain management?
No. Epidural injections are the most common nerve block performed for pain management, but there are many more options available. Through your history and examinations, we are able to guide you toward the most appropriate treatment for your condition. Our extensive fellowship training provides us knowledge of many different options. In addition to treating your pain more effectively, we can also help your surgeon determine if surgery is needed.
Are these treatments alternatives to surgery?
Interventional pain management treatment options should be explored prior to considering any type of surgery. They should be one of your first treatment options, not your last. If we determine you need surgery, those recommendations will certainly be made. The overwhelming majority of patients are candidates for more conservative, non-surgical treatments.
What is x-ray guidance?
Most of the procedures performed are done under x-ray guidance using a fluoroscope. This makes pain relief more precise and longer lasting. The radiation dose for a procedure is generally less than being in the sun for a few hours. Please note that x-rays are still not recommended during pregnancy.
Will the procedure hurt?
Every effort will be made to make your procedure comfortable. This includes a pleasant and courteous staff to assist you, the use of local anesthetics to “numb” the skin prior to any needle placement and the judicious use of sedative medications. The vast majority of patients state the procedures were not nearly as painful as they thought they would be. And getting a procedure done should not be nearly as bad as the pain that sent you to us. We believe that each patient and each procedure is unique and, therefore, a customized approach is used for each patient. Our goal is to provide excellent medical care in a manner that is non-painful and safe.
Will I require more than one treatment?
Each patient’s treatment is individualized. Usually it will take more than one treatment, but occasionally just one procedure will provide lasting relief.
Will I need someone to drive me home after a procedure?
We recommend having a driver to assist you home, particularly for injections you may be getting for the first time. However, if you are unable to get a driver, you are welcome to stay at our facility until you feel able to leave on your own. Of course, if sedation is used for any procedure, you will be required to arrange a ride home.
Do I need to stop taking my medications prior to treatment?
Do not stop taking medications without speaking with your treating doctor or primary care physician first. However, some medications will affect our treatment. You will be directed by our staff on how to take your medications on days of procedures.
Can these procedures also be done in a hospital or ambulatory surgery center?
Yes they can. However, your total visit there will usually be about 60-90 minutes longer than if we did your injection in our office. Most often, this is due to lengthy check-in and check-out requirements. We value your time and want to get you back in action with only a minimal disruption to your daily schedule.
A procedure done in a hospital or surgery center also generates a “facility fee” for the use of that facility. For most injections, this facility fee is about $1500. By doing the same procedure in our office, you get the same outcome and get to keep that money in your pocket.
Are there risks to interventional pain treatment?
All medical treatments from medications to surgery involve risks. Generally, interventional pain management procedures are very safe and complications are rare. Common side effects and risks will be explained to you prior to your particular treatment therapy. Please ask if you have a specific question.
What methods are used to evaluate my chronic pain?
Pain history, past medical history, physical exams and diagnostic studies may be recommended by your physician to evaluate your pain.
Should I tell my other doctors about coming for a chronic pain evaluation?
While the decision is completely up to you, it is recommended that you tell your other physicians about your chronic pain condition and treatment that you have sought. This will allow communication between all of your healthcare providers. Upon your request, we will provide your other treating physicians with your medical information and treatment.
What about psychology and psychotherapy?
Pain is mediated by the brain and we know that emotions and thoughts significantly alter the sensation of pain. This is a physiological fact. Therefore, it is very important that a pain physician address psychological issues. If our evaluation reveals psychological “barriers” to recovery, we may institute specific tests and/or refer the patient to a specialist for evaluation and/or treatment. In this day of enlightened thinking, psychological therapy does not mean someone is “crazy.” Some therapies, such as biofeedback and hypnosis, represent another modality to use in combination with medications, physical therapy and injections to decrease pain and improve function.
Do you use chiropractic in your treatments?
Like physical therapy, the combination of chiropractic care and injection therapy can have a synergistic response in certain painful conditions. Chiropractors provide a broad range of services and the appropriate use of this type of treatment depends upon the specific pain problem. We work closely with several excellent chiropractic clinics.
What is sciatica?
Sciatica refers to pain in a lower extremity caused by irritation of a spinal nerve in your lower lumbar (lower back) region. It’s commonly caused by a herniated lumbar disc, but may also occur with degenerative arthritic changes of the spine or, less commonly, with irritation of the sciatic nerve outside the spine.
