Interventional Pain Management for Chronic Pain

Interventional pain management procedures are generally more invasive and include injections and spinal cord stimulation surgery. Interventional pain management is used to treat a range of chronic pain symptoms.


Injections for Chronic Pain Relief

Injections can be more effective than oral medication because they deliver the treatment directly to the source of pain. Often injections for chronic pain may include steroids, lidocaine (pain numbing medication), or simply a saline solution.

Examples of injections are described below.

  • Epidural steroid injections are placed directly into the epidural space in the spine.
  • Joint muscle/tendon injections are placed in the joint or muscle causing the pain.
  • Peripheral nerve injections focus on blocking pain in a specific area of the body by injecting a local anesthetic in a nerve or nerve bundle. This stops pain signals from being transferred to the brain.

Pain relief can last anywhere from 6 weeks to 6 months. Damage to the injection site, including tendons, cartilage, and ligaments, can result if injections are given too frequently.

Spinal Cord Stimulation Surgery

Spinal cord stimulation surgery—which involves the implantation of a device in the body—is recommended for a range of chronic conditions, such as back pain, neck pain, and complex regional pain syndrome. It works by sending mild electric currents to the spinal cord to stop pain signals from reaching the brain.

Spinal cord stimulation surgery is typically done in 2 parts:

  1. A trial period is done to determine whether or not an individual is a good candidate for spinal cord stimulation. It is usually based on the devices effectiveness to relieve the patient’s pain.
  2. Permanent implantation of the generator is done if the doctor and patient agree that the trial period was successful. The generator powers the electric pulses and can usually be controlled with a portable device.

This procedure generally requires up to 8 weeks of recovery time. A doctor may suggest prescribing opioids for post-surgical pain. If a patient is uncomfortable taking opioids he or she should tell the doctor; other medications are available to control pain after surgery.

See When Are Opioids Appropriate?

Spinal cord stimulation does not eliminate the source of pain, which means that the degree of relief achieved will vary from person to person.