Interventional Methods for Pain Control

Interventional Procedures for the Treatment of Chronic Pain

Interventional methods for pain control refer to procedures that act on a specific anatomical structures or nerve pathways. These methods are usually applied in  chronic pain patients who do not respond to drug therapy. The interventional methods used for pain control can vary depending on the patient's complaint, the location, and type of pain. These methods can block or modify the nerves causing the pain by targeting the source of the pain.

Some commonly used interventional pain management methods include:

1. Nerve Blocks:

Nerve blocks are divided into two;

1. 1. Combination of Local Anesthetic and Steroids: These methods involve injecting local anesthetic drugs into specific portions of the nerves that carry pain signals. For instance:

• Facet Joint Blocks: Injections done on nerves surrounding the facet joints. (See; Interventions on Spine)

• Nerve Root Blocks: Injections targeting the spinal nerve roots. (See; Interventions on Spine)

1. 2. Neurolytic Blocks (Nerve destroying blocks): Administering solutions such as pure or 50% alcohol or phenol that cause destruction in the intended nerves; However, used in cancer pains. For instance;

• Celiac Plexus Block and Splanchnic Nerve Block: Administered in pancreatic and upper abdominal cancers. (See; Interventions in Cancer Pain)

• Intercostal-rib nerve block: Administered in rib cancer metastases. (See; Interventions in Cancer Pain)

2. Radiofrequency Ablation: This procedure targets and destroys the nerves transmitting pain using a radiofrequency current. (See; Radiofrequency Thermocoagulation)
3. Epidural Steroid Injections: These injections involve administering an anesthetic drug along with a steroid into the epidural space of the spinal canal. (See; Interventions on Spine)
4. Sympathetic Nerve Blocks (See; Sympathetic Nerve Blocks)
5. Spinal Cord Stimulation: In this method, small electrodes are placed near the spinal cord, and low-level electric currents are used to modify pain signals. (See; Neuromodulation)
6. Peripheral Nerve Stimulation: This method aims to control pain by stimulating the peripheral nerves causing pain. (See; Neuromodulation)
7. Intrathecal Pumps: These devices control pain by administering drugs directly into the spinal canal. (See; Interventions in Cancer Pain)
8. Sacroiliac Joint Injections: These injections are used to control pain directed towards the sacroiliac joints. (See; Interventions on Spine)
9. Vertebroplasty and Kyphoplasty: These procedures are used to treat spinal fractures and to reduce pain. (See; Advanced Methods)
10. Botox Injections: Botox is used to reduce muscle spasms and pains in some chronic pain conditions. (See; Injections)
11. Trigger Point Injections: This method involves injecting anesthetic drugs into painful "trigger" points in muscles. (See; Injections)

Each of these methods has its risks, benefits, and contraindications. Such interventional methods should be administered by an experienced  pain specialists after appropriate diagnosis and assessment. The decision on which method to apply should be based on the cause, location, intensity, and duration of the pain.