One Trust - serving our local communities Lewisham and Greenwich
Chronic Pain Service
Procedure Leaflet
University Hospital Lewisham
This booklet has been written by the Chronic Pain team at University Hospital
Lewisham. It is intended for patients who have been referred to the service and
their family members and carers.
Please take time to read through this leaflet. If you have any questions
please contact the pain team on:
Direct line: 020 8690 9127 (Monday to Friday 9am–5pm) Fax: 020 8333 3248
This leaflet is to help answer some of the PROCEDURES
questions you may have about having a
procedure under the Chronic Pain Team. Available procedures include:
It explains what you can expect when you Epidurals
come to hospital. If you have any questions or Facet joint injections
concerns, please speak to a doctor or nurse Radiofrequency
caring for you.
Root blocks
We perform all of our pain relief injections in the Capsaicin Patch
Riverside Treatment Centre. Joint injections
Trigger points
When you come for your procedure please go
directly to the Riverside Treatment Centre reception, Other nerve blocks
on the ground floor of the Riverside building.
All patients require an appropriate ADULT to collect them from the Riverside Treatment
Centre following a procedure. If you are using hospital transport, you should have an
adult waiting for you at home when you return.
There is limited space in the Riverside Treatment Centre, so patients are restricted to
one escort. You escort will need to wait in the reception area. If you prefer you can bring
your escort’s contact number and we will call them when you are ready for discharge.
Please note: Parking is often difficult so please allow for this when planning
your journey.
Your whole visit will last between 2–3 hours.
What should I do before I arrive for my procedure?
Please bring your glasses if required, and a magazine or book.
Make sure you have some painkillers such as paracetamol at home for any soreness
that you may feel.
Have a light meal before coming into hospital unless your procedure requires
sedation. This will be stated in your appointment letter.
Have a bath or shower before you attend.
Please take ALL your normal medication (drugs) unless specifically told not to by the
pain team. If in doubt please contact us on 020 8690 9127.
Please bring a current list of medication with you as failure to do so may
result in your procedure being cancelled.
If you take any of the following medications: Clopidogrel (Plavix), Warfarin (or
equivalent), Pradoxa, or Aspirin with a dose higher than 75mg please contact the
Chronic Pain Service as soon as possible on 020 8690 9127 for advice on stopping
these medications before the procedure.
Please note there is no facility to store valuables.
Please let us know if you are or think you may be pregnant or are currently breastfeeding.
If you cannot come for this appointment please call the Pain Department on
020 8690 9127 to arrange a new date. If you do not come for your procedure, your
name will be removed from the waiting list and your GP will be informed.
On admission
We will complete an admission form.
To do this we will need to know:
What medications you are taking
Your past medical history
Allergies/reactions to medication
Any other relevant information
It is very important that you tell us about any medical conditions you have.
These include:
Heart conditions
Diabetes
Asthma/COPD/sleep apnoea
Renal failure
Epilepsy
And also any:
Alcohol intake
Recreational drug use
Needle phobia
You will be asked to change into a hospital gown.
You will meet your Consultant to discuss your procedure. They will answer any
questions you may still have.
If you require sedation, an intravenous cannula will be inserted.
Women of child bearing age will be asked to provide a urine sample to
exclude pregnancy.
What should I expect from the procedure?
Depending which procedure you have, pain relief is not usually immediate and may
take up to a month to be effective. Sometimes an increase in pain may occur. This may
last from a few days to a week after your injection. Should any of this happen, please
take your usual painkillers regularly until this settles down.
What are the risks of my procedure?
As with any procedure, there are some possible risks. The most common risks are:
A minor risk of contracting an infection.
There is a possibility of having numbness or weakness.
Some patients report headaches after an epidural injection – your Doctor will
advise you what to do if this happens.
Patients with diabetes who are given steroid injections may notice their blood
sugar levels become unstable for up to a fortnight afterwards. We advise you to
take more frequent blood sugar readings. If there are any problems, please ask for
advice from the diabetic nurse at your surgery.
No immediate pain relief.
No pain relief at all.
An increase in pain from a few days to a week after the injection, occasionally
longer. Seek medical advice from your GP if your painkillers are not effective.
For more specific risks associated with your procedure, your consultant will happily
discuss this with you either in clinic or during the consent process.
The procedure
Theatre staff will come to collect you from the waiting room and do some final checks.
During the procedure you will lie on your side or your stomach. Some procedures
require different positions. A local anaesthetic will be used to numb the area being
injected. Occasionally sedation may be given during the procedure.
For some procedures, x-ray or ultrasound is used.
We will monitor your blood pressure, heart rate, respiration rate and oxygen levels
during and immediately after the procedure. If required, we will give you oxygen
and/or other medication.
After the procedure
Do not to try and get up from the trolley until you have been assessed by the nurses
on the ward. You will be regularly monitored to assess how you are feeling.
If you have no side effects and have no numbness and feel fine to get up, we will
help you out of bed, so you can go to the toilet and get dressed. Once the nurse has
assessed you as safe for discharge, you may go home.
Expect to stay a minimum of 1 hour after the procedure.
We will contact your escort when you are ready for discharge.
We will give you aftercare instructions for when you are back home. You need to
keep all dressings clean and dry until the next day, when they can be removed. Wait
to take a shower or bath until the next morning.
We advise you NOT to drive for 24hours after your procedure. Please be aware that
many motor insurance policies are not valid for the first 24 hours after a procedure.
If you have been given sedation, do not drink alcohol for 24 hours as it may have
adverse effects.
We recommend that you do not return to work on the day you have your procedure.
You can resume normal activities the following day.
Will I be seen again after my procedure?
Yes. A follow up appointment will be made to see either the Pain Nurse Specialist or
Pain Consultant and they will review the effect.
Notes
Please write down any questions you may have for your doctor.
If you would like this information in another language or format including Braille, large
print, audio tape or computer disc, please contact 020 8836 4592 or e-mail
LG.pals@nhs.net
PALS (Patient Liaison Service ) provides confidential advice, support, information and
help for patients, their families and carers.
If you have any further questions or would like more information, please ask the nurse or
doctor caring for you.
Disclaimer
The information in this leaflet is for guidance purposes only and is in no way intended to
replace professional clinical advice by a qualified practitioner.
This information sheet was written and prepared by the Chronic Pain Team, University
Hospital Lewisham London SE13 6LH.
© Lewisham and Greenwich NHS Trust
University Hospital Lewisham
Lewisham High Street
London
SE13 6LH Reference no. CC 15/61
Date: November 2015
Tel: 020 8333 3000 Review date: November 2018
Fax: 020 8333 3333
To re-order email debby.black@nhs.net
www.lewishamandgreenwich.nhs.uk and quote REPU000165
