Pain Intervention Procedures

In this sections there are animations relating to the Pain Interventions that are available to a pain specialist in treating various different types of Pain Conditions. The animations at the bottom of this page have been designed to explain;

 The relevant anatomical structures
 The approach to the target area
 The drugs and the devices that may be used to provide relief from, and control of pain

Just click on the animation relating to the particular procedure that is of interest to you.

Pain Interventions usually take the form of the following;
  1. Injection of drugs

    This usually involves the injection of Local Anaesthetic and a steroid into the Epidural space, around a particular nerve or nerve root, in and around a joint (periarticular) or into a Trigger Point Zone.

    They provide relief of pain for about 2-3 months with on average about a 70% reduction in pain.

    If they are helpful then I usually repeat them every 3-4 months and try to reduce the patient's pain medications in the meantime.

    I am only too aware of their limitations but in my experience they can be invaluable in helping patients cope with their pain.

  2. Radiofrequency Treatment

    This is the application of a probe through which a special current is passed. It leads to the tissues around the probe being heated up.

    The types of currents that can be applied;

    • Conventional Radiofrequency (CRF) - this is effectively a heat burn and it destroys the tissues in the immediate vicinity. It is usually applied to nerves. The greatest evidence for the application of CRF is in the treatment of facet joint disease in the lumbar area but it may used in other areas of the spine as well.

    • Pulsed Radiofrequency (PRF) - this is a relatively new technique and the temperature rise is restricted to 42 degrees Centigrade. This means that the tissues are not destroyed. Pain specialists are not entirely sure how PRF works but it seems to have very useful modulating effect on the pain nerve. It is gaining rapidly in popularity.

  3. Advanced techniques.

    This falls into two main categories;

    • Intra thecal Opiate Pumps

    • Spinal Cord Stimulation

    Both are effectively described in the animations below.


 Caudal Steroid Injection

 Celiac Plexus Block

 Cervical Epidural Steroid Injection

 Cervical Facet Radiofrequency Neurotomy

 Cervical Selective Nerve Root Block

 Cervical Transforaminal Epidural Steroid
      Injection


 Costovertebral Block

 Disc Biacuplasty (TransDiscal System)

 Discography

 Facet Joint Injections

 Intradiscal Electrothermal Therapy (IDET)

 Intrathecal Pump Implant

 Kyphoplasty

 Lumbar Radiofrequency Neurotomy

 Lumbar Sympathetic Block

 Lumbar Transforaminal Epidural Steroid
      Injection


 Medial Branch Block

 RACZ Caudal Neurolysis

 Sacroiliac Joint Steroid Injection

 Spinal Cord Stimulator Implant

 Stellate Ganglion Block

 Thoracic Epidural Steroid Injection

 Thoracic Transforaminal Epidural Steroid
      Injection


 Trigeminal Neuralgia

 Vertebroplasty


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