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Interventional pain management uses injections of drugs to reduce pain. Besides its therapeutic benefit, interventional pain management can play a role in identify the source of the pain.
Often an X-ray or magnetic resonance imaging (MRI) scan of the spine shows more than one area that the pain could be coming from. By selectively injecting each separate area or spine structure with anesthetic, your doctor can begin to pinpoint the problem.
Interventional pain management doctors are skilled at performing pain injections. An orthopaedic surgeon may perform the injection or refer you to another specialist:
- Epidural Steroid Injection. This is the most commonly done procedure to relieve pain. The injection delivers a powerful cortisone solution directly to the spine, which reduces the swelling and irritation around a nerve or part of the spinal cord. Most patients who receive epidurals will have less pain for a number of weeks or months. This allows them to participate in a rehabilitation program. Epidural injections are usually repeated when severe symptoms flare-up.
- Selective Nerve Root Injection. In this procedure, the doctor uses X-ray guidance (fluoroscopy) to locate a particular nerve root. The drug is injected into the troubled nerve root, rather than into the entire spine. The injection can be even more tightly focused if it is being done to diagnose the source of the pain.
- Facet Joint Injection. The bones (vertebrae) of our spines are linked to each other by facet joints. The facet joints are paired (one on the right and one on the left side of the spine) on every vertebra. Injecting medication directly into the facet joint with the aide of X-ray guidance (fluoroscopy) helps to locate and relieve the source of the pain.
- Sacroiliac Joint Injection. At the base of the spine is the tailbone (the sacrum). The sacroiliac joint connects the sacrum to the pelvis. It can become a source of lower back and leg pain. An injection into the sacroiliac joint can provide relief from pain.
- Joint and Soft Tissue Injections.The doctor injects a corticosteroid or pain reliever directly into the affected joint or soft tissue space (the space between the muscle and bone) to provide relief for weeks or months, or longer. The injection also may be used to remove fluid build-up in an inflamed joint.