Interventional Pain Management Las Vegas

Pain medicine is the study of pain, and interventional pain management involves preventive medicine and various minimally invasive treatment options. Various situations lead to pain, such as having surgery (postoperative pain), nerve damage (neuropathic pain), and malignancy (cancer pain).

What is a pain management specialist?

A pain management specialist is a doctor who treats pain and manages painful health conditions. This specialist serves as a consultant to primary care practitioners. Pain management involves prescribing medicines, counseling patients and families, direct procedural treatment, and coordinating care with other healthcare workers.

How does the doctor determine if or not I need interventional pain management?

An evaluation of pain involves a review of laboratory tests, a detailed medical history, various imaging scans, electro-diagnostic studies, and a patient interview. Once the doctor is familiar with your condition, he will recommend a pain management treatment plan.

What are the different types of pain?

There are two main types of pain: acute and chronic. Acute pain occurs after an injury, or due to a treatment intervention or disease. As soon as the underlying mechanism heals, acute pain will resolve. Chronic pain persists after normal healing has occurred. As defined by the International Association for the Study of Pain (IASP), chronic pain is an unpleasant experience influenced by cognitive, affective, and environmental factors.

What are the specific kinds of acute and chronic pain?

Recurrent pain can be either acute or chronic. This pain is intermittent and episodic, and it occurs along with pain-free intervals. Cancer pain is a discomfort associated with treatment from radiation or chemotherapy, surgery, or with disease progression.

What treatment options are interventional?

Interventional pain management involves identifying the exact source of a patient’s pain, and then offering real, direct treatment for the condition. An intervention is a minimally invasive procedure done to target the affected nerves. Treatment options are:

  • Facet joint injection (FJI) – Typically given in a series of three spaced a few weeks apart, these injections are used to relieve the pain associated with facet joint syndrome or spinal arthritis.

 

  • Epidural steroid injection (ESI) – This procedure involves using a long-acting anesthetic along with a corticosteroid. The medications are injected into the epidural space to offer effective pain relief.

 

  • Intrathecal pain pump implant – This device is surgically implanted. The small unit delivers pain medicines directly to the spinal cord to target the central nervous system.

 

  • Medial branch block – With this procedure, a long-acting anesthetic and/or a neurolytic substance is injected onto a targeted spinal nerve root. This alleviates discomfort and blocks pain signal transmission.

 

  • Radiofrequency ablation – Sometimes called a rhizotomy, this involves use of heat onto specific spinal nerves. The ablation destroys a portion of the nerve root for long-term pain relief.

 

  • Spinal cord stimulation (SCS) – A special devices is implanted into the lower abdomen or buttock. The unit connects via wires to electrodes surgically place near the spinal cord. The mild electrical current interferes with pain signal transmission.

 

  • Joint injection – For arthritis of the knee or hip, the doctor can inject a long-acting corticosteroid into this space. Hyaluronic acid can be injected to replace lost synovial fluid of the knee joint.

 

  • Vertebroplasty and kyphoplasty – Both of these procedures will relieve pain in patients diagnosed with a vertebral compression fracture. These breaks occur due to osteoporosis, cancer, and/or trauma.

 

  • Intradiscal injection – This procedure is used to treat various chronic forms of discogenic (disc-related) back pain.

 

Resources

McGuirk BE & Bogduk N (2011). Low Back pain. Chapter 72, Bonica’s Management of Pain 4th Edition. Page 1105 – 1122.