Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group What to ask at Pain Clinic

I have my first appointment at the pain clinic on May 1. I am trying to put together a list of questions to ask him. Any help would be appreciated. My Rheumy wants me to get shots in my lower back. I'm nervous.

Donna, I would jot down a typical day, describe stiffness & pain levels from the first you wake and throughout the entire day and then explain what you go through during a flare or with breakthrough pain, tell them how many years you've been in pain, what medications you've tried in the past for pain and how well they did or did not work, don't be afraid to tell them about your pain, remember, they work for you...good luck, big hugs...

If you do get shots, ask your doctor to use a topical anesthetic to make it easier. Many doctors use those anyways, but be prepared to ask for it just in case.

here's a few questions i found useful:


ask about the details of the shots.

ask how long the results should last.

ask about other alternatives.

ask what the longest lasting solution would be.

ask what to expect after the shots (results, side effects, etc)

what kind of shots? why, if i may ask, are you nervous? maybe we can put your mind at ease?

i've always had wonderful results from cortisone injections, triggerpoint injections. and the needles are so thin these days, you barely feel them. the only pain i ever have is because the joint is inflamed and has fluid in it to begin with, so a little pain cause of that. but nothing compared to the pain that is already there. hope that helps, a little.

Maybe these shots are different then what one of my friends had. She has lower back problems, but not AS. She said that they offered sedation and she declined and wished afterwards that she had said yes. I have had lots of cortisone shots in knees and shoulder, I just do not feel good about having needles stuck anywhere near my spine.

One of my worries is that I have so many different places that hurt. The lower back is the worst, but then there is the hips, shoulders, knees, hands. ribs and breastbone. I just don't know how much pain relief I can expect. I guess if I can just have less pain, I should be happy.

the cortisone into my wrists, neck, topically into my SI- no sedation, no problem. quick and it was done.

the cortisone injections, bilaterally, deep into my SI joint under fluoroscopy. i opted out of the sedation. silly silly me! if they are doing this and offer the sedation, take it! it took longer, was more painful going deep into a deep joint. and i had med students doing it, making it even worse. but i got through it. if i had had the sedation, it wouldn't have been an issue at all. next time, i'll know that topical SI joint injections and deep ones are NOT the same at all.

well, see what he wants to do.

That sound like good advice. If they offer sedation, there must be a good reason. If it didn't hurt, they wouldn't offer it. At least thats what I'm thinking.

LOL! that's what i should have realized too! you're much wiser than i was!

Not wiser, just older.

This is what I would ask:

Has this Dr. treated anyone with A.S.?

Is the same Dr. you are going to see also do the procedures. Sometimes it is another Dr. in the office.

If your Rheum has M.R.I's of your spine, make sure they are sent to the new pain specialist. Lab reports as well.

Make a list of all the medications you are on and who prescribes them.

Make sure they give you a follow up appt. of no longer then a month away.

If you have any side effects from the med's that they give you, call the Dr.s nurse. If you don't hear back in two days, call the office manager.

Have them explain exactly what they are going to do to inject your back. Is it a steroid shot or a block? Some Dr.s will give you a Valium (low dose) to take before your procedure if you are nervous about having it done and you will need a driver. They usually give you a little more when you get there and then inject you right under the skin to numb you up and then they do the actual injection. They usually do this under a fluoroscope and can see exactly where they are going. Hope this helps.