Chronic pain and discomfort seem to be something that everyone has to deal with at some point, but it’s especially common in older adults. In fact, as many as 65% of older adults report feeling arthritic pain in their lower back, and as many as 40% feel general musculoskeletal pain at other points in the body.
While chronic pain is ongoing, it doesn’t mean that there isn’t a way to find relief. There are plenty of different ways to manage pain, and interventional pain management is one of the most widely utilized.
Here’s everything you need to know about how it works and how it can help individuals find relief.
What Is Interventional Pain Management?
If you’ve ever felt general muscle stiffness or soreness yourself, you may have tried using over-the-counter medication or utilized some stretches to alleviate the discomfort. However, when chronic pain becomes too difficult to bear, it can affect the way you perform everyday activities.
When this happens, interventional pain management is often used. This is a method that utilizes pain-blocking techniques to enhance comfort and reduce feelings of pain. It is a branch of medicine involved in diagnosing and treating pain-related disorders.
Interventional pain management takes a multidisciplinary approach in which a team of professionals works together to treat and manage pain from all angles.
What Is an Interventional Pain Specialist?
Those who practice interventional pain management techniques are known as interventional pain specialists. These individuals have special training in the diagnosis and treatment of all different types of pain.
Pain specialists understand the physiology of pain and can evaluate patients with complicated or co-occurring pain problems. They also appropriately prescribe medications for varying pain problems and are skilled to perform a number of procedures.
How Does Interventional Pain Management Work?
If a patient believes their chronic pain might benefit from interventional pain management, here is what they can expect as they work through their treatment journey.
Step 1: Physical Examination
At a person’s first appointment with a pain management specialist, they’ll be given a thorough physical examination to try to uncover the cause behind their chronic pain. This will likely include discussion of medical history, so you can expedite the process by coming prepared with past test results or x-rays.
At this stage, they’ll also need to let the doctor know of any and all medications that are being uses or have been used. Discuss other pain treatments they’ve had, as well as their effectiveness, so that their provider can gain a clearer picture of the patient’s situation.
Step 2: Diagnostic Testing
Next, the doctor will perform a series of related diagnostic tests to rule out other conditions or narrow down their diagnoses. This might include blood tests, X-rays, CT scans, or MRI scans. They may also conduct psychological evaluations at this time.
Step 3: Treatment Plan
After a thorough evaluation combined with diagnostic testing, a doctor will come to a conclusion about what is likely causing an individual’s pain and how it can be treated. They’ll then work with ythem to craft a personalized treatment plan so that they can manage and overcome their discomfort.
This third step is an ongoing process. If the first treatment method does not work as planned, it can be adapted and modified to each persons needs.
Types of Interventional Pain Management Treatments
The treatment an individual receives will be based on their specific condition and symptoms, as each type of treatment requires some amount of invasiveness.
Nerve Blocks
Nerve blocks are some of the most common forms of interventional pain management because they are effective yet less invasive compared to other alternatives. These are typically injectable medications, and their purpose is to block pain from specific nerves.
A needle, along with the help of an ultrasound or CT scan, is gently guided to the nerve or group of nerves that require pain blocking. Then, a pain-relieving or anti-inflammatory drug is injected at the nerve site.
Nerve blocks work by numbing the pain messages and signals coming from the nerves in a particular area of the body. One of the most common nerve blocks is an epidural, which many pregnant mothers ask for to mitigate the pain of childbirth. They can be temporary or long-lasting, depending on the type.
Joint Injections
Joint injections, also known as cortisone shots, can help alleviate pain and inflammation in joints. They’re commonly injected into places on the body like your ankles, hips, knees, elbows, spine, or wrist. They’re very effective at treating the pain associated with arthritis.
As the needle is injected, a fluoroscopy X-ray is used to guide the needle and ensure it makes it to the right spot. Then, the corticosteroid medication is released into the injection site. They work by shutting down collagen production in the tendon or joint, therefore suppressing inflammation and indirectly reducing pain.
The amount of joint injections that a person can get per year is limited, but they usually last a few months before wearing off. And while they commonly cause a temporary flare-up, they can bring you a lot of relief in the long term.
