What is interventional pain management?

Interventional pain management refers to a group of pain relieving procedures that are performed with the a physical instrument such as a needle or probe. These procedures range from simple trigger point injections to more complex, image guided spinal procedures. Physicians who practice interventional pain procedures have a medical degree and speciality and subspeciality training in pain medicine. Sub speciality certification in pain medicine is gold standard for these physicians.

There is no law that prevents a licensed physician performing spine interventions. Therefore, many physicians without recognized training or credentials indulge in these high risk practice of medicine. These physicians take weekend courses on cadavers or train themselves from video presentations. It's like an electrician doing plumbing after watching HGTV. If you are searching for the bonafide interventional pain physician, you should ask the following questions:

A) Are you a graduate of an ACGME (The Accreditation Council for Graduate Medical Education is responsible for the accreditation of post-MD medical training programs within the United States) approved pain fellowship program? More information at acgme.org

B) Are you an ABMS ( American Board of Medical Specialists) board certified in the sub speciality of pain medicine. Those who have successfully completed a ACGME approved pain fellowship are board eligible for the sub speciality certification? More information at abms.org

What can you do for Whiplash Injury?

Whiplash injury results from sudden acceleration and deceleration injury to the cervical spine and causes head and neck pain. The pain generators seem to be the facet joints and the associated cervical musculature. Many tend to have persistent pain even after many months of physical therapy and modalities. Patients depend on strong pain killers to mask the pain generators. I first offer a diagnostic procedure which will temporarily block the pain generators for 6-8 hours. If the temporary block relieves the worst pain, then my patients are selected to undergo a procedure known as radiofrequecy ablation or thermo coagulation. This procedure targets the tiny nerves that carry painful singnals from the pain generators to the other parts of the nervous system. By selectively destroying these tiny nerves, I am able to disconnect communication and thereby relieve the persistant pain in the head and neck region. The first step or the diagnostic procedure is called facet nerve block or medial branch of the dorsal rami block. The definitive procedure is called radiofrequency ablation of the facet nerves or neurotomy of the medial branches of the dorsal rami.

The patients who see me with neck and head pain have usually failed the first line of treatment for whiplash injury. My associates offer trigger point injections, chiropratic adjustments, physical therapy and modalities such as ultrasound, transcuatanous electricl stimulation, and medications for this problem as first line of treatment. If the preliminary treatment plan fails, the patients consult me for the procedure I have described above. Most patients do very well with the preliminary treatment and will never need the advanced procedure.