You may wonder what interventional pain management is and why you should consider it a treatment for your pain. Ultimately, it is a “fancy” way of saying pain management solutions that help reduce the need for pain medicine.
Technically speaking, interventional pain management uses minimally invasive procedures or devices to improve patients' pain while decreasing their dependence on medications. There is a wide variety of treatments depending on the type of pain a patient has. Still, the main reasons for interventional pain management are this reduction of medication dependency and the fact that most treatment options are completed in less than 30 minutes with little to no downtime so you can get back to living fully sooner. Decreasing the need for medications can significantly reduce incidents of side effects, falls, dependency, and addiction - all factors that prevent you from getting back to living life like you used to.
What Interventional Pain Management Solutions Are There and How Can They Help Me?
No two patients’ journey with pain is the same, so their treatment plans should not be either. Every treatment plan should be tailored to the patient and their specific goals by a pain management specialist, but here is an introduction to some of the interventional pain management solutions available. Need help right away? Appointments are available with our Excel Pain and Spine team within 48-hours or less. Contact us today to schedule an appointment.
Injection therapies are one of the most commonly performed interventional pain management treatments. These injections are typically performed with either x-ray or ultrasound guidance to improve accuracy and effectiveness. Injections can contain steroids or anti-inflammatory injections to decrease pain and inflammation. Other times injections can be used to diagnose areas or causes of pain. With these injections, local anesthetic is placed over the area of pain. The anesthetic numbs the nerves. If the pain improves, the nerves responsible are identified. Other injections can be used to help decrease or break up spasms.
Common examples include:
- Cervical and Thoracic Epidural Steroid injections
- Knee Injections
- Trigger Point Injections
- Lumbar Transforaminal Epidural Steroid Injections and Nerve Blocks
- Scar Neuroma Injections
- Occipital Nerve Blocks
Nerve Ablation Therapies
Radiofrequency ablation can be used to stun or burn nerves that are carrying pain. These interventional pain management therapies can dramatically decrease pain by interrupting the nerve signal and decreasing painful transmission. Radiofrequency is typically performed with little to no anesthesia, typically with no associated recovery or downtime. The ablation is performed using a small needle. The tip of the needle is placed over the desired nerve to be ablated or stunned. The procedure can be repeated every 6-12 months as it is normal for the nerves to regrow.
Common examples include:
- Cervical Medial Branch Blocks and Medial Branch Radiofrequency Ablation
- Lumbar Medial Branch Blocks and Medial Branch Radiofrequency Ablation
- Sacroiliac Joint and Lateral Branch Radiofrequency Ablation
- Genicular Blocks and Radiofrequency Ablation
- Obturator and Femoral Nerve Blocks and Radiofrequency Ablation
- Suprascapular Nerve and Shoulder Blocks and Radiofrequency Ablation
Nerve Stimulators (or neuromodulation) are a category of interventional pain management in which devices are used to interrupt blocks or reset nerve-related pain. These devices use a small amount of electrical energy to decrease pain. Pain typically improves by more than 50% with the use of these treatments. These devices can be both temporary and permanent. These devices use technology similar to heart pacemakers. The stimulators can be placed near the spine or over peripheral nerves in the extremities to aid chronic pain.
Before any implantable device is used, every patient has a temporary or trial device placed to determine the level of pain relief. Procedures for both trial and implantable devices are completed in about 1 hour, and patients return home the same day. The type and location of the pain will ultimately determine which is the best device for each patient.
Common examples include:
- Spinal Cord Stimulator Permanent Implants and Battery Replacements
- Dorsal Root Ganglion Stimulation
- Peripheral Nerve Stimulation
Intrathecal Pain Pumps
Implantable devices can be used for the long-term treatment of chronic pain. Intrathecal pain pumps are typically used to provide a potent dose of medication in the intrathecal space. This space contains cerebrospinal fluid or CSF. This fluid communicates directly with the brain and spinal cord. When medication is delivered to this fluid, it quickly and directly acts on the brain and spinal cord pain centers. An intrathecal pump can be used to infuse or deliver this medication directly to the CSF. By delivering medication to this area, it decreases side effects by limiting medication exposure to other body systems. Intrathecal therapies are typically reserved for cancer-related pain and severe refractory surgical-related pain.
Regenerative Medicine is a type of interventional pain management in which a patient's cells aid in healing, repair, and decrease pain. Over the last decade, these interventional pain management therapies have gained notoriety and exposure as many athletes use these options to heal injured tissues and return to the playing field. The most commonly used regenerative medicine therapy is platelet-rich plasma, commonly known as PRP.
Platelet-rich plasma is derived from each patient's blood. A sample of blood is drawn when a patient arrives at the clinic. This sample is centrifuged or spun down so that the different layers are separated. The platelet layer is identified and isolated. This platelet-rich layer is rich with growth factors, cytokines, and natural proteins that accelerate the body's healing process. The PRP is typically injected near or in the area of degeneration. Platelet-rich plasma is an excellent option to reduce the need for steroid injections or surgical intervention.
Platelet Rich Plasma (PRP) injections treat various tendon-related injuries such as rotator cuff tendinosis, tennis elbow, and Achilles tendonitis. PRP is also used to treat joint-related arthritis. Commonly treated joints include but are not limited to the hips, knees, and shoulder.
Learn more about PRP: Platelet Rich Plasma (PRP)
Spinal Implants are a category of interventional pain management in which small devices or bone grafts are used to treat spinal conditions that are not responsive to injections and will not improve with surgery.
Indirect Spinal Decompression
One of the most commonly performed spinal implants is for indirect spinal decompression for spinal stenosis patients. This interventional pain management technique uses a small device to wedge or open the space which is narrowed. One example of this procedure is the Vertiflex Superion procedure.
Sacroiliac Joint Fusions
The second type of spinal implant is used to complete sacroiliac joint fusions. These treatments can either be performed with a medical device implant or with a small bone graft. In both scenarios, the sacroiliac joint is fused or fixed to prevent movement. Sacroiliitis, SI joint pain, or SI joint arthritis is a well-known cause of lower back pain. Fusion is considered when patients fail to improve from injection therapy, physical therapy, and radiofrequency ablation.
Compression Fracture Stabilization
Compression fractures typically occur within the spine. A vertebral compression fracture is a fracture of the vertebral body. A vertebral compression fracture is the most common type of osteoporotic fracture. Vertebral compression fractures often occur after falls or trauma such as car accidents. The vertebral body appears compressed, causing significant pain and worsened kyphosis (forward bending of the spine). Typically bracing, rest, and pain medication are the first line of treatment. If patients do not respond or improve, then stabilization of the fracture can be considered.
Kyphoplasty and Sacroplasty:
Sacroplasty and kyphoplasty are interventional pain management procedures used to place glue or cement inside the fracture to promote healing, improve pain, improve posture, and improve mobility. Sacroplasty and kyphoplasty are both used to treat compression fractures of the spine. Sacral fractures or sacral insufficiency are treated with sacroplasty. Both of these procedures are performed in the outpatient setting and typically take less than one hour.
Learn more about Kyphoplasty and Sacroplasty: Kyphoplasty and Sacroplasty
Pain management historically has been associated with only medications and opioid management. The field of interventional pain management is growing, and new therapies are now available to treat both acute and chronic pain that decrease pain, disability, and need for medications. If you have an ailment that you are suffering from or want to lower your need for pain medication, interventional pain management should be a treatment you consider. Our team at Excel Pain and Spine has expertise in the field of interventional pain management, with greater than 30,000 procedures completed.
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