Interventional Pain Medicine

Interventional Pain Medicine

What is Interventional pain management?

It is the subspecialty of medicine that deals with treating pain using precision-guided injection techniques to deliver pain-relieving medicine to specific areas of your body. The doctors who perform these procedures are trained for one or more years in pain medicine and are board certified. The injections are typically done using X-ray, Ultrasound or CT scan control. It involves blocking nerves to diagnose the exact source of pain. This helps us to plan further management. These injections are also done in the joints and in the discs between your spine bones. The medicines used in the injections are mainly local anaesthetics. Following diagnosis, we use radiofrequency current to stun the nerves carrying pain impulses.

What kinds of pain could be treated with interventions?

Many different pain problems could be treated with interventional pain medicine, but the most common are chronic lower back pain, sciatica, neck pain, joint pain and cancer pain. The cancer pain interventions involve permanently blocking the nerve to provide respite in the end stages of life. Pain due to problem in the blood vessels, and head and neck pains could also be treated with interventions. That is not all; we treat more than 300 types of pain using interventions.

What types of procedures are done?

The most common procedures are X-ray or Ultrasound guided injections to relieve inflammation in spinal structures caused by herniated discs, spinal canal narrowing or arthritis. These procedures include epidural injections, facet joint injections and sacroiliac joint injections. Local anaesthetics to block the tiny nerves in your lower back or neck are typically used to plan further treatments like radio-frequency ablations. Testing the integrity of the disc and confirming it as the source of pain – termed Diskogram, and Selective Nerve Root Blocks are also done by us to help the spine surgeon choose the level at which the operation needs to be done. On occasions, alcohol or phenol is injected to permanently destroy the nerves that carry cancer pain. Certain advanced procedures such as inserting electrodes in the spinal cord (spinal cord stimulator) and pumps that deliver pain killer medicines into the spinal fluid (intrathecal pumps/spinal pumps) are also used. We have one of the largest experience in India for such advanced procedures.

Are these procedures safe? Are there any side effects?

Most people are concerned about the discomfort or pain during the procedures. However, when performed with precision by a skilled and experienced doctor, the procedures are safe and relatively painless. You will have the opportunity to speak to the doctor prior to your procedure. Having your questions answered by the pain physician would help allay most of your concerns. At Sri Ramakrishna Pain Management and Research Institute, a nurse assists the doctor in making sure that you are comfortable and reassured during the procedure. On some occasions the pain following the procedure might last for a few days. These are typically short lived and commonly seen after radiofrequency and cancer pain treatment injections.

Are these treatments successful?

The treatments can be very effective when expertly performed using X-ray or Ultrasound guidance. The results depend on the presenting diagnosis and the doctor’s expertise. For instance, we spend a good few hours with you with our multi-disciplinary assessment and comprehensive physical examination prior to offering interventions. Following interventions, you would be offered a rehabilitation programme that involves relaxation techniques, coping strategies, home-based exercises, ergonomic advice, and on occasion home modifications. If you have a very clear and specific diagnosis that correlates with your symptoms, the long-term success rates are good.

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