Interventional Pain Management

Chronic pain is one of the most common reasons people go to the hospital. It is a serious problem that reduces the quality of life due to the functional limitations, psychological and social problems it causes. The treatment process of pain is a complicated task that requires the use of many modalities together. Physical therapy, medical therapy, behavioral therapy and interventional therapy approaches are the methods used when necessary in the pain rehabilitation process.

1. Local Nerve Blocks:
Regional nerve blocks show their effect in the treatment of pain by blocking the nociceptive traffic at its source and affecting the abnormal reflexes accompanying the pain in the extremity innervated by the nerve. The injection material used generally consists of local anesthetic and depot corticosteroid. Suprascapular nerve block, femoral nerve block, sciatic nerve block, intracostal nerve block, craniofacial nerve blockade (such as maxillary nerve, mandibular nerve, greater occipital nerve, trigeminal ganglion blockade), spinal nerve blockade are the most commonly used methods for diagnosis and treatment in pain rehabilitation.

2. Epidural Injections:
It is applied in some special cases such as low back and neck pain originating from spinal radicular root and post-herpetic neuralgia. Epidural steroid injection reduces inflammation in acute and subacute disc herniations and spinal stenosis. There is a consensus that epidural steroid injections shorten the recovery time of discopathies.

3. Trigger Point Injections:
The most common cause of musculoskeletal pain is pain of myofascial origin. Acute trauma or repetitive microtraumas cause focal hyperirritable tight bands and trigger points in muscle fibers. While local anesthetic, saline, corticosteroid, botulinum toxin type A can be used in trigger point injection, only dry needling can be used.

4. Intra-Articular and Soft Tissue Injections:
Injections are an effective diagnosis and treatment method in chronic painful conditions arising from intra-articular, bursa tendon sheaths and other tissues of the musculoskeletal system. Regarding soft tissue; bursitis, tendinitis, ganglion cyst, neuroma, nerve entrapment syndromes, fasciitis, joint related; Inflammatory arthritis, synovitis, osteoarthritis, crystal arthropathies, facet syndrome, sacroiliitis are chronic painful conditions for injection indications. Corticosteroid, local anesthetic, saline, hyaluronic acid for injection are substances used in various indications.

5. Sympathetic Blockage:
Sympathetic blockade is a good diagnosis method in chronic painful conditions accompanied by increased sympathetic activity, as well as a good treatment option in chronic painful conditions where physical therapy and oral medication cannot be adequately improved. Interventional approaches have an important place in the pain rehabilitation process.

Local nerve blocks, epidural injections, trigger point injections, intra-articular and soft tissue injections, sympathetic blockade are among the interventional treatment methods that are frequently and successfully applied by specialist doctors within FIZICA.