Interventional Pain Management

Interventional pain management may be an alternative or adjunct to prescription pain medication, and may be offered by your pain specialist if it is appropriate for you. Interventional pain management includes procedures such as injections and radiofrequency ablation.

These procedures are performed by a specialist doctor either in the operating theatre or in the radiology department, and are performed under imaging guidance. They usually take a short time (30 - 40 minutes), after which you will require a brief period of monitoring on the ward prior to returning home. 

It is difficult to know if an intervention will provide significant pain relief and by how much and for how long. Sometimes, you may notice a difference in your pain immediately, however, more often than not, it can take weeks to notice benefits; hence it may be beneficial to allow time for the intervention to be helpful. Ideally, an intervention can last for many months, though sometimes the effectiveness may last for weeks.

Common Interventional Pain Management Procedures

  • Epidural injection: this is an injection (generally steroids and/or local anaesthetic) into the epidural space of the spine (which contains nerve roots) that aims to target the nerves associated with pain
     
  • Radiofrequency ablation (also known as denervation or rhizotomy): this procedure uses radiowaves to burn or stun the nerves for a longer term benefit
     
  • Nerve blocks: this is an injection (generally local anaesthetic) that blocks specific nerves supplying the regions associated with pain
    • Stellate ganglion block: head/neck/upper limb region

    • Suprascapular nerve block: shoulder region

    • Lumbar sympathetic block: lower back/lower limb region

    • Coeliac plexus block: upper abdominal region

  • Device implantations: this is a procedure that embeds a device under the skin in the back to stimulate the spinal cord nerves to relieve pain

Adverse Events

Adverse events are not common, but as with all procedures, serious adverse events may occur including failure to provide pain relief, nerve damage, bleeding and infection. Adverse events are reduced through image guidance and doing the procedure in a sterile environment.

Preparation for Interventional Procedures

Please see the fact sheets below under 'Resources' to prepare for your upcoming procedure.