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What to Expect at Colorado Pain Specialists

We understand the effect that chronic back and neck pain can have on you and your family. Chronic pain often brings stress, uncertainty and a host of questions. It is normal to feel overwhelmed at first — wondering what to expect from your diagnosis and treatment.

At Colorado Pain Specialists, we are dedicated to serving you. We do everything we can to put you and your family at ease and help you through this process. We work as a team to provide you with the best treatment options and answer all of your questions along the way.

During your initial evaluation, a board certified pain management specialist in conjunction with other health professionals will perform a thorough assessment and develop a plan for your care. This plan will be shared with your referring physician as well as the health care team assembled to address your needs. As requested by your referring physician, additional treatment will be provided and the physician and health care team will evaluate your progress.
Throughout the entire treatment process, Colorado Pain Specialists will communicate your progress to your referring physician. As you near the end of your treatment plan, your referring physician will spend additional time providing you with information about how to manage your condition.

We are confident that your experience with us will be beneficial and ultimately result in a better quality of life for you and your loved ones.

Pre and Post Procedure Information


The procedure cannot be performed if you have an active infection, flu, cold, fever and high, or uncontrolled blood pressure, or if you are on blood thinners. Please make your Physician aware of any of these conditions. This is for your safety!

PRE-INJECTION PATIENT INSTRUCTIONS

  1. Have NOTHING to eat or drink 6 (six) hours prior to the procedure. This includes cigarettes, gum, mints, etc.
  2. DO NOT take any product containing aspirin for 3-5 (three to five) days prior to the procedure. DO NOT take any non-steroidal anti-inflammatory (Motrin, Advil, Aleve, etc.) medications for three days prior to the procedure. Continue to take prescribed medications as instructed by your doctor. You should not take any pain medication the day of the procedure. You may start them again after the procedure is completed. Advise the doctor if you are currently being treated for any infection or if you feel that you may be acutely sick (fever, chills, nausea, etc.).
  3. Please advise if you are on any blood-thinning medications, i.e., Coumadin. It is recommended that you DO NOT take any blood thinning medications 3-5 (three to five) days prior to the procedure.  You MUST contact your prescribing physician regarding your procedure and instructions on stopping your blood thinning medications.
  4. DO NOT take any herbal medications 3-5 (three to five) days prior to the procedure.
  5. Bring your pain management prescription and any relevant x-rays (especially recent MRI scans) with you.
  6. Arrive at least 1 hour before your scheduled visit. The surgery center will call you the night before with a final time. Arrange for someone to drive you home after the procedure.
  7. After you are checked-in, you will be asked to sign a consent form for the procedure. Tell the nurse, at this time, if you have any allergies. If you have any questions, you should ask them at this time. The nurse will place an IV in your arm for safety and to allow for any required medication and/or sedation (if desired).
  8. Please allow approximately 4 hours for your visit to Colorado Pain Specialists.
  9. Upon discharge, you will be given post procedure instructions.

POST PROCEDURE PATIENT INSTRUCTIONS

GENERAL INSTRUCTIONS

  1. Take it easy for the next 12 hours.
  2. NO DRIVING FOR 24 HOURS after receiving any IV sedation.
  3. Have an adult stay with you for 12 hours after receiving any kind of sedation.
  4. ICE the area for the first 3 hours following an injection for 10 minutes at a time. Follow by icing the area as needed for relief of local pain.
  5. YOU MAY HAVE INCREASED DISCOMFORT BEFORE YOU FEEL BETTER.
  6. If medications have been prescribed, take as directed.
  7. Call our office if you experience itching, rash, stomach upset or difficulty breathing.
  8. IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, CALL 911.

Steroids can cause side effects. They are almost all short lived in duration. Some of these side effects include:

  • Sweating
  • Insomnia
  • Swelling
  • Flushing
  • Headache
  • Fluid Retention
  • Palpitations
  • Flu like symptoms
  • Nausea
  • Increased Heart Rate
  • Menstrual Changes

How to prepare for the injection:

On the day of your injection, do not have anything to eat or drink for at least 6 hours before your scheduled procedure. If you take medicine for blood pressure, diabetes, or any type of heart condition, take this medication at the usual time with a sip of water. If you take any type of medicine than can thin the blood or increase the risk of bleeding, discuss this with your doctor beforehand. These medicines are typically used to protect against stroke, heart attack, or blood clots. Examples include Coumadin (Warfarin), Aggrenox, Plavix (Clopidogrel), Lovenox, Pletal, Dabigatran, and Rivaroxaban among others. For most procedures, you will need somebody to drive you home.

