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FAQ

My medical record :

1. Is your clinic private?

No, the Doctor will always be paid by health insurance of Quebec, therefore the consultation, monitoring and evaluation are covered by insurance. Patients pay only processing fees.

2. As a resident outside Quebec, may I receive care at your clinic? If yes, are there additional fees?

Yes, there are additional fees that apply, given that patients are not covered by the heath insurance of Quebec. These fees depend on the type of treatment.

3. May I get a copy of my report?

If a patient wishes to obtain a copy of their report, he or she must make a request to his referring doctor or to our clinic’s reception in exchange for certain administrative fees.

4. Can you provide me with a detailed invoice after my injection in order for me to request reimbursement from my group insurance?

Indeed, after each injection, we can provide you with a detailed invoice (including the nature of treatment, products and quantity injected, cost, and so on.)

5. After an injection, will I be automatically called for a follow-up appointment at your clinic?

No, because doctors do not follow-up with patients they see in fluoroscopy or diagnosis ultrasound. By contrast, a report will be sent after a short time to your referring doctor. Then you must communicate with this doctor to get a follow-up appointment.

Injection : Facet blocks and epidurals

1. If I have a fever on the eve of my appointment, will I still be able to receive my injection?

No. If you have a fever, it is your body fighting an infection and it is a contra-indication to cortisone injections.

2. What is the difference between normal injections and an injections under fluoroscopy?

The difference is that in fluoroscopy, there is medical imaging equipment that enables us to visualize the area to inject. Certain parts of the body, especially peripheral joints, can be injected in our office without fluoroscopy guidance.

3. What will the doctor assess before performing the injection?

Before the performance of all techniques, the patient is assessed and examined by a doctor in order to see if her or she is a good candidate for injection.

4. Can the doctor proceed to other types of injection than those prescribed by my referring doctor?

Indeed, according to their evaluation, the doctor can perform other injections than those prescribed. 

5. Might the doctor decide that I don’t need injection?

The doctor can decide that injections are not recommended. He will explain in this case why and what your next steps should be.

6. Is it possible to have further injections at the same time?

That depends. If it is in the same part of the body, for instance, two cervical facet blocks, two can be performed at the same time. By contrast, if it is in two different areas, for example, the knee and the shoulder, you will have injections on two different days.

7. If serious complications occur in the days following an injection, should I return to your clinic?

In the case of serious complications, which are very rare according to studies, you must absolutely present yourself to a hospital emergency room near your home. Our clinic does not offer emergency services. Please note that a sheet containing potential complications and side effects will be automatically given to each patient. After injections, you can contact us if you have any questions.

8. How long should I rest after an infiltration?

We suggest to patients that they take at least one day. In certain cases, a doctor can provide a sick leave sheet to the patient, depending on whether his or her work is physical or not.

9. Why do I need to get a written authorization from my doctor to stop taking my anticoagulants?

You must have a written authorization from your doctor to stop taking anticoagulants because in certain cases the risks associated with stopping to take anticoagulants or antiplatelets are very high. In certain cases, you cannot stop taking anticoagulants or antiplatelets.

10. How long do the effects of Cortisone last?

Because each person reacts differently to injections, it is impossible to predict. This can vary between several days to a more permanent time-frame. In cases where the inflammation does not come back, the beneficial effects will always be present.

Epidurals

1. What is the difference between an epidural for childbirth and an epidural at your clinic?

2. The difference is mainly the product injected. At the physiatric and sport medicine clinic, we inject cortisone to remove the inflammation around the nerve, while for childbirth, it is an anesthetic product to remove the pain.

2. How long do the effects of Cortisone last?

Because each person reacts differently to injections, it is impossible to predict. This can vary between several days to a more permanent time-frame. In cases where the inflammation does not come back, the beneficial effects will always be present.

3. In the long term, can Cortisone have negative effects on my health?

Cortisone is a hormone produced by the body. Taking Cortisone can cause a transitory increase of blood pressure, of blood glucose and may affect hypothalamic-hypophyseal axis. These modifications are transitory and completely reversible. The dose of cortisone received by injection is a small dose and it is eliminated quickly by the body. There are no negative effects on the health if we limit injections to a maximum of 3 injections per year.

4. Because epidural injections are practiced near the nerve roots of the spine, if certain complications follow, could I become paralyzed?

The risks of complications are extremely rare. There exists three types of major complications from either an infection, allergic reaction, and blood clot within the artery of the nerve or of the spinal cord. At the physiatric and sport medicine clinic, specialized doctors perform all spinal injections under fluoroscopy guidance. This technology enables us to visualize the spine and the exact area of the needle. In addition, before we inject cortisone, we use a colorant for increased accuracy and security of the procedure. At our clinic, we follow the recommendations of the International Spinal Intervention Society. While there are no specific studies on this particular question, we can estimate that the chances of major complication are about 1 in 10 000.

5. Might the doctor decide that I don’t need injection ?

Doctors can decide that infiltrations are not recommended. He will explain in this case why and what your next step should be.

Discal Stimulation

1. What complication are linked to discal stimulation?

When this technique is performed well, complications are rare. It can cause an increase in pain for several days. A disc infection (diskitis), an epidural abscess, or meningitis can occur. However, an antibiotic is injected in the disc during the procedure, minimizing the risk infection. A lesion of nerve roots can also occur, but again, this is extremely rare.

2. If disc stimulation hasn’t had the expected effect on my problem, what are the next steps?

It is impossible to respond to this question, as each case varies. Further diagnosis will be undertaken to determine the next steps.

3.Following disc stimulation, do I need to rest and if yes, for how long?

Following disc stimulation, the patient must limit him/herself to only basic, daily tasks (dressing, washing, eating, and so on) for a period of 48 to 72 hours. Thereafter, he or she can return to normal, daily activites. The patient should avoid sportive or physical activities for two weeks.