Why Coagulation Status Matters

Interventional Pain Management procedures are minimally invasive and have an outstanding risk/benefit ratio. While highly effective — and safer than surgical alternatives — certain procedures require precision safety protocols for patients on blood thinners or anti-coagulants.

Why We Take Extra Precautions

Some procedures involve placing a needle within or near the spinal canal, such as epidural injections or spinal cord stimulation. In these areas, excess bleeding can be dangerous because bleeding in a confined space may place pressure on the spinal cord and potentially lead to lasting neurologic issues.

To minimize this risk, your coagulation status must be as close to normal as safely possible at the time of your procedure.

Coordination With Your Prescribing Physician

We do not ask patients to stop medications in a vacuum. Stopping blood thinners carries its own risks for conditions such as coronary artery disease, stent placement, heart valve replacement, deep vein thrombosis, or pulmonary embolism.

Our team coordinates directly with your prescribing physician to determine how long a medication should be held. In high-risk situations, a heparin “bridge” may be used to minimize the time you are without protection.

Hidden Risks: Anti-Depressants and Supplements

It is not only prescription blood thinners that matter. Other medications and supplements may increase bleeding risk, especially when combined.

• SSRIs/SNRIs & NSAIDs: Medications such as Prozac, Lexapro, or Zoloft may increase bleeding risk when combined with anti-inflammatory medications such as Ibuprofen, Naproxen, or Celebrex.
• Supplements: Fish Oil/Omega-3s, Gingko, Vitamin E, Garlic, and Ginger may also thin the blood.

Our Guiding Standards

At Pain Specialists of Greater Chicago, we follow current national safety evidence and published guidance for interventional spine and pain procedures.