Interventional Pain Management for Chronic Pain

Injections, Stimulation, Pain Pumps, and Other Treatments

See also Regenerative Medicine

For many people living with chronic pain, finding pain relief can be tough. A lot of trial and error is involved to find a pain treatment that works. Interventional pain management may help chronic pain patients cope with their pain.

Similar to other pain management treatments, such as taking prescription medications, interventional pain management can help you manage your pain. But what makes interventional pain management different is that it uses techniques, such as injections and radiofrequency rhizotomy, to directly address the source of your pain.

Some conditions interventional pain management techniques commonly treat include:

  • chronic headaches, mouth, or face pain
  • low back pain
  • muscle and/or bone pain
  • neck pain

Sometimes interventional pain management techniques play a part in a multi-disciplinary approach to relieve your pain and other symptoms. These techniques may be used in conjunction with mental and emotional therapy and prescription medications, for example.

Below are some of the most commonly used interventional pain management techniques.

Injections—also called nerve blocks—work to provide temporary pain relief. They send powerful medications, such as steroids and opioids, onto or near your nerves to relieve pain.

One of the most common injections is an epidural steroid injection in your lumbar spine (low back). This injection sends steroids directly to the nerve root that’s inflamed.

Other common injections are facet joint injections, single nerve root blocks, and sacroiliac joint injections.

You’ll most likely need 2 or 3 injections for maximum benefits, but you shouldn’t have more than that due to the potential side effects of steroids and other medications. 

Radiofrequency Rhizotomy
Using x-ray guidance and a needle with an electrode at the tip that gets heated, radiofrequency rhizotomy temporarily turns off a nerve’s ability to send pain messages to your brain.

Other names for radiofrequency rhizotomy are radiofrequency ablation and neuroablation.

For many patients, this procedure can provide pain relief for 6 to 12 months. During these pain-free months, however, your doctor will most likely recommend physical therapy. A physical therapist can help you address underlying physical problems that are causing pain.

Intrathecal Pump Implants
Intrathecal pump implants, also known as pain pumps, provide potent medications straight to the source of your pain. They’re a type of neuromodulation—a treatment that interrupts pain signals to your brain.

Pain pumps are commonly used for cancer pain and failed back or neck surgery.

With this procedure, a small device—called a pump—gets implanted under your skin. Your doctor programs the pump to deliver a specific amount of medication, and he or she will need to refill the pump every few months.

The main benefits of pain pumps are that they provide consistent pain relief, and if you’re taking oral medications, you don’t have to rely on them as much.

Because this is a more invasive procedure than an injection, a pain pump is typically used only if other treatments have been unsuccessful.

Electrical Stimulation
Electrical stimulation is another type of neuromodulation. Similar to a pain pump, something gets implanted in your body with electrical stimulation. But with this procedure, a stimulator is implanted along with an electrical lead to send electrical pulses directly to the area that’s causing pain—the spinal cord, nerves, or brain, for instance.

Electrical stimulation can be used for certain spine conditions as well as conditions that affect your brain or nerves, such as Parkinson’s disease, epilepsy, and diabetic peripheral neuropathy. You can have spinal cord stimulation or deep brain stimulation, for example.

Instead of pain, some people feel a tingling sensation with this treatment.

However, as with a pain pump, electrical stimulation is usually one of the last interventional pain management treatments tried.

Other Interventional Pain Management Techniques
There are other interventional pain management techniques that can help you cope with pain. Intradiscal electrothermic therapy, for example, uses heat to destroy nerve fibers to reduce your pain. Another example is cryogenic cooling, which is similar to radiofrequency rhizotomy, but instead temporarily shuts nerves down by freezing them.

Is Interventional Pain Management an Option for You?
You may need to try several interventional pain management techniques or perhaps a combination of these techniques as part of a comprehensive pain management plan. These techniques can provide pain relief to improve your quality of life.

As with any procedure, interventional pain management procedures have certain risks. Have a discussion with your doctor about whether interventional pain management is an option for you.

Updated on: 04/13/18
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The Safety of Epidural Steroid Injections: What You Need to Know