Interventions

About Interventions for pain management

Interventions in pain cover a wide range of procedures from simple injections that can be done in rooms, all the way up to implanted spinal techniques.  Before considering an intervention, it is important to remember that not all conditions that cause pain can be helped by interventions.  For instance if someone has pain felt throughout their body there is little opportunity to use a procedure to help such a problem. In addition, an intervention if appropriate must be coupled with other forms of treatment.

Interventions are usually day case procedures with low risks and complications and mostly done with an anaesthetist in attendance to provide a very small amount of sedation.

In pain conditions, the usual approach is to do a nerve block to assess the source of the pain. This then tells us more clearly where a pain is coming from as often, in for example back pain, there are usually many sites of pain. Once we know more clearly where the major sources of pain are, then we can do longer term treatments such as radiofrequency.

Radiofrequency treatments work by providing a small electric current to the nerves carrying pain. There are two forms – Pulsed Radiofrequency and Radiofrequency neurotomy. In pulsed radiofrequency we are just trying to calm a nerve down and get it to stop sending pain signals but overall we want the nerve to keep working. This is used in pelvic pain, post surgical pain and some back and leg pain problems eg from the discs in the back.

In radiofrequency neurotomy we are producing a very small burn to a nerve that we want to stop working. These nerves are only good at sending pain signals so damaging them on purpose is useful. We use radiofrequency neurotomy for example in one of the major back pain syndromes where pain is coming from the facet joints. In this case a day case set of “test” nerve blocks is done to help identify the pain and a second procedure, the radiofrequency procedure if we have a positive test.

As in all pain conditions though an intervention is only one part of the process to pain management. The onus is on you to engage with a physiotherapist to start moving and rehabilitating.

Information on the different kinds of interventions for your pain syndromes can be discussed with your specialist.