Patient information

On the same day

 

No hot tub, swimming or bath for 24 hours (showers are permitted)

 

If needed, apply ice (bag of frozen vegetables, gel bag, Sac Magique) on the injection site for 10 to 15 minutes every 2 hours.
 

Take your regular pain relievers as prescribed by your physician. If you do not have a prescription, you can take Tylenol Extra Strength. Over-the-counter anti-inflammatories (Advil, Motrin) and Robaxacet are acceptable provided you do not have stomach problems, high blood pressure, heart disease or an allergy.
 

On the following days

 

No physiotherapy, physical exercise or sports for 48 hours

 

• You may experience an increase in your usual symptoms for a few days. This is normal. We have inserted one or more needles into a site that was already painful, and cortisone acts gradually.

 

• Applying ice or heat (heating pad, Sac Magique, warm bath) can alleviate the pain. Use the method that you find the most soothing.

 

 

There is a good chance the injections will provide you relief, but it will not be immediate (with some exceptions). Most results can be noticed from three days to three weeks.
 

It is important to see your physician again to update your condition.

 

A report will be sent to your physician within three weeks.

Women

The date, duration and flow of your next two periods may change.
 

People with high blood pressure

You might have higher blood pressure for two weeks. Call your pharmacist as needed.
 

People with diabetes

Monitor your blood-sugar levels and follow the enclosed recommendations.
 

Patients taking anticoagulants (blood thinners)

Take your next dose of anticoagulants at the regular time. If you are taking Coumadin or Sintrom, have your PT/INR checked in 10 days.
 

Other

• You may also experience redness and heat (flushing) in your face. Do not worry. This is a side-effect that will go away approximately 48 hours after the injection.

 

• If you feel unusual sensitivity at the injection site accompanied by redness and heat and/or if you have a fever of 38 oC or more, contact your clinic as soon as possible or, if you feel it is an emergency, dial 8-1-1 for Info-Santé.

 

Immediately after the treatment, you must:

• Monitor your capillary blood glucose four times daily for at least a week:
  – before breakfast
  – before lunch
  – before supper
  – at bedtime
• If your blood-sugar level is higher than normal, it is recommended to:
  – increase hydration to 250 ml/hour
  – monitor your food intake
  – watch for the appearance of symptoms such as intense thirst, drowsiness, blurred vision
• For those using an insulin scale, follow it and modify your doses as needed.

 

If you do not have any symptoms, you do not need to consult a doctor. It is temporary. You can call Info-Santé at any time by dialling 8-1-1.

 

IF YOU ARE SYMPTOMATIC OR IF YOUR BLOOD-SUGAR LEVEL IS ABOVE 20,

  SPEAK TO YOUR PHARMACIST

FOR A REFERRAL TO THE EMERGENCY DEPARTMENT OR TO A WALK-IN CLINIC.

Questions on techniques and methods
Ultrasound

Is it painful?

• Injection: Possible pain at the injection site (usually lasting less than a week), tolerable and usually light to moderate, but pain is relative, meaning each patient will interpret it differently.

 

Driving restrictions. Accompaniment required for the following injections:

• R foot?
  – No driving for 24 hours
  – Preferably accompanied

• L foot?
  – OK if driving automatic
  – No driving manual for 24 hours, so preferably accompanied

• Knee?
  – No

• Hip?
  – Greater trochanter and hip joint: No
  – Piriformis: No driving for 24 hours and
  preferably accompanied

• R or L wrist?
  – No, except for carpal tunnel injection: No
  driving for 24 hours

 

Greater occipital nerve and driving restrictions:

• Injection on one side: driving is permitted
• Injection on both sides during the same appointment : no driving for 24 hours and the patient should be accompanied

 

Botox injection:

• Yes, we inject Botox.
• Minimum time between Botox injections: three months

 

Minimum time between Visco/Cingal injections:

• For the same joint: at least three to six months
• If a surgery is planned for the same joint: at least three to six months before the surgery; otherwise no injection
• For another joint: at least one month

 

Expiry date for an open prescription

• 12 months
• If more than 12 months, an MD must evaluate the case and decide whether a new consultation is necessary or not

 

Can a pregnant woman have cortisone or other injections?

• There is no absolute contraindication, but should be avoided and, if done, only at a hospital. Please show the request to the MD
• No fluoroscopy, under ultrasound guidance only

 

PRP

Is it painful?

• Injection: Possible pain at the injection site, tolerable and usually light to moderate (normally lasting less than a week) Occasionally (rarely), onset of pain exacerbation manifests three to five days after the injection and continues for three to four weeks before relief occurs (especially for intratendinous and plantar fascia injections).

 

Why do you need to properly hydrate before a PRP appointment?

• Blood needs to be drawn to prepare the PRP. It’s easier to take blood (insert the IV catheter) when the person is well hydrated.

 

Walking boot / crutches for PRP

• Hip:
  – Greater trochanter: Crutches only
  – Coxofemoral intra-articular: No

• Knee:
  – Patellar tendon: Crutches only
  – Knee intra-articular: No

• Foot-ankle:
  – Plantar fascia: Crutches and walking boot
  – Achilles tendon: Crutches and walking boot
  – Ankle intra-articular: No

 

PRP and NSAID:

• Yes, agree to cease NSAID (Naproxen, Voltaren, Aspirin, Celebrex, Advil, Vimovo, Motrin, etc.) for at least two weeks before and two weeks after the procedure

• Anticoagulants and antiplatelet agents, stop times are the same, BUT only if the attending MD agrees; otherwise PRP remains a potential option, but the product obtained (to be re-injected later) is less than optimal (usually, a patient who has been taking anticoagulants or antiplatelet agents has already been spoken to in person)