Bridging the Gap: Interventional Pain Medicine

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Dr. Tim S. Chowdhury M.D.
Interventional Pain Specialist

You may have been hearing more and more about the Interventional Pain Physician in the news lately.  What exactly is Interventional Pain Medicine?

Interventional Pain Management is defined as the medical discipline devoted to the diagnosis and treatment of pain and pain-related disorders by applying interventional techniques in managing sub-acute, chronic, persistent intractable pain, including cancer, pain, and headaches, independently or in conjunction with other modalities.

The twenty first century has been marked by numerous developments of interest to Interventional Pain Physicians and pain sufferers.  Interventional techniques are minimally invasive procedures, such as needle placement of drugs to targeted areas, ablation of targeted nerves, and some surgical techniques such as Kyphoplasty, MILD (Minimally Invasive Lumbar Decompression), IDET (Intradiscal Electrothermal Therapy), and the implantation of narcotic and baclofen pumps and spinal cord stimulators.

The value of Interventional Pain Management lies in the concept of what pain is and the pathway used in its transmission to the brain.  Pain is a sensory event of the peripheral and central nervous systems.  It is a phenomenon that affects the process of consciousness and even the definition of “self” for those individuals in pain.

When a severe injury occurs, the pain signal is transmitted to primary pain receptors (nociseptors) and then by means of a cascading series of chemical reactions to primary pain nerve branches.  These nerves, called A-Delta fibers and C-Fibers, carry the pain sensation to the brain via a pathway in the spinal cord.  The brain processes these signals, and we perceive the pain.  An Interventional pain specialist intervenes with the pain pathway by blocking the peripheral nerves, nerve roots, and sympathetic nerves.

If we dispense appropriate medicines at the spinal cord level, we need 300 times less medicine versus the use of oral medicine.  The less medicine, the smaller the side effects, and we achieve a lot better pain control.  Thus, interventional pain medicine bridges the gap between conservative pain treatments that may offer little or no relief, and the more invasive and expensive surgery options that could have less than positive outcomes.

The primary goal of physicians is to improve the health and well-being of their patients.  Diagnostic and therapeutic interventional techniques have been proven to be valid and effective.  The future of interventional pain management is promising indeed.

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