Interventional Pain Management and Back Pain
Interventional Pain Management refers to pain centers that specialize in treating back pain and other types of joint pain. The healthcare practitioners who treat patients at these centers include nurses, radiologists, pain specialists, neurosurgeons, and other experts in the field of pain reduction. The purpose of international pain management therapies such as epidural steroid injections is to reduce back spasms and provide lower back pain relief that is both immediate and lasting. Though interventional pain management treatments usually will not cure the source of the problem, they may help patients resume a quality of life that they had prior the onset of symptoms. Also, the short term pain reduction may enable patients the ability to resume activities and exercises that will prevent the pain from coming back. Interventional pain management usually involves injections directly into the inflamed joints causing back pain. Examples of interventional pain management procedures include epidural injections, facet joint injections, trigger point injections, stellate ganglion block, and sacroiliac block. The injections into the inflamed or sensitive joints will usually be the final step of the procedure. Prior to the actual injections, radiology images are taken to determine the specific source of inflammation and pain. Next, an anesthesiologist will numb the skin and site of injection. Finally the damages or inflamed joint will be injected, and hopefully, the patient's pain will be modified. These procedures will be performed when it has been determined that the patient's muscular trigger points, nerves, or intervertebral discs are the source of a patient's pain.
Your primary doctor or spine doctor will order radiographic imaging (X-Ray, CT Scan, MRI) if they think that nerve compression or disc damage is the cause of your back pain. If the source of your back pain if nerve root compression or disc damage that is not bad enough to require surgery, than injections at an interventional pain management center may be recommended as appropriate . Injection therapies fall into three groups: trigger point injections, steroid injections, and blocking using local anesthetics.
Other pain management procedures are designed to either electrically stimulate certain nerves or to destroy other ones that are the cause of so much pain. Additional procedures are designed to halt damage to vertebrae using epoxy materials to cement fractures. In procedures such as a laser discectomy, a small amount of damaged disc material is vaporized using a miocrolaser. For patients with minor damage or bulging to their intervertebral discs, an Intradiscal Electrothermal Annuloplasty (IDET), may be appropriate. In the IDET procedure, a catheter is positioned into the walls of the disc associated with back pain, and the disc is heated with the purpose of stunning the nerve fibers that are the cause of pain. The IDET procedure was more popular in the 1990s and through about 2004, until recent studies suggested small reductions of pain reduction in the long term, and no benefits in pain reduction at 1 year following the procedure.
Other procedures are designed to remove or destroy damaged portions of herniated discs rather than procedures to remove the entire disc. Chemonucleolysis is one such procedure where an enzyme (chymopapain) is used to remove the damaged portion of a herniated disc. Patients who have mold disc bulging or herniations are more likely to have success with this procedure than patients with severe herniation or damage to multiple intervertebral discs.