Pain Clinic Guidelines (ESI)

Epidural Steroid Injection (ESI)

Guidelines and instructions for patients scheduled for an ESI at the Rutherford Regional's Pain Clinic.  Please keep these guidelines/instructions for use or reference during. Telephone Interviews and for any future Epidural Steroid Injections you might have.

  1. If this is your first Epidural Steroid Injection or you have not had an ESI done in six (6) months or more, you will need to be scheduled for a Pretest Appointment 7 to 14 days prior to the injection date.
  2. In many instances the ESI Pretest Appointment interview can be done by the Outpatient Department Nurse by telephone.  If so, you will not need to come into the hospital for your ESI Pretest Appointment.  The Outpatient Nurse will tell you if you DO NOT need to come in for our interview.
  3. If you have not had an MRI or CT of the back in the past year, your attending physician wil need to schedule the necessary MRI or CT before you can have the ESI done.
  4. You will be asked about any previous back surgery.
  5. You will need to bring a list of all your current medications to the Pretest Appointment Interview to give to the Outpatient Nurse or, if the Interview is done by telephone, you will need to have this list of medications readily available to tell the Outpatient Nurse when she calls.  This list of medications need to include:
    1. All prescribed medications.
    2. All herbal medications.
    3. All over-the-counter medications.

For seven (7) days Prior to Procedure, DO NOT take these medications:

  • Plavix
  • Aspirin
  • Lovenox
  • Ginkgo Biloba
  • Coumadin (if taking, notify anesthesia)
  • Trental
  • Pletal
  • Mobic
  • Ticlid

For 24 Hours Prior to Procedure Do Not Take These Medications:

  1. Advil
  2. Aleve
  3. Bextra
  4. Celebrex
  5. Daypro
  6. Ibuprofen
  7. Motrin
  8. Naprosyn
  9. Relafen
  10. Vioxx
  11. Voltaren

DO NOT Take Any Diabetic Medications the Day of the Procedure

If you are taking any of the above medications that need to be withheld, you must contact your physician and let him/her know you need to withhold these medications.  If withholding these medications is not okay with your physician, call the Outpatient Charge Nurse at 828-236-5310.

Patient Instructions:

  1. Do not begin any new meds or over-the-counter meds without your ordering physician's approval.
  2. If procedure is scheduled in the AM, do not eat or drink anything after midnight.
  3. If procedure is scheduled in the PM, no solid foods after midnight.  You may have liquids up to 8 AM.
  4. On the day of the procedure you may take all of your AM medications with a small sip of water EXCEPT for those medications listed in the chart above.
  5. Bring someone with you who will be able to drive you home.
  6. Bring the report or x-ray films of CT/MRI if this was done at another hospital.