Pain is one of the most common symptoms with which a person visits a doctor. Attempts to relieve the pain had been there since ancient times in diverse ways like use of opium (later morphine was extracted from opium) or use bark of willow (aspirin was extracted). Surgery has also been tried in different situations. Like holes (trephine surgeries) were made in skulls to relieve headache. Till late 20th century, methodsof two extreme ends, medicines at one end and surgeries at other ends were in use to treat different painful conditions.
But use of oral of injectable medicines has is side effects and relieves pain for hours only. And surgeries have its own extensive list of complications. Thus, in mid-20th century interventional pain management came in the hand of John Bonica.
Interventional Pain Management (IPM) is defined as the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders by the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatments. (1)
Interventional techniques mean minimally invasive surgeries or injection techniques without any cut & stich. It is done under image guidance, either fluoroscopy or ultrasound guided. It helps in diagnosis (2) and tries to cure the disease in most situation and even when cure is not possible like in cancer it gives long term pain relief.
1. Manchikanti L, Staats PS, Singh V, Schultz DM, Vilims BD, Jasper JF, Kloth DS, Trescot AM, Hansen HC, Falasca TD, Racz GB, Deer T, Burton AW, Helm S, Lou L, Bakhit CE, Dunbar EE, Atluri SL, Calodney AK, Hassenbusch S, Feler CA. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician 2003; 6:3-80.
2. Pang WW, Mok MS, Lin ML, Chang DP, Hwang MH. Application of spinal pain mapping in the diagnosis of low back pain—analysis of 104 cases. Acta Anaesthesiol Sin 1998; 36:71-74.
How interventional pain management is better than surgeries?
As we discussed pain management is in between oral/injectable medicines and surgeries. Majority of the painful conditions which were earlier treated with surgeries, can now be treated with interventional pain management.
Here is a table to compare:
• More invasive
• Extensive list of complications of both surgery & anaesthesia
• Longer hospital stays
• Costlier to patients
• Cut, stitches & scars
Interventional pain management
• Minimally invasive
• Very limited complication, no complications related to anaesthesia
• Mostly day care procedures
• Less costly
• No Cut, Not Stiches, No Scar
Thus, interventional pain management is becoming more and more popular throughout the world.