What is Interventional Pain Management?

Interventional pain management is a relatively new medical field which uses special procedures to treat and manage pain. The goal of this therapy is to pinpoint the source of a patient’s pain and to direct treatment specifically to that source. The procedures or ‘interventions’ used may include injections,nerve blocks, and physical therapy. Only physicians who are specially qualified in both anesthesiology and pain management can perform these techniques.

When is Interventional Pain Management Used?

Interventional pain management is used in cases of severe, intractable pain that interferes with a patient’s daily activities of living. A patient is considered suitable for interventional pain management treatment after a series of assessments by his physician, a review of medical history, and a physical exam.

How Does Interventional Pain Management Help the Patient?

The techniques used may help patients in a variety of ways:

• Reduce the severity of pain and the amount of time it is experienced
• Allow for an increase in activities at home and work
• Overcome isolation
• Learn new skills for coping with pain
• Determine ways to end sleep problems
• Improve the quality of life
• Rehabilitate

How is Interventional Pain Management Different from Other Pain Management Methods?

Interventional Pain Management emphasizes the importance of a precise diagnosis so the treatment can be started immediately. Rather than prescribing just medications or recommending only physical therapy, an interventional pain management specialist uses a multidisciplinary approach.

Conditions Treated with Interventional Pain Management

Interventional pain management specialists treat symptoms closely related to chronic pain. Patients who suffer from distress and discomfort due to a variety of medical conditions may opt for interventional pain management. These include:

• Chronic low back and neck pain
• Chronic reflex sympathetic dystrophy (RSD) or complex regional pain syndrome
• Chronic head, mouth and face pain
• Postsurgical procedures
• Malignancy
• Post-traumatic pain syndrome
• Muscle and/or bone pain

Interventional Pain Management Techniques

Treatment options are recommended by an interventional pain specialist based on the location, source, and severity of pain. For this, an accurate diagnosis of the source of pain is important. Some commonly used interventional pain management techniques include:

Injections

Injections or nerve blocks produce insensitivity in a part of the body by injecting an anesthetic close to the nerves that supply it. They help to direct medications such as steroids or opioids onto nerves, tendons, joints or muscles to relieve pain. During the procedure, X-rays may help the physician to pinpoint the exact location for injecting. The first injection serves as a trial. If it significantly helps to reduce pain, it can be safely determined that the nerve or joint is the source of pain. Injections provide temporary pain relief. A common injection used is the epidural steroid injection in the lumbar spine or lower back.

Radiofrequency Rhizotomy

Radiofrequency rhizotomy, also called radiofrequency ablation or neuroablation, uses highly localized heat generated with radiofrequency to destroy the nerves causing pain. By destroying these nerves, pain signals are prevented from being transmitted to the brain. A successful procedure reduces pain without reducing nerve function. The procedure can provide pain relief for 6 to 12 months.

Intrathecal Pump Implants

In this procedure, a small device called a pump gets implanted under the skin. The pump is programmed to release small amounts of medications directly in the intrathecal space (area surrounding the spinal cord). Pain signals are thus prevented from being perceived by the brain. Intrathecal pump implants are commonly used for cancer pain and in failed back or neck surgery. They provide consistent pain relief. Since they are more invasive, they are used only if other treatments have been unsuccessful.

Electrical Stimulation

This therapy uses a low voltage electrical current for pain relief. Electrical pulses are directly sent to the area causing pain, such as the spinal cord, nerves, or brain. Conditions in which this technique can be used include Parkinson’s disease, epilepsy, diabetic peripheral neuropathy, etc. This therapy is usually amongst the last interventional pain management techniques tried.

Other Interventional Pain Management Techniques

Other interventional pain management techniques which can help to cope with pain include intradiscal electrothermic therapy, which uses heat to destroy nerve fibres, and cryogenic cooling which temporarily shuts down nerves by freezing them.