Preparing for the procedure

  • DO NOT EAT AFTER MIDNIGHT if you are having anesthesia/sedation.
  • You will NEED a driver if you are undergoing anesthesia. If you are arranging for transportation, you must travel with a responsible caregiver. If you have a “local” procedure without anesthesia, arranging for a driver is not an obligation, however, we can only discharge you under safe conditions. If you do drive yourself, you must identify a way to find transport home in case there is a problem.
  • Wear light comfortable clothing. Please do not wear heavy jewelry, belts and large garments.
  • Alert medical staff if you have a recent illness, take antibiotics or have any changes in health since the last clinic evaluation.

Medications to Stop Before the Procedure

Please STOP anti-inflammatory (NSAID) medications 5 days prior to the procedure. These medications include:

Aleve (naproxen), Celebrex, Mobic (meloxicam), Indocin (indomethacin), Voltaren (diclofenac), Zipsor, Sprix (ketorolac spray), etodolac, nabumetone, oxprozin, piroxicam

If you need to take an NSAID or anti-inflammatory medication, you make switch to ibuprofen (Advil or Motrin) and stop 24 hours BEFORE the procedure. Do not take more than 800mg in a day.  Alert medical staff if you took ibuprofen or any other NSAIDs beyond the safe timeline.


Antiplatelet and anticoagulation medications increase the risk of bleeding when performing any injection. For spine injections, uncontrolled bleeding can lead to permanent nerve damage and even paralysis in rare cases.

If you are taking these medications due to a previous history of heart attack, stroke, blood clots, pulmonary embolism or valve replacement, we need the physicians who prescribe the antiplatelet or anticoagulation medications to determine if it is safe for you to stop these medications for a spinal procedure.

If you take:

  • Coumadin, you need to stop the medication for 5 days prior to the procedure and then check an INR to ensure that it is less than 1.5.
  • Plavix should be stopped for 7 days prior to the procedure.
  • Pradaxa should be stopped for 5 days prior to the procedure.
  • Eliquis and Xarelto should be stopped 3 days prior to the procedure.

You may restart your medications 24 hours after the procedure.

Please contact your prescribing doctor and ask if it is safe to discontinue your medication for the above period.

Fax all relevant documents to:   267-337-7950


Aspirin should be stopped for 6 days prior to injection if there is no medical condition. If you have a history of heart disease, blood clots, stroke, or other vascular disease, please discuss with the pain provider about the use as in some cases it may be unsafe to stop aspirin.


Herbal remedies should be stopped 5 days prior to the procedure.