When pain becomes chronic or stubborn, we usually give up on treatment and start to adjust to it. However, living with pain is not easy. It can affect your physical, emotional and psychological health. It can cause depression, anxiety, insomnia and stress.
Therefore, a lot of research has been performed to better understand how to deal with chronic pain and its physiological basis. This has led to the discovery of pain treatments that can offer complete or partial pain relief.
Untreated pain can interfere with the healing process by affecting the immune system and leading to other undesirable results. In the case of back pain, discomfort can hinder the rehabilitation process by interfering with exercise and increasing the risk of psychological distress.
Let us talk about 5 popular interventional pain management techniques:
Injections (Blocks):
A pain specialist usually recommends injections after other conservative measures such as medicines and physical therapy have failed to give you relief from back pain. In this procedure, they inject steroid or anesthetic drug directly into the joint, muscles or around nerves. This gives prompt and long-lasting relief because the medicine reaches the site from where the pain was originating. Moreover, steroid medication helps in bringing down the inflammation in the tissues. These injections also play a role in diagnosing the cause of the pain.
Radiofrequency Nerveablation:
In this procedure, a pain specialist aims to destroy the nerve fibers carrying pain signals to the brain. It provides lasting relief from chronic pain, especially in the lower back and neck. This procedure, also called Rhizotomy, is a minimally invasive method that uses heat to reduce the transmission of pain. Radiofrequency waves burn or ablate the nerves that were causing the pain. Benefits of Radiofrequency Nerveablation include: quick pain relief, less recovery time, improved function, avoidance of surgery and pain medications and faster return to work.
Surgically Implanted Electrotherapy Devices:
These include 2 types of implantable devices- Spinal cord stimulators and peripheral nerve stimulators. Your pain specialist may suggest this procedure if other treatment strategies like medicines or physical therapy have not given you sufficient relief from pain. In this procedure, mild electrical pulses are directed to disrupt the pain signals to the brain, reducing the perception of pain. A small implantable generator sends electrical impulses through wires, to block the pain signals.
Implantable Opioid Infusion Pumps:
The pain specialist can implant a very small medicine delivering pump in your spinal cord. This pump can deliver pain medicine at regular intervals to the nerves which carry pain signals. This helps in relieving the pain. Morphine is one such common drug delivered by the infusion pump. The pump can be customized by the pain doctor to suit the individual preferences and requirements. More than one medicine can be used in the pump like an opioid (narcotic agent) and an anesthetic agent to treat the pain more effectively. Although pain pumps may not completely eliminate the pain, they may provide significant relief from pain that can improve your day-to-day life. It also reduces your dependency on pain medications.
Prolotherapy:
Sometimes chronic back pain is caused by connective tissue injuries of the musculoskeletal system, which fail to heal with rest or other therapies. Prolotherapy is also called with different names like sclerotherapy, regenerative injection therapy or proliferative injection therapy. In this procedure, the pain specialist injects a substance into the soft tissue that induces an inflammatory response at the site, which in turn initiates the healing process.
Resources:
https://my.clevelandclinic.org/health/treatments/17411-radiofrequency-ablation
https://www.health.harvard.edu/pain/back-pain-what-you-can-expect-from-steroid-injections
https://www.spine.org/KnowYourBack/Treatments/Injection-Treatments-for-Spinal-Pain/Epidural-Steroid-Injections
https://www.spine-health.com/treatment/pain-management/invasive-pain-management-techniques