title: Interventional pain management: a commentary.
abstract: The care of pain patients often requires a specialized knowledge base and skill set that allows the pain medicine specialist with tools necessary for optimal patient outcomes. Interventional pain medicine is the field of judiciously and appropriately applying such skills in the diagnosis and treatment of chronic pain; with the increasing prevalence of the disease, it cannot be overemphasized that providers must be equipped with the knowledge and skills to provide the care needed. This commentary provides brief, point-of-care information for providers of pain therapies in a portable, easy-to-navigate format. With continued advances made in interventions available to treat pain, this article offers up-to-date details of and instructions for the use of procedural techniques as well as a concise yet informative discussion of the evidence supporting their application. We will discuss some of the most commonly performed procedures. The article presents the readers with a clear understanding of the background, indication, as well as the clinical utility of the discussed procedures. It is important to note the evidence is strong in comparison with other modalities, for example, multiple pharmacologic agents that are considered mainstream, generally accepted management tools have been approved by the U.S. Food and Drug Administration after 12-week trials. Multiple interventional techniques have reported trials of 6-42 months in duration. It must be mentioned, however, that stronger evidence, namely, level 1 studies (double-blinded, controlled studies with long follow-up and outcome measures documenting both pain relief as well as functional improvement) are needed to provide a basis for interventional care.
authors.affiliation: Anesthesiology and PM&R, Virginia Commonwealth University, Richmond 23225, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hamza
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy*; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D015552:Injections, Intralesional; D017116:Low Back Pain / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D018570:Risk Assessment; D012446:Sacroiliac Joint / Q000187:drug effects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States
chemical_list: D000305:Adrenal Cortex Hormones; D000700:Analgesics