Interventional Pain Management
New field helps patients with chronic pain
By Eric Homberg, M.D.
Before entering the specialty of pain medicine, I never appreciated the number of people who suffer with debilitating, chronic pain — especially in the elderly population. I’ve just been shocked with the prevalence of it.
Many physicians, including me, are specializing in a relatively new field of medicine called interventional pain management. It was developed to help patients suffering from chronic pain who are not candidates for, or who do not wish to undertake, surgical correction.
Pain management specialists strive to help patients bring their pain under control so they can live active and healthy lives. Surgery is a good solution for many people, but it is not always successful in relieving chronic pain. And in a few cases, it can make the pain worse. That’s why we try to be very selective of who we refer for surgery because it is not the only option.
A successful approach to managing a patient’s pain is a balanced regimen of physical therapy, procedures to manage pain, medications and surgery when appropriate.
Previous pain management techniques primarily involved physical therapy and medication. Interventional pain management adds education about exercise and minimally invasive procedures, such as nerve blocks, to a multimodal and balanced approach to help patients with recovery and the management of pain.
I primarily treat patients with injection procedures aided by fluoroscopy — intermittent X-rays and ultrasound — to deliver medications to the source of the pain without impacting the rest of the body. The method is not a replacement for surgery, but it is a middle ground for patients in search of options.
Because a variety of pain management techniques are associated with interventional pain management, patients don’t have to rely as heavily on narcotics to bring their pain under control. There is a national epidemic of prescription drug abuse, and we try to minimize our patient’s usage of opioids. We really strive to treat the patient without giving them another problem to deal with down the road.
Treating chronic pain is generally ongoing and more intense in the beginning. But once the pain is under control, the treatment is less frequent and may only be necessary for flare-ups. The goal is to treat a patient’s pain, bring it under control and make the patient less dependent on his or her doctor in the process.
Many patients with constant pain also are elderly. It’s important to understand their goals before embarking on a clearly defined path of pain management. Very often, they want to be able to work in their rose garden or pick up their grandchild.
When treating pain, it’s also important to try to find out what life circumstances contribute to the chronic pain, whether it’s bad habits or genetics. Patients also should be taught how to exercise regularly and live a healthier lifestyle. The reality is that all of us can be in better shape, and all of us can be more active.