Frequently asked questions by patients

Que:1 When should I seek VIROC Pain Management?

You should seek us when:

  • Your pain has lasted for more than 3 months with no obvious cause.

  • Your condition is painful enough to interfere with your daily tasks.

  • You are feeling frustrated due to the constant ache.

  • You are unable to sleep.

  • You or your family member is suffering from chronic pain, and you would like to gain more information about the pain treatments available.

Que:2 What can VIROC Pain Management do for me?

Our multi-disciplinary services will:

  • Decrease frequency and intensity of your discomfort

  • Suggest treatments for your painful condition which may involve pain relief tablets and other therapies

  • Increase your personal functioning

  • Empower you to give the confidence to lead a better quality life

  • Learn new skills to cope with your pain

Que:3 What can I expect during my first visit?

Your initial evaluation will involve getting a detailed history of your pain and physical examination. This will be followed by discussion of pain treatment options and an opportunity to answer your questions and clear away the doubts.

Que:4 What course of treatment can I expect from VIROC Pain Clinic?

Typically, we discuss with you the best pain treatment options. These may include pain relief injections, pain relief medicines, physiotherapy, relaxation training, pain education programme, or even no further treatment. If we have an opening in the schedule, we may be able to schedule a pain relief injection on the same day of your initial consultation.

Que:5 What should I do before my procedure ?

Your stomach must be empty for the procedure, since anxiety and sedation can cause some people to be nauseous. Please don't eat for 4 hours before your appointment. However, you can take your usual medications with sips of water.
Que:6 What medications can I take before my procedure?

We recommend that you take your regular antihypertensive medications and pain medications before your procedure. If you are diabetic and will not be eating prior to your procedure, please consult with your physician regarding your diabetic medications.

Que:7 What medications should I avoid before my procedure? 

Coumadin (warfarin) for 4-7 days - please consult with your physician prior to discontinuation. An INR will need to be obtained the evening before or morning of your scheduled procedure.

Lovenox Injection (enoxaparin) for 24 hours 
Plavix (clopidogrel) for 7 days
Pradaxa (dabigatran) for 3 days
Ticlid (ticlopidine) for 14 days

Que:8 Why can’t I drive or eat if I’m scheduled for a procedure?
Some procedures require sedation that prevents you from safely eating or drinking. Also, some procedures may inhibit movement in parts of your body that would make it unsafe for you to drive. Since we cannot be sure how the treatment will affect you, we require you to follow instructions that will be provided.

Que:9 Do these procedures hurt?
Pain is minimized with the use of anaesthetic agents.

Que:10 Do you use steroids?
We do use steroids when indicated to provide a desired treatment response, but we use them at the lowest dose possible to reach a desired therapeutic response.

Que:11 How long do procedures take?
Our pain relief injections are considered Same Day or Out Patient procedures. The injections take from 15-45 minutes to perform. The time spent in the recovery is about 30 min, and that includes a snack and a drink.

Que:12 How long should I be off work ?
Generally patients are off work for 1 to 2 days following a procedure. With advanced procedures, patients could be off for 2-6 days depending on the procedure and the patient’s field of work.

Que:13 Can I have a procedure on the same day as my evaluation?
Sometimes, but it can take time to check with your insurance carrier and secure authorization before scheduling the procedure. The pain clinic staff will work as quickly and efficiently as possible so that you can have your procedures in a timely manner. You can help this process by making sure that your insurance information is updated

Que:14 How soon after a procedure will I start to feel relief?
With most procedures, you may begin to feel pain relief within a few days. The full effect may take a couple of weeks to set in.

Que:15 Are these procedures covered under Health Insurance (Mediclaim)?
Yes, most of the procedures are covered under health insurance / mediclaim. For more details, you may speak to us.

Que:16 What is a herniated disc?
A disc is the fibrous cartilage pads that lie between the spinal vertebrae; each is made up of two parts: a jelly-like center (the nucleus pulposus) that loses moisture with age, and a tough outer ring (the annulus fibrosus) that can split with age or injury. A herniated disc occurs when the disc's jelly-like center (the nucleus pulposus) ruptures the tough, fibrous outer ring (the annulus fibrosus) oozing through small openings and pressing on the nerves.

Que:17 What is the difference between a herniated disc and a bulging disc?

A bulging disc is a slight protrusion of the center of the disc (nucleus pulposus) into the spinal canal. A disc herniation is a large protrusion of the nucleus pulposus (center of the disc), which has burst through the annulus fibrosus (outer ring of the disc) into the spinal canal, invading the surrounding nerves and causing pain in the back, buttocks, hips, or legs.

Que:18 Are bulging or herniated discs normal?  
No, they are not "normal" in that we are not born with herniated or bulging discs. They are very common and occur with age and natural dehydration and degeneration of the disc. MRI studies of asymptomatic patients showed that approximately 40% of the population has herniated or bulging discs.

Que:19 Do all patients of Herniated Disc need surgery?

More than 85%t of the patients with slipped disk will cured by simple means like rest, pain medication and physiotherapy. Only a very small percentage will need surgery.

Que:20 Will I have irreversible damage if I delay surgery?
Your physician will advise you based on your condition. In general, if there is severe spinal cord compression or a nerve is compressed over a period of time there may be irreversible damage. If a patient experiences an increase in weakness, weakness in the legs, loss of balance, or loss of bladder or bowel control, they should be reevaluated by their spine specialist immediately.

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