 

What happens after an injection?

You will be monitored for approximately 30 minutes after the procedure. Some procedures may provide immediate pain relief due to the effect of anesthetic which may wear off after several hours, whereas others may provide delayed improvement in pain.  When steroids are used, benefit may not appear until two to three days.  You also may feel some irritation or soreness at the site of the injection, which may be caused by the needle or by the medicine itself. This irritation usually resolves within 1-2 days. You should be able to return to work the day after the procedure in most cases.

Procedure Animations

As a service to our patients, Colorado Pain Specialists provides a library of animations that make the latest pain treatments easier to understand and visualize. This is an educational resource for you and your family to learn more about common conditons and some of the surgical and non-surgical procedures we perform.

We encourage you to view the animation that relates to the particular procedure you may be having, as well as any others that may be of interest. This is a great starting point to get an idea of what the procedure involves and develop a list of questions for your physician.

We will be adding more animations in the future, so please check back soon for updates.

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(Flash Player required)

Click here to open Animations Viewer.

Participating Insurance Plans

  • Alliance Network
  • Blue Cross/Blue Shield PPO, Indemnity
  • CCN (Casualty Care Network and Mountain Medical Affiliates)
  • Cigna HMO/PPO
  • CMN (Casualty Management Network)
  • First Health Network
  • Humana (Choice Care Network)
  • Metro West Medical Practice Assoc
  • MMA
  • United Payors
  • USA Managed Care
  • First Health
  • Galaxy Health Network
  • Pro-Net
  • One Health Plan of Colorado
  • Great West Life
  • PHCS
  • Pinnacol Workers’ Compensation
  • Prudential
  • Rocky Mountain HMO
  • Sloan’s Lake PPO/Auto
  • TriCare (Campus)
  • United HealthCare of Colorado

We accept Workers Compensation and auto injury cases

Referral Information

Patients may be referred for consultation, evaluation and treatment. To make this process a smooth transition for you, we request the following information from your primary care physician, via fax at 303-736-4147.

  • A written referral from your primary care physician.
  • All medical records pertaining to the pain problem including physicians’ note, X-rays, MRI’s, CT’s, blood work, etc.
  • Insurance information and copy of insurance card if available.

Once we receive this information, we will contact you for scheduling and to verify insurance coverage.

Glossary

CAT Scan (computed axial tomography scan) [also called a CT scan (computed tomography scan)] – A painless imaging technique that utilizes a computer to produce detailed three-dimensional images of a body from a collation of cross-sectional X-rays taken along an axis.

Cervical Spine (neck) – has 7 vertebral bodies (segments). The tope segment is connected to the skull.

Cortisone – Cortisone is a very strong anti-inflammatory medicine that may control the inflammation surrounding the nerves and may ease the pain caused by irritated nerve roots.

Degenerative Disc Disease – the flexible disc shrinks and degenerates as a normal part of aging. Limited range of motion of the spine and back or neck pain are common. The disc itself may also be directly responsible for the pain.

Degenerative Disc Disease – Gradual or rapid deterioration of the chemical composition and physicial properties of the disc space.

Discogram or Discography – provocative testing of the intervertebral disc that may help discover the intervertebral disc as a significant pain generator. Also allows for morphologic evaluation of the disc’s structure when combined with CT scan. This test has no therapeutic benefit but does help the surgeon in planning for the type of operation that should be performed.

Facet Joints – small stabilizing joints located between and behind adjacent vertebrae.

Facet Syndrome – a form of arthritis of the joints at the back of the spinal column (facet joints). The degenerated joint can directly cause pain as well as cause narrowing of the canal where the spinal nerves exit.

Fluoroscopy – Fluoroscopy is a special type of x-ray used to project live images onto a monitor (e.g. Computer/TV screen)

Herniated Nucleus Pulposus (slipped disc) – commonly occurs in the lumbar spine, followed by the cervical spine and the thoracic spine. The inner nucleus pulposes slips past the fibrous outer layer and in its new location causes severe epidural inflammation resulting in pain, numbness, tingling or weakness in your arms or legs.

Interlaminar or Transforaminal Epidural Steroid Injections – steroids deposited into the narrowed and inflamed areas “transforaminally” (across the narrowing) act to suppress nerve inflammation and firing in many patients, thereby lessening their pain and allowing them to tolerate physical therapy, ultimately resulting in improvements in their functionality.

Intraarticular Facet Injection – an injection indicated for those patients degeneration of their facet joints. The inflamed joint is the major contributor to the patient’s pain and depositing potent anti-inflammatory medications into the joint serves to cool the area and provide pain relief.

