The management of chronic spinal pain by blockades: a review.
This review of the use of blockades in the diagnosis and symptomatic treatment of spinal pain syndromes is based on increasing knowledge of the innervation of the spine as their rationale. Several clinical syndromes related to the spine are considered. Problems in making a correct diagnosis are discussed. Because of the relative aspecificity of signs and symptoms in spinal pain, a substantial part of the diagnosis may rely on test blockades. The place of test and therapeutic blocks is determined as far as possible. Problems of a pain classification system are discussed. Benefit for the patient depends on the following conditions being achieved: correct diagnosis, careful patient selection, the availability of technical equipment (e.g., fluoroscopy), and a well-designed and well-performed technique in experienced hands.
Tagesklinik für Schmerzbehandlung Rodenkirchen, 50996 CologneGermany Rudolf Magnus Institute for Neurosciences, Department of Functional Anatomy, Utrecht University, 3584 CG UtrechtNetherlands.
Robert Jan
RJ
Stolker
Arnoud C M
ACM
Vervest
Gerbrand J
GJ
Groen
D002908:Chronic Disease; D006801:Humans; D009407:Nerve Block; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy*; D013122:Spinal Diseases / Q000175:diagnosis / Q000188:drug therapy*