Interventional Radiology Pain Treatment

Non-pharmacologic and non-opioid treatments are preferred over opioid use for chronic pain management (1). Image-guided pain management techniques and have evolved in recent years to provide better pain management for more patients (2).
Minimally invasive pain management procedures are typically performed in with musculoskeletal-related chronic pain and cancer patients who experience cancer-related pain. However, venous and arterial disease and postoperative scar tissue are important causes of pain that require treatment.
In patients with osteoarthritis, a wide range of procedures exist for the diagnosis of conditions that lead to pain (such as joint aspiration) to the treatment of hyperactive nerves and reduction of blood flow to decrease joint inflammation. Post-operative pain can also be treated by identifying and treating nerves affected by scar tissue that produce pain, such as patients with groin pain after hernia repair surgery.
Cancer-related pain can lead to decreased mobility, appetite, quality of life and performance status. Minimally invasive image-