Extreme long term pain can reduce quality of life and make every day a struggle.
Interventional pain management is a method which utilizes pain blocking techniques in which invasive intervention such as electro-stimulations, nerve blocks or implantable drug delivery system may be used as a part of the treatment process.
Interventional pain management is generally used when pain is severe enough to interfere with daily activities, and other treatment types have not been successful in reducing pain. If you are searching for a solution to your chronic or acute pain, then it may be time to find an Interventional Pain Management consultant who can help.
Figure 2. New adaptation of the analgesic ladder
NSAID-nonsteroidal anti-inflammatory drug, PCA-patient-controlled analgesia.
The interventional pain management is now well established medical sub-specialty in United states but in India the practice of interventional pain management by dedicated medical professionals & their training is still in nascent stage. Now more & more anesthesiologist are showing interest in the field of interventional pain management.
The common methods used in Intervention pain management depends on type of pain & its location.
1. Nerve block
Sensory nerves take pain signal to brain, nerve block techniques used to break the pathway & interrupts signal to reach brain to provide relief in pain. Most of the nerve block give relief lasting for hours or days to weeks. The nerve blocks are usually given under fluoroscopic control.
Infusion involves the delivery of pain relieving drug in body for longer duration in controlled manner such as intra-thecal-infusion for drug delivery in subarachnoid space in brain & spinal epidural infusion.
3. Local injection
Generally steroid (Potent anti-inflammatory) along with local anesthetic drugs are injected into epidural space, facet joints in spine, trigger points, Intra-articular in joint cavities & in ligaments etc.
Management : Disc Herniation
Under fluoroscopic Guidance Correct level of the prolapsed disc is identified
Needle is inserted into the centre of the Disc and ozone is Injected.Pain relief starts usually within one week and ozone takes 3-4 weeks for its complete effect
4. Radiofrequency Ablation
This treatment is usually used to treat lower back and neck pain, 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. This method decreases the pain signals from that area.
5. Spinal Cord Stimulation
This technique treats chronic pain by applying gentle electrical currents to the source of the pain. 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, thus blocking the ability for the brain to perceive pain.
6. Peripheral Nerve Field Stimulation
This treatment type 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 follows the same general process as Spinal Cord Stimulation.