Interventional Pain Procedures
Interventional pain procedures are recommended for patients who can no longer control chronic or severe pain with medications and other conservative or non-surgical treatment methods. In utilizing pain-blocking and inflammation-reducing techniques, they can help make day-to-day activities less difficult for patients and effectively restore their quality of life.
The idea behind interventional pain management is to use minimally invasive medical procedures to interrupt the nervous system’s transmission of pain-filled messages from the nerve endings to the brain, thus disrupting the pain cycle.
Interventional pain procedures are effective in treating pain caused by
- Arthritis
- Cervical Disorders
- Neck and Back Disorders
- Low-back Pain
- Lumbar Disorders
- Sciatica
- Sacroiliac Joint Pain
- Spinal Disc Rupture
Common Interventional Pain Procedures Used to Manage Pain
Interventional pain procedures such as Interventional surgery, epidural steroid injections, electrostimulation, nerve blocks, or implantable drug delivery systems may be used as part of the treatment process. Some of the most common procedures include:
An epidural steroid injection is a minimally invasive procedure that can help relieve neck, arm, back, and leg pain as a result of inflamed spinal nerves due to spinal stenosis, disc herniation, or degenerative disc disease.
During a lumbar epidural injection, Dr. Ball injects a corticosteroid (anti-inflammatory medicine) and anesthetic mix into the epidural space around the spinal nerve roots to reduce inflammation and swelling caused by spinal conditions that irritate or compress the nerve roots. The most common approach is from the back of the spine, an interlaminar (between two laminae of the vertebra) injection. When the injection is done from the side where the nerve exits the spine, it is called a transforaminal injection. Dr. Ball will decide which approach is best for you. During the procedure, a fluoroscope (a video x-ray device) is used for guidance and proper placement of the needle. These injections are performed to relieve low back pain and radiating leg pain. Many patients get significant relief from only one or two injections.
Facet block and radiofrequency ablation are done under fluoroscopic guidance. This procedure is done to relieve pain coming from the facet joint(s). Typically, the pain is worse with the spine or neck in extension (arched back) on physical examination. If a facet injection is successful, the patient may be a candidate for a radiofrequency ablation procedure to be determined by the pain management specialist.
This treatment is related to Spinal Cord Stimulation, except that it is localized on other parts of the body. The electrical leads are placed as close to the source of pain as possible and follow the same general process as Spinal Cord Stimulation.
This treatment is effective in pain in the lower back and neck, especially when pain is caused by arthritis. This technique uses a radio wave to produce an electrical current, which is then used to heat an area of nerve tissue to decrease the pain signals from that area.
A selective nerve root block is a specifically placed injection of either a lidocaine derivative, steroid, or both placed where the nerve root exits the spinal canal. This may be done to confirm a diagnosis or plan for a foraminotomy procedure, or for therapeutic purposes to treat an inflamed or irritated nerve root.
Spinal cord stimulation is effective in treating patients with chronic pain. During this procedure, electrical leads are inserted close to the spinal column, while a tiny generator is inserted into the abdomen or buttock. The generator emits electrical signals to the spinal column, blocking the ability of the brain to perceive pain.
At a Glance
Dr. Hieu Ball
- Double fellowship-trained orthopedic
- Orthopedic surgery residency at Harvard Medical School
- Over 20 years of spine surgery experience
- Learn more
