Interventional pain management is an area of medicine focused on relieving pain by means of specialized injections or minor surgeries. Medications, physical therapy, acupuncture and other treatments may be used in conjunction with injection type therapy.
A therapeutic injection is given with the intent of treating a painful condition, whereas a diagnostic injection is performed to identify a specific pain generator. Some diagnostic injections may additionally be pain relieving, but the intent of a diagnostic injection is primarily to elucidate the problem causing the pain so that surgery or other treatments can be accurately planned.
Sadly, usually not. Injection of corticosteroid may reduce inflammation enough that pain subsides for months and sometimes years. Other types of treatments may result in more protracted pain relief. For example, facet rhizotomies may relieve pain for up to 2 years.
Interventional pain procedures are generally done in an operating room in a sterile environment. Fluoroscopy is a live X-ray and is used to guide the provider in accurately placing the medication at the desired location.
Usually people are able to undergo the procedures with local anesthesia at the site of the injection. Some prefer to have intravenous sedation to further blunt discomfort. Sedation is available if desired.
All blood thinners need to be discontinued prior to your procedure. Plavix and Aspirin needs to be discontinued 7 days before, Coumadin 4 days, NSAIDS 5 day. Other specific instructions will be provided.
If you will be receiving intravenous sedation, then you will need to not eat or drink for 6 hours prior to your procedure.
If you receive intravenous sedation, then you will need someone to drive you home.
Usually within 3-5 days people begin to feel the benefit of the injection. This may continue to build over a couple weeks.
This is variable depending upon your particular pathology. Some conditions respond dramatically to a single injection and then continue to improve with no additional treatments. Other conditions are managed with episodic injections every few months.
Narcotic pain relievers cannot be called in. All opioid prescriptions require that you be seen in the office. Non narcotic medications can usually be called to a pharmacy.
Anytime you experience progressive neurologic decline, such as more leg or arm weakness or loss of bowel or bladder control you should call Dr. Denham and seek immediate emergency care. Additionally, a high fever or worsening pain following a procedure may indicate an infection and requires emergency attention.