Intravenous Infusions
Infusions are similar to joint injections, however, the main difference is that certain substances are injected into the bloodstream rather than a joint. One of the most common intravenous injections is lidocaine, which blocks sodium channels in cell membranes that may otherwise play a role in neuropathic or inflammatory pain.
An intravenous catheter is placed in the arm and medications are slowly infused over a period of time. And while they are often not used as a first line of treatment, this method has shown promise in being effective for alleviating certain types of pain.
Spinal Cord Stimulation
When nonsurgical lower back pain relief options have failed, a common intervention is called spinal cord stimulation. With this procedure, thin electrode wires are placed between the spinal cord and the vertebrae. A battery-like generator is then placed under the skin, usually in the buttocks, thus sending small electrical impulses to the spine when an individual feels pain.
Experts don’t fully understand the mechanisms behind this device, but it can target multiple muscle groups and even alter how the brain perceives feelings of pain. It’s sort of like a pacemaker for back pain and discomfort.
Percutaneous Discectomy / Nucleoplasty
A nucleoplasty is a minimally invasive treatment for pain associated with herniated discs. During a nucleoplasty, radiologists use image-guided technology to remove small amounts of disc tissue to relieve pressure on the nerves in the spine.
Radiofrequency Ablation
Radiofrequency ablation is a minimally invasive procedure that is used to treat chronic neck and back pain. A needle-like probe is sent into the body, where radiofrequency waves are sent from the probe into surrounding tissues. This causes cells to die, resulting in disabled nerve fibers that are carrying pain signals to the spinal cord.
Who Should Use Interventional Pain Management?
Any of these treatments can be recommended by physicians to help alleviate discomfort for a wide variety of different diseases. However, interventional pain management is not often the first course of action, as non-invasive techniques are typically tried first.
Non-invasive pain relief includes any procedure that does not actually enter the inside of the body. For chronic pain, non-invasive treatments include physical therapy, hot and cold packs, anti-inflammatory lotions and creams, or occupational therapy.
But if these do not work to bring down feelings of pain or discomfort, interventional pain management will likely be the next step. They are often recommended as a supplement to surgery if a surgical procedure for pain does not help the problem as much as it should.
Pain management specialists can even help individuals with dementia, as they can help to pinpoint the source of some of their irritable outbursts or behaviors by allowing them to feel more comfortable.
Who Conducts Interventional Pain Management?
While your a primary care physician may offer some interventional treatments within their practice, it’s likely that they’ll need to refer patients to other physician for the proper treatment.
This might include one or more of the following healthcare professionals:
- Physiatrists
- Internists
- Anesthesiologists
- Occupational therapists
- Physical Therapists
- Nurses
- Psychologists or psychiatrists
The real magic of interventional pain management occurs when everyone on the medical team communicates with one another. The process of care coordination is just as important as the actual therapeutic treatments that each patient receives.
Where To Get Interventional Pain Management Treatment
Starting at a primary care physician for interventional pain management is the typical course of action, but what if access to PCPs is limited?
And while medications are effective, they often come with adverse side effects, especially for seniors with dementia.
At Lightyear Health, we’re committed to redefining the aging process. Our pain management specialists can offer many of the treatments listed above to help enhance an individual’s quality of life.
Get in touch with our care team to learn more about how we can help.
In Conclusion
Interventional pain management is the process of using minimally invasive pain-blocking techniques to alleviate discomfort and enhance quality of life.
Key Takeaways:
- The three steps of interventional pain management include a physical examination, a diagnostic assessment (x-rays, MRI scans, bloodwork, etc.), and a personalized treatment plan.
- Types of interventional pain management include joint injections, infusions, nerve blocks, intravenous injections, nucleoplasty, spinal cord stimulation, and radiofrequency ablation.
- Interventional pain management specialists include physical therapists, physiatrists, internists, occupational therapists, and even psychologists.
Lightyear Health is proud to offer a variety of pain management techniques to help individuals live their best lives. To learn more about how we redefine the aging process, get in touch with us here.
Sources:
Overview of Persistent Pain in Older Adults | American Psychological Association
Nerve Blocks | Johns Hopkins Medicine
Cortisone shots | The Mayo Clinic
Intravenous infusions in chronic pain management | NCBI
Spinal Cord Stimulator | Johns Hopkins Medicine
Nucleoplasty (Percutaneous Discectomy) | Massachusetts General Hospital
