Interventional Treatments Target Pain Where It Hurts

By Amy Geiszler-Jones
Tuesday, December 25, 2018
Specialty: 

With the misuse of opioids at epidemic levels, many physicians — and their patients — want to find nonaddictive methods of managing chronic pain.


Rebecca Sanders, MD

Interventional pain management techniques are making it safer to treat patients with chronic pain. These minimally invasive procedures have fewer risks and side effects than opioids and are far better at treating pain directly at the source, says Rebecca Sanders, MD, an interventional pain management specialist who will begin seeing patients at the Pain Center at Kansas Spine & Specialty Hospital in Wichita in January.

Chronic pain is one of the most common reasons adults seek medical care, according to a recent CDC study. The study indicated about 50 million U.S. adults suffered from chronic pain in 2016; more than 19.5 million had high-impact chronic pain.

Interventional pain management treatments “go directly to the source of the pain,” notes Dr. Sanders. “Opioids are more of a Band-Aid, and they can mask the pain and cause side effects. Interventions can often target the patient’s pain generator.”

Here are four common interventional pain management treatment options:

  • Stimulators. Advances in spinal cord stimulation, a therapy first approved by the FDA in the 1980s, are making this a more effective treatment particularly for patients with chronic nerve pain and even those with low back pain. Fishing line-thin electric leads are placed in the epidural space, and the mild electrical impulses interrupt the pain signals sent to the brain, a process called neuromodulation, Dr. Sanders says. Stimulators can also be used for treating other sources of pain, such as the neck and extremities.
  • Injections. Steroid injections can be directed at the pathology of pain, according to Dr. Sanders. A common option is an epidural steroid injection into the spinal column that sends medication directly to the area of inflammation.
  • Radiofrequency ablation. With guided imagery, a needle with an electrode is used to burn off the nerve sending the pain signal from a particular joint. This treatment is best done in conjunction with physical therapy, Dr. Sanders says. Physical therapy will help strengthen muscles around the source of the pain. More often used with patients who have low back and neck pain, recent applications have indicated success for those with hip and knee joint pain. “It you don’t have a surgical solution — or if the patient still has pain following a replacement — this can be a good solution,” she says.
  • Intrathecal pump implants. Small tubing is placed in the spinal canal to deliver a set amount of medication directly in the cerebrospinal fluid — where it can directly act on pain receptors. Side effects are lessened because the medication takes a more direct course to the pain source — unlike oral medications that pass through the bloodstream and organs, notes Dr. Sanders. The reservoir needs to be refilled after a few months. This is a good pain management option for those dealing with cancer-related pain, Dr. Sanders says.

After earning her medical degree at the University of Arkansas, Dr. Sanders completed an anesthesia residency and a fellowship in interventional pain management at the Mayo Clinic. Before joining the Pain Center at Kansas Spine & Specialty Hospital in Wichita, she was a member of the Mayo Clinic faculty. To refer patients to or consult with Dr. Sanders, call 316-462-5072 or email rsanders@ksspine.com.