title: Interventional approaches to pain management.
abstract: This article reviews the evidence for several common interventional techniques for the treatment of chronic pain, including: intraspinal delivery of analgesics, reversible blockade with local anesthetics, augmentation with spinal cord stimulation, and ablation with radiofrequency energy or neurolytic agents. The role of these techniques is defined within the framework of a multidisciplinary approach to the neurobehavioral syndrome of chronic pain. Challenges to the study of the analgesic efficacy of procedural interventions are explored, as are the practical issues raised by their clinical implementation, with the aim of helping nonspecialist physicians identify the patients most likely to benefit from these approaches.
authors.affiliation: Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, USA. john_markman@urmc.rochester.edu
authors.forename: John D
authors.initials: JD
authors.lastname: Markman
authors.forename: Annie
authors.initials: A
authors.lastname: Philip
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D001416:Back Pain / Q000188:drug therapy; D002447:Celiac Plexus / Q000187:drug effects; D002908:Chronic Disease; D006801:Humans; D007278:Injections, Spinal; D009407:Nerve Block; D010146:Pain / Q000188:drug therapy*; D013577:Syndrome; D004561:Transcutaneous Electric Nerve Stimulation; D021801:Zygapophyseal Joint / Q000503:physiopathology
chemical_list: D000701:Analgesics, Opioid