Pain Relief with Interventional Radiology

Nerve Block Procedures

Nerve blocks involve the injection of anaesthetics or other medications near specific nerves to interrupt pain signals.

• Celiac Plexus Block : Used for abdominal pain, especially in patients with pancreatic or gastrointestinal cancer.
• Facet Joint Injections & Radiofrequency Ablation (RFA) : Target chronic back pain, especially pain from the small joints (facet joints) in the spine.
• Sympathetic Nerve Blocks : Effective for treating neuropathic pain or conditions like Complex Regional Pain Syndrome (CRPS).

Spinal Interventions

These procedures are designed to relieve pain originating from the spine.

• Epidural Steroid Injections : For chronic neck or back pain due to conditions like herniated discs, spinal stenosis, or sciatica. Steroids and anaesthetics are injected around the spinal cord to reduce inflammation and pain.
• Vertebroplasty & Kyphoplasty : Treat spinal fractures caused by osteoporosis. Bone cement is injected into the fractured vertebrae to stabilize it and alleviate pain.

Radiofrequency Ablation (RFA) & Microwave Ablation (MWA)

Both RFA and MWA use heat (radiofrequency or microwave) to destroy nerve tissue that transmits pain signals.

• Applications : Often used to treat chronic pain in the back, neck, or joints (e.g., from arthritis or facet joint syndrome). These techniques can also be used to treat tumours causing compression or pain.
• Facet Joint RFA : Specifically targets nerves around the spine’s facet joints, providing long-lasting relief from arthritis pain.

Cryoablation

Cryoablation uses extremely cold temperatures to destroy pain-transmitting nerve tissue.

• Common Uses : It’s effective for managing pain from tumours (e.g., in the liver, kidney, or bones) or chronic conditions like spinal pain.

Intrathecal Pump Implantation

For patients with chronic pain that hasn’t responded to other treatments, an intrathecal pump can deliver pain medications (e.g., morphine) directly into the cerebrospinal fluid.

• Benefits : This method offers better control with lower medication doses and fewer side effects than oral medications.

Palliative Cancer Pain Procedures

These procedures aim to relieve pain caused by cancer.

• Tumour Ablation : Techniques like RFA, cryoablation, or microwave ablation shrink or destroy tumours in the liver, kidneys, lungs, or bones to relieve pain.
• Biliary Stent Placement : For patients with blocked bile ducts (often due to cancer), a stent can be placed to alleviate pain and discomfort.

Spinal Cord Stimulation (SCS)

An SCS device is implanted near the spinal cord to deliver electrical pulses that mask pain signals.

• Ideal For : Chronic, intractable pain, especially neuropathic pain, which has not responded to other treatments.

Bursa Injections

Bursae are small fluid-filled sacs that cushion joints. When they become inflamed (bursitis), they can cause significant pain.

• Treatment : Corticosteroids or anaesthetics are injected directly into the bursa to reduce inflammation and alleviate pain.

Disc Procedures (Discography, Disc Biopsy, Disc Ablation)

These procedures diagnose and treat pain related to the spinal discs.

• Discography : Involves injecting contrast dye into the discs to locate the source of pain. Disc Ablation/Aspiration: Can help alleviate pain in patients who continue to suffer after spinal surgery.

Arthrography & Intra-articular Injections

For joint-related pain, imaging is used to guide the injection of pain-relieving substances directly into the joint.

• Treatments : Injections may include corticosteroids, hyaluronic acid, or platelet-rich plasma (PRP), depending on the condition being treated.

Artery Embolization for Knee & Other Arthritic Conditions

For refractive pain in patients who are unsuitable for knee or other joint replacement surgeries, it is a very useful procedure in reducing pain and providing relief.

• Indications : Small catheter is passed into the arteries which supply in region of the joints and reduction in blood flow is achieved. Currently joints like knee, shoulder, elbow can be considered. Post surgical implant bleeding in the joint implants also can be treated

Gonadal Vein Embolization

Blocking blood flow to varicose veins in the pelvis to relieve pelvic pain. Minimally invasive and effective, in women who suffer from pelvic congestion syndrome. Equally, it can also be treated for pain in men with scrotal varicocoele.