What Is Interventional Pain Management and Who Does It?
Pain can be acute or chronic, but regardless of its duration and severity, everyone wants it to stop. If the pain is related to an injury or disease, then it is often readily treatable, but if there is no apparent cause, then physicians must resort to treating the pain symptoms.
Treating the pain itself is often more challenging than remedying a known health condition because in many instances, we don’t understand the nature of the pain. To manage the pain, clinicians must use all the therapeutic tools available to them.
That is the essence of interventional pain management. Interventional pain management is a multi-disciplinary approach to relieving pain that is chronic and intractable. Instead of using the traditional approach of prescribing a pain medication, interventional pain management practitioners may combine a pharmacological remedy with more holistic therapies like physical therapy, mindful meditation, or cognitive behavioral therapy.
Common Interventional Pain Management Techniques
If you visit an interventional pain management practice, you should expect to encounter some or all the following therapies:
- Epidural steroid injections—a local anesthetic and a steroid are injected into the epidural space, the area around the spinal cord. A single injection may reduce inflammation and pain to a significant degree, but additional injections given every 3 to 4 weeks may be needed.
- Nerve block – a local anesthetic, with or without steroids, is injected close to a targeted nerve or group of nerves to interrupt pain signals.
- Radiofrequency ablation—this method uses radio waves to generate an electrical current that heats nerve tissue. This procedure kills the nerve cells that transmit the pain impulse to the brain. Eventually, the nerve will regrow, so the procedure must be repeated.
- Spinal cord stimulation/ Peripheral nerve stimulation—a current generator is implanted near the spine so that a low intensity electrical impulse is transmitted to the spinal nerves. This mild current disrupts transmission of pain impulses to the brain.
- Adhesiolysis—this interventional pain management therapy removes scar tissue that can produce pain by hindering movement or press on a nerve. This scar tissue may be the result of an injury, surgery, infection, or radiation. Adhesiolysis is most often performed on the lower back.
- Trigger point injections—if a muscle is in a state of continuous contraction, then it may require a trigger point injection to relax it and relieve the pain. The injection itself is composed of a local anesthetic and possibly a steroid compound.
- Kyphoplasty/vertebroplasty—these treatments for vertebral fractures involve placing cement or an inflatable balloon into the collapsed vertebra that will relieve the pressure on spinal nerves.
- Medication management—is a type of outpatient treatment strategy that involves an initial evaluation of the patient’s need for their medication. Prescribed drugs are carefully reviewed to look closely at the possible side effects that each could cause. Some patients may be taking medications that are no longer benefiting them or they may need a prescription for a particular medication that hasn’t been prescribed yet.
- Sacral Iliac Joint Fusion— is a posterior approach minimally invasive option often used to mitigate excessive mobility at the SI joint which causes up to 40% of low back pain.
Who Practices Interventional Pain Management?
Interventional pain management is a team-based practice that includes professionals from multiple health care disciplines. These may include
- Interventional pain physician—these medical specialists serve as the coordinators of the team and play decisive roles in determining the course of treatment. They often perform minimally invasive or injection treatments.
- Chiropractor—these allied health professionals use spinal manipulation to help relieve back pain.
- Physical therapist—often tasked with performing regular treatment sessions, physical therapists provide valuable, personalized care for joints and muscles and equip patients with techniques they can use to address pain and functionality themselves.
- Acupuncturist—practitioners of this form of alternative medicine have become more common on Interventional pain management teams. Acupuncture has become much more accepted in the medical community due to its potential benefits and low risks.
- Mental health therapist—psychologists and psychiatrists play essential roles in Interventional pain management because they treat anxiety and depression, conditions that often exacerbate chronic pain.
What to Expect When You See an Interventional Pain Management Clinician
If you are going to see an Interventional pain management specialist, you have probably already visited a primary care doctor who has conducted the standard tests like x-ray or MRI. At your first visit at an Interventional pain management clinic, your physician will perform a comprehensive physical examination and go through your medical history.
You should try to be open and honest about what treatments you have already tried and the results. This information can help narrow the scope of the investigation. Your doctor will then conduct some diagnostic tests to help identify the pain condition. They may also ask you to undergo a psychological evaluation as well.
This period of evaluation and diagnosis may take several sessions if the condition is difficult to identify. Once pinpointed, the Interventional pain management team will work with you to formulate a treatment plan. Your team may ask you to undertake several therapies simultaneously in an effort to identify any therapeutic synergies that are especially beneficial to you.
Should You Consider Interventional Pain Management?
Of course, anyone who has undergone traditional pain treatments without improvement should strongly consider an Interventional pain management program because of its diverse treatment approach. If you find that pain medications alone are insufficient to remedy your pain symptoms, then a more holistic approach that includes multiple therapeutic disciplines may hold the key to pain relief.
If the cause of your pain remains a mystery to your previous physicians, then an Interventional pain management program may prove more successful at treating your pain symptoms. An Interventional pain management clinic can’t promise to determine the underlying health condition that is causing your pain—in many ways, pain remains a mystifying phenomenon even to modern health experts—but your team will use all the tools available to them to try to bring you relief.
Not everyone, however, is right for Interventional pain management treatment. If you are suffering from comorbidities like psychosis or suicidal ideation, then it is probably in your best interest to obtain treatment for those conditions first.
Finally, it is important to seek help from an Interventional pain management clinic with realistic expectations. Many people do find pain relief from these programs, but it often takes considerable time and effort. You should also keep in mind that no medical treatment is a hundred percent successful.
Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care
M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees. The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship. Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA, and you should not post any of your private health information.