Intradiscal Electrothermal Annuloplasty (IDEA) – to treat chronic pain originating from Intevertebral discs. A minimally invasive treatmentin which controlled levels of thermal energy (heat) is applied to a broad section of the affected disc wall. Therapy may result in contraction or closure of the disc wall fissures or a reduction in the bulge of the inner disc material.

Lumbar Spine (lower back) – five vertebral bodies that extend from the lower thoracic spine (chest) to the sacrum (bottom of the spine). The vertebral bodies are stacked on top of each other with a disc in between each one.

Lumbar Sympathetic Block – an injection of local anesthetic around a group of nerves in your lower back. It may be done if you have reflex sympathetic dystrophy(RSD), a disease involving a disturbance of circulation to the skin or neuropathic pain(pain caused by a disorder of the nervous system).

Magnetic Resonance Imaging (MRI) – The MRI scan is an imaging test that allows physicians to assess a patient’s spinal anatomy and investigate an anatomical cause of the patient’s pain. The physician will correlate the findings on the MRI scan with the patient’s signs and symptoms in order to arrive at a clinical diagnosis.

Nucleoplasty – a procedure for partial removal of the nucleus to relieve pressure in the disc and on the nerve roots, providing relief from disc pain.

Percutaneous Disc Decompression – a procedural technique to remove the degenerated portion of the center of a herniated disc, reducing pressure within the disc and on the adjacent nerve roots without open surgery.

Peripheral Neuropathy – Peripheral neuropathy is a general term referring to disorders of peripheral nerves. The peripheral nervous system is made up of the nerves that branch out of the spinal cord to all parts of the body.

Radiculopathy – Radiculopathy is the medical term used to describe a “pinched nerve” in the spine. A radiculopathy occurs when a nerve is irritated by something that is either rubbing on the nerve or pressing on the nerve.

Radiofrequency Nerve Lesioning – a therapy that can be used to temporarily deactivate the pain generating nerves around the spine. This technique literally interrupts the firing of the nerves that supply the facet joints using radiofrequency energy to heat the surrounding tissue and deactivate the pain generating nerves. The result is dramatic pain relief in the properly selected patient.

Reflex Sympathetic Dystrophy (RSD) – Reflex Sympathetic Dystrophy (RSD), more recently known as Complex Regional Pain Syndrome (CRPS) is a disease brought on by damage or trauma to the Sympathetic Nervous System.

Sacroiliac Joint Block – sacroiliac (SI) joint blocks are injections that are used for diagnosing and treating the low back pain associated with sacroiliac joint dysfunction. The SI joint lies next to the spine and connects the sacrum(bottom of the spine) with the pelvis (hip).

Sciatica – pain along the course of a sciatic nerve, especially noted in the back of the thigh and below the knee. Pain radiating down the sciatic nerve into the posterior thigh and leg; can be caused by irritation of a nerve anywhere from the back to the thigh.

Selective Nerve Root Block (SNRB) – an injection primarily performed to diagnose the specific source of nerve root pain and, secondarily, for therapeutic relief of low back pain and or leg pain.

Spinal Column – the bony ridge that runs vertically through the trunk of our bodies and which supports the majority of our weight.

Spinal Cord Stimulator – a small implantable device that stimulates the spinal cord to treat pain and improve circulation.

Spinal Stenosis – narrowing of the bony spinal canal causes pressure on the spinal cord and spinal nerve roots. Patients usually have pain, with numbness, tingling or weakness that worsens with walking.

Spondylolisthesis – the forward slippage of one vertebra on an adjacent vertebra that most commonly occurs in the lumbar area. This condition results in lower back and leg pain that worsens with activity. The pain is due to narrowing of the spinal canal where the spinal cord resides and the foramen, where the spinal nerves exit.

Stellate Ganglion Block – an injection performed to decrease pain and increase the circulation and blood supply tot eh affected limb. A stellate ganglion may be performed for people who have circulation problems or the following nerve injuries: Reflex Sympathetic Dystrophy, causalgia, herpes zoster and phantom limb pain.

Steroids – Steroids (short for corticosteroids) are synthetic drugs that closely resemble cortisol, a hormone that your adrenal glands produce naturally. Steroids work by decreasing inflammation and reducing the activity of the immune system. Steroids are used to treat a variety of inflammatory diseases and conditions.

Therapeutic Nerve Blocks – local anesthetic injections given near a specific nerve or group of nerves to relieve pain.

