Interventional Procedures at New Hampshire NeuroSpine Institute at New Hampshire NeuroSpine Institute

New Hampshire NeuroSpine Institute is pleased to offer the convenience of an onsite procedure suite. Patients that require steroid injections are able to have the comfort of a private office setting along with one-on-one contact with the nurse and the provider.

If you are interested in seeing a provider to be evaluated for steroid injections please call one of our offices for a consultation or email us at

Steroid injections such as epidurals, facet blocks, nerve root blocks and medial branch blocks are designed to treat pain and inflammation. They also help the provider to positively identify the area that is producing pain. After a consultation your provider will determine the type of injection that will best relieve your pain.

Listed below are the different types of injections and an information video to help patients understand more about the procedure they may be having.

Please click a procedure to learn more:
Cervical Epidural Steroid Injection
Cervical Selective Nerve Root Block
Facet Joint Injections
Lumbar Transforaminal Epidural Steroid Injection
Medial Branch Block

In preparation for your injection
Your provider will explain the procedure to you and discuss the risks and benefits. Each provider does have a set of pre-procedure instructions which will be given to you at the time your injection is scheduled or you can print the instructions below. Please be sure to notify the provider if there is any chance that you are:

1. Pregnant or chance of being pregnant
2. Allergic to: anesthetic, steroids, radiologic dye, seafood, medications or latex
3. Taking blood thinners or have a bleeding disorder
4. Diabetic or have uncontrolled blood pressure problems

If you are having an Epidural steroid injection, Sacroiliac (or SI) joint injection or a nerve root block instructions are linked below separated by performing provider:

Click to view instructions for injections with Dr. Aron Jeffrey
Click to view instructions for injections with Dr. Adam Cugalj
Click to view instructions for injections with Dr. Thomas Frates or Dr. Robert Monighetti

If you are having Medial branch blocks or Facet blocks done the instructions are linked below by performing provider:

Click to view instructions for injections with Dr. Aron Jeffrey or Dr. Robert Monighetti
Click to view instructions for injections with Dr. Adam Cugalj
Click to view instructions for injections with Dr. Thomas Frates

If you are having Radio Frequency the instructions are linked below:

Click to view instructions for Radio Frequency injections

What to expect when you arrive

You will be brought into the fluoroscopy suite by a nurse or medical assistant and prepared for the procedure.

  • A monitoring device will be used to monitor your vital signs.
  • You will lie on your stomach.
  • Your back will be cleaned and the area covered with a sterile drape.
  • Medicine is then given to numb the skin near the injection site.
  • Fluoroscopy (X-ray imaging) is used to get a picture of your spine. Contrast "dye" may be injected to help get a better image.
  • The doctor then injects a combination of anesthetic (numbing) medication and steroids to reduce inflammation.
  • A bandage will be placed over the injection site.

*You will be monitored for 15-20 minutes after the injection and then you will be sent home. You must have a responsible adult to drive you.

What to expect afterwards
You may have some soreness at the injection site for the first 24 hours after your spinal injection. If so, applying ice will help.

  • You do not need to stay in bed when you get home. In fact, it is best to walk around. Just be careful not to do too much, even if you feel better right away.
  • The day after your injection, you can remove the bandage and wash with soap and water. You may resume your pre-procedure activities.
  • The duration of pain relief depends on many factors and is difficult to predict.
  • The results of the injection will help your physician plan your ongoing treatment. Be sure to keep the "pain log" which you were given at the procedure and complete each day. Bring the Pain Log to your follow-up appointment.

When to call us
Call us right away if you notice any of the following:

  • • Severe pain or headache
  • • Fever or chills
  • • Loss of bladder or bowel control
  • • Redness or swelling around the injection site


Bedford, NH - Main Office
4 Hawthorne Drive Bedford, NH 03110

Contact NH NeuroSpine Institute