Spinal nerve irritation may cause pain, loss of normal sensation, loss of muscle strength or any combination of these symptoms. The pain is usually quite specific, occurring in a thin, band-like distribution from the lower back to the thigh, leg and foot. It may come on gradually over time or rapidly after an acute injury. The discomfort may vary from a mild tingling sensation in the foot to sharp, searing pains that shoot down the leg.
People who do a lot of heavy lifting, both young and old, are at risk for sciatica, as are older people with arthritis. Sciatica in a younger person typically occurs from a herniated disc which pushes on the nerve or releases inflammatory chemicals that irritate the nerve. In older people, sciatica may occur because of disc degeneration, the abnormal movement of one vertebral body over another, arthritis of the small joints in the back of the spine or thickening of the ligaments of the spine. Or it may occur because of a combination of all of these things.
What do I do if I have a problem after the injection?
It is not uncommon to feel tired or to have some localized tenderness after an injection. We recommend rest for at least four hours after your procedure and the use of ice for any areas of tenderness. If you experience a fever, severe pain or any neurological change, please call our office immediately. One of our staff providers will answer your questions and recommend a appropriate course of action.
Do you use physical therapy and how does it help?
Active physical therapy represents a way for a patient with pain to increase activity in a safe, supervised and gradual fashion, strengthening the back muscles, correcting postural problems and educating the patient in ways to prevent recurrent injury. In addition, passive modalities such as heat, massage and ultrasound may reduce the inflammation and pain. It is our philosophy that the synergistic use of physical therapy and interventions optimize patient recovery in most conditions. We work closely with several physical therapists.
Questions about Epidurals
Does it take a long time to get an epidural?
It takes just minutes in our office at about half the cost of a hospital.
Are epidurals painful?
No. The patient may feel a pressure sensation down the legs or in the back. The injection is rarely uncomfortable and most patients report that the anticipation of the injection is worse than the actual treatment.
How is an epidural administered?
An epidural injection is usually administered with the patient comfortably lying face down. The back is cleansed with an antiseptic and x-ray images are made in real time to identify the structures of the spine to aid in guiding the injection. A numbing medicine is placed just under the skin to numb the area. Sometimes more than one site on the spine in treated so there may be several numbed areas on the skin. A very small wire-like needle is used to deliver the medication at the appropriate site.
Why are epidural injections prescribed?
Most epidural injections are given for back pain and leg pain (sciatica) from a disc or bone spur irritating the nerves. An epidural is prescribed to reduce pain, tingling and numbness caused by nerve inflammation. However there are many other medical problems that epidural injections can help treat. Those include spinal stenosis, arthritis of the spine and degenerative disc disease to name just a few.
When I get an epidural, what is the medication injected?
The medication injected is usually an anti-inflammatory steroid and a local anesthetic (numbing) medicine. This reduces the inflammation around the nerves and discs in the spinal canal.
What is an epidural?
An epidural is an injection of medication in the epidural space just outside the spinal fluid. The epidural space is the area that surrounds the spinal cord running from the base of the brain to the tailbone including the spinal nerves as they exit the spine.
Questions Related to Insurance
Why do I have to fill out so many forms?
Paperwork has become an unpleasant but necessary part of modern medicine. Insurance companies and governmental agencies require that certain forms be completed. In order to properly bill your insurance company, we need specific information. To expedite your evaluation, we ask that you fill out a questionnaire addressing your present and past medical conditions.
Does insurance cover the procedures?
We accept most private insurance, Medicare and Workers’ Compensation but do not accept Medicaid. As many of you have witnessed, insurance companies have tightened coverage over the past few years with many medical decisions subject to pre-authorization. Thankfully, despite these restrictions, most of our procedures (except for platelet rich plasma/stem cell) remain covered. However, you will need to check with our staff when your appointment is made to see what kind of restrictions/pre-authorizations are unique to your policy.
If your insurance doesn’t cover your procedure, your insurance denies your procedure pre-approval, or if you have a high deductible, don’t worry, we have the most affordable self pay rates in Charleston – less expensive than other offices, surgery centers or hospitals.
Do I need a physician referral?
A referral is not necessary unless your insurance requires it. Our staff will check your insurance benefits prior to an appointment and let you know.