Summary: Prescription medications and invasive surgeries are the most common options for treating both acute and chronic pain. But interventional medicine is another option. It can reduce dependence on medication and delay or prevent the need for surgery.
We often work with patients who previously avoided pain medicine because they assumed a clinic like Lone Star Pain Medicine was nothing more than a precursor to surgery. Surgery has its place in modern medicine, no doubt. But it is sometimes appropriate to delay surgery or prevent it entirely. Modern interventional pain management is designed to do exactly that.
The key challenge of surgery is its permanence. There is no going back once a patient goes under the knife. But interventional medicine is different. In terms of treating pain, it is more about restoring function than anything else. Interventional pain management seeks to restore function with minimal downtime.
Understanding the Pain Signal
A pain management doctor never assumes anything about a person’s pain. His first task is to understand the specific pain signals. In a broad sense, this means understanding whether the patient is experiencing acute or chronic pain. The differences between the two matters from an interventional standpoint:
1. Acute Pain
Acute pain is a normal function of the human body. It is essentially an alarm system designed to warn that something is off. For example, it could be a sharp, stinging pain experienced on the soccer field when an ankle is twisted. By nature, acute pain is protective. It is also temporary.
2. Chronic Pain
Chronic pain is more like a glitch in the body’s alarm system. It continues even after the injury or medical condition behind it has fully healed. And sometimes, chronic pain is nonspecific – there is no known cause.
It is believed that chronic pain is sometimes the result of central sensitization, a condition in which the nervous system remains highly reactive. Any slight stimulus causes the nerves to react, with pain signals being sent to the brain.
Regardless, neither acute nor chronic pain is pleasant or easy to deal with. When pain medications don’t do the trick, patients are left asking, “What next?” That is where pain management comes in. Clinics specializing in interventional pain management, like Lone Star, are able to offer treatments outside of traditional prescriptions and surgeries.
Intervention: Precision Over Prescription
Pain management is interventional by nature. This means that treatments aren’t designed simply to mask pain or introduce corrective procedures that permanently alter the body. Rather, treatments intervene at the point of origin. The goal is to prevent pain signals from ever reaching the brain. Below are two examples:
1. Epidural Steroid Injections
An epidural steroid injection (ESI) is designed to do two things: provide temporary, short-term pain relief and reduce inflammation. Addressing inflammation provides more long-term pain relief. It is one option for relieving the pain of a herniated disk.
ESI’s purpose is to address the inflammatory proteins that are causing the patient’s pain. This is accomplished through a simple outpatient procedure involving an injection. The doctor uses fluoroscopy to guide a needle to the appropriate location, followed by an injection. The medication being injected is a combination of anesthetic and steroids.
2. Facet Joint Injections
Facet joint injections are similar to ESIs in terms of both principles and goals. They are so named because they are designed to target the facet joints – the joints between each bone in the spine. Again, the doctor injects a combination of anesthetic and steroid to provide temporary pain relief and reduce swelling in the long term.
The injections can be used as both a treatment and a diagnostic tool. From a diagnostic standpoint, successful treatment confirms that the doctor has correctly identified the problem joint.
Switching Off the Nerves
Many of the interventional treatments we offer are considered injection-based therapies. But we also offer treatments designed to ‘switch off’ the affected nerves, thereby relieving pain. One of the most common among them is known as radiofrequency ablation (RFA) or radiofrequency neurotomy (RFN).
The procedure makes it possible to temporarily turn off a nerve without the permanency of surgery. Instead of severing the nerve, we use heat to create a small lesion on the targeted nerve. The lesion blocks pain signals from traveling through the tissue, with relief lasting from 6 to 18 months.
Nerve tissue naturally regenerates itself, so the procedure doesn’t result in permanent damage. Some patients do not need second or third treatments even after the first one wears off. But those who need additional treatments can rest comfortably in the fact that RFA is both repeatable and safe. Pain relief can be accomplished without more traditional fusion surgery.
Physical Therapy’s Role in Pain Management
The pain management treatments we offer are quite effective for most patients. But it should not be assumed that injection therapies or switching off nerves are the only solutions to patient discomfort. Rather, think of our treatments as windows of opportunity. When combined with physical therapy, great things can happen.
Chronic pain, for example, tends to limit a person’s willingness to exercise. A lack of exercise leads to a loss of strength and muscle tone. In turn, this leads to increased pain as the muscles and joints fail to provide the necessary support. By relieving pain – even temporarily – we make it possible for people to start exercising again.
We essentially break the cycle. When it’s broken, physical therapy becomes a more effective tool for increasing strength and mobility, which is almost always the best long-term treatment.
Three Reasons for Choosing Interventional Medicine
Pain medications are appropriate some of the time. Surgery also has its place. But here are three reasons to consider an interventional path instead:
- No Hospitalization – Treatments are provided in an outpatient setting. Most procedures require 30 minutes or less.
- Rapid Recovery – Most patients return to normal activity within 24-48 hours.
- Fewer Medications – Interventional medicine can reduce the need for pain medications, particularly prescription opioids.
When pain medications are not getting the job done and surgery is not the preferred option, interventional pain management is the way to go. It is what we practice here at Lone Star Pain Medicine.
FAQs
Isn’t interventional medicine just a band-aid?
Unlike pain medications that merely mask pain, interventional medicine gets to the root of the problem. It targets pain at its source for better and more thorough relief.
Will I still need surgery even after an interventional treatment?
Each case is different. Some patients are able to delay surgery for an extended amount of time, while others ultimately end up not needing surgery at all.
Are the procedures you offered done under anesthesia?
Most of the procedures we perform are done using local anesthetic. You remain awake and aware throughout.
How long does pain relief last?
Patients responded to interventional therapies differently. Depending on the condition and treatment, some patients experience pain relief lasting anywhere from a few months to more than a year.
Will I still need physical therapy?
Whether or not you will need physical therapy is up to your doctor and therapist to determine. Remember that interventional treatments are often considered an open door to physical therapy that improves function and range of motion.