Thoracic Spine (upper back) – twelve vertebral bodies that have very little motion because they are firmly attached to the ribs and sternum (breastbone). Because there is little motion, this region of the spine is generally not the source of pain.

Trigger Point Injections – injections of small amounts of local anesthetics and steroids in the area of the muscle where you have pain or tenderness. These areas are called trigger points because, when stimulated, they produce pain. Trigger point injections are performed if you have myofascial pain, which is pain in a specific muscle or muscle group.

Vertebral Bodies – act as a support column to hold up the spine. This column supports about half the weight of the body, with the other half supported by the muscles.

Vertebral Disc – primary purpose is to act as a shock absorber. Discs are actually composed of two parts: a tough outer core and a soft inner core, much like a jelly doughnut.

Resources

Understanding information about your diagnosis and its treatment is vitally important. Information from popular news sources – radio, television, newspapers and magazines – may not contain information that is specific or accurate enough for you. Sorting through all the details can be confusing without a reliable source of information.

The best sources of information are the physicians who will care for you. Don’t be afraid to ask us about things you don’t understand. The more information you have about your condition, the stronger a partner you are in your own care and the more effective we are in treating it.

In addition, the following resources and links can provide you with valuable information.

FAQs

How do I make an appointment?
Appointments are made by calling our office at 303-268-4040 or 1-866-356-4040. Our fax number is 303-736-4147. You or your referring physician can call to set up the appointment. Either you or your physician will need to provide CPS with the necessary information to set up the appointment. Appointments are made during our office hours only, which are Monday-Friday, 8am-12 noon and 1pm to 4:30pm.

What do I need to bring to my appointment?
For your first appointment with CPS, you will need to bring your medical records from your referring physician, any MRI or CT scan films, your insurance card and a list of questions you wish to ask the physician. If your insurance requires you to have a referral, you are responsible for contacting your primary care physician to obtain that referral prior to your visit with CPS.

How long will the appointment last?
You should plan on an hour for your evaluation, and 30 minutes for a follow-up visit. If you have an appointment for an injection, please allow 4 hours from arrival to departure from the surgery center.  There will be paperwork to be completed at your initial evaluation, so please plan to arrive 15 minutes prior to your appointment time.  The surgery centers are independent of CPS and therefore, they will have paperwork to be completed each time you visit, so please arrive at the time given to you by the surgery center during your reminder call.

What type of insurance plans do you participate with?
Please contact our office at 303-268-4040 or 1-866-356-4040 to see if CPS participates with your insurance plan.

Will you bill my insurance for me?
As a courtesy, CPS will verify insurance coverage for your visit and bill your insurance carrier. It is important that you understand that this is not a guarantee of payment for your services.  It is very important that we have your correct information in order to bill the insurance carrier. Please understand that if your appointment is not approved by your insurance carrier, it will be canceled. Please call our office to inquire about self pay options.

Please be aware that we do not do bill for the surgery center and their facility fees.  Any billing or collection issues regarding facility fees must be handled by the surgery center. 

Do I need to pay my co-pay and deductible at the time of the visit or will you bill me?
According to the contract you have with your insurance carrier, co-payment and deductibles are due and payable at the time of service. We accept cash, check, Visa and Mastercard.  It is possible that you will have a deductible and/or co-pay with the surgery center as well.  Please contact the surgery center you will be visiting for deductible or co-payment details, or to speak with them about payment.

Where are you located?                                                             Colorado Pain Specialists has numerous locations in the Denver Metro area to accommodate your geographic needs.  We share office space with other physicians in order to make this possible.  You may not see our name on the office directory, but rest assured we are in the suite number listed on the location sheet attached.  Any questions you have on location, maps or directions, please visit our website at www.coloradopainspecialists.com or contact us at 303-268-4040 or 1-866-356-4040.                                                                                                                                                     

Medications
Medications prescribed by the physicians of CPS will be the only medications managed by CPS. Medications received by your other treating physicians will need to be obtained by them. Medication refills require a scheduled appointment with the physician. Walk-in visits for medication refills are not allowed. Medications will not be phoned in to a pharmacy, or faxed to a pharmacy. Medication refills will not be obtained on the phone or after hours. You are solely responsible for following the dosage of the medication prescribed by your physician. You are solely responsible for the safe keeping of your medication, to prevent loss or theft.

SCHEDULING PHONE NUMBER:
303-268-4040
866-356-4040

SCHEDULING FAX NUMBER:
303-736-4147

We welcome out-of-state patients. If you are coming to Colorado to see us, please contact us at 1-866-356-4040. We would be happy to help you coordinate your travel plans.