Late Stage Minimally Invasive Treatments for Chronic Pain
Generally, healthcare providers at first recommend conservative treatments, then try medications, on to minimally invasive techniques, and eventually recommend more advanced surgery for chronic pain relief. The minimally invasive techniques include:
Facet joint injections
The local anesthetic and anti-inflammatory steroid is injected into the cervical, thoracic, or lumbar facets. These facet joint injections help reduce facet joint pain over a prolonged period of time.
Facet joint denervation
The facet joint denervation procedure occurs after the facet joint injection is a success. This procedure treats central neck or back pain due facet joint pain caused by an injury or arthritis. The special needles are placed under continuous fluoroscopy where the tip lies on the nerve that carries the pain signals from the facet joint. Radiofrequency energy is passed through the needles to heat the tissue at about 80 degrees to coagulate and disable the nerves.
Epidural steroid injection
The epidural is the tissue layer that surrounds the spinal cord. In the spine, a long acting local anesthetic, anti-inflammatory steroid, and other pain modifying drugs are injected via a needle directly into the epidural space to reduce inflammation.
Transforaminal epidural injection
These injections are commonly done once or several times on patients who have lumbar radiculopathy or cervical radiculopathy. The transforminal epidural and epidural steroid injections are commonly performed as the same time.
Selective nerve root block (SNRB)
This injection is mainly used to diagnose the nerve root’s source of pain and for low back pain and/or leg pain management.
Spinal cord stimulation
A small device that is implanted near the spine, creates pulses to treat neuropathic pain and dysfunction from other conditions. This procedure helps alleviate stubborn nerve pain often seen in lumbar radiculopathy after spinal surgery.
Pulsed radiofrequency treatment
These radiofrequency energy passes through the tissue with moderate heat to interrupt the pain carrying nerve fibers. Conventional radiofrequency treatment coagulates all the tissue at the end of the needle to preserve the nerve function.
Contact your healthcare provider to learn more about the last stage minimally invasive treatment options for your chronic pain.