Back Pain Specialists: Interventional Radiologists

Interventional Radiologists are back pain specialists, who are medical doctors, who use aid in surgeries and pain management procedures that involve the injection of contrast agents and epidural steroids.

Interventional radiology is a sub-specialty of radiology that involves the doctors using medical imaging techniques as a guide to finding precise structures to be removed or repaired. Radiology does not simply involve static images to be looked at on a light board, but also procedures where doctors are looking at radiographic bones and soft tissues of parts in live time, during operations. Interventional radiologists may be present at pain clinics, where interventional radiology is used to locate the area of interest, so that the doctor giving the injection knows exactly where to position the needle. In other cases, such as surgery, an interventional radiologist guides and operates the radiographic equipment so that the doctor is able to guide his or her equipment into place, and to look at a series of images taken before, during, and after the procedure.

Typically, the technology used is Fluoroscopy or X-Ray imaging, which allows doctors to be able to get a good view of the bones, muscles, and soft tissues that are the source of a person's back pain. X-Ray involves static X-Ray images, while Fluoroscopy involves being able to look at structures of the body, as a video image. When fluoroscopy equipment is being used the structures in the body can be observed by the interventional radiologist in live time, and recordings can be made in single images or in short video segments. Most hospitals only have the technology to take short video segments of Fluoroscopy procedures because of the huge amount of data that the video takes up. The only limitation of Fluoroscopy is that it requires a radiology room with a dedicated Fluoroscopy table and associated equipment, such as an overhead X-Ray tube and lead lined walls and windows. This is why X-Ray is more likely to be used in operating rooms, and procedures and tests that use Fluoroscopy are located in Radiology Departments and in places such as pain clinics.



Both Fluoroscopy and X-Ray involve the use of X-Ray, which is invisible light that is capable of passing through a human and creating an image on the opposite side. Some structures in the body are thicker and denser than other structures. For This reason, some of the X-Ray light photons are able to make it through the patient while some are absorbed. The X-ray beams that make it from the X-Ray tube through the patient and onto the image receptor behind the patient show up black on an image. The regions behind the image receptor where fewer X-Rays are able to pass through the patient show up whiter on the image receptor, and thus whiter on the film. This contrast of whites, grays and blacks give doctors enough information to see what is going on in our bodies, and to make diagnostic and surgical decisions.

Often, the cause of back pain is due to damage of the joints and soft tissues in the spine and pelvis. In general, denser structures like bone show up very well on radiographic pictures, and joint tissues, ligaments, and tendons show up poorly. For diagnostic and interventional procedures involving the soft tissues of joints, Interventional Radiologists often inject a contrast into the areas of interest. The injection of the contrast agent often results in much better detail and contrast of the surrounding structures.

The ability to see very small soft tissues of the body, with the aid of a contrast agent in many cases, gives doctors the ability to see into the body with very good detail, without opening it up. This technology results in much small incisions and much shorter recovery times, when surgical procedures are required.