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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;
- 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.
- 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.
- Advanced techniques.
This falls into two main categories;
- Intra thecal Opiate Pumps
- Spinal Cord Stimulation
Both are effectively described in the animations below.
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Caudal Steroid Injection