Procedures or interventions are used in the management of chronic pain as one element of the pain management process. They provide temporary relief from pain; this allows more intensive physical rehabilitation to be performed. During this period of pain relief the goal is to improve muscle strength, stability and daily function.

Many interventions can be performed for pain relief. Some of the more common ones are listed below.

Joint and Soft Tissue Injection

Arthritis and tissue inflammation can cause chronic pain. If it is thought necessary a needle is introduced under sterile conditions into a joint to obtain a sample of synovial (joint) fluid. Local anaesthetic and steroids can also be injected into the joint to provide pain relief and relieve inflammation.

 

Facet Joint Injection

Throughout the spine there are small joints called facet (or zygopophyseal) joints. These small joints provide stability and allow movement especially at the neck and waist. Unfortunately, they are also prone to degeneration (osteoarthritis) a process in the spine called spondylitic change. Injection of these small joints follows the same principle as joint injection. As the joints are smaller, x - ray facilities are required.

Radio frequency Neurotomy

If injection of the facet joints joints provides pain relief patients can undergo a more permanent procedure, radio frequency neurotomy. Radio frequency neurotomy involves guiding a radio frequency needle under x - ray guidance to the nerve supplying an individual facet joint. Once the needle is in the right position a radio frequency lesion of the nerve is performed.

 

Epidural Injection

Many patients experience pain in their arms or legs due to irritation of nerves originating from the spine. If patients do not respond to more conservative treatment an epidural steroid injection can be performed. A needle is introduced into the epidural space (a space containing fat and blood vessels around the spinal cord), once the needle position is confirmed local anaesthetic and steroid is injected into the space. This may provide temporary pain relief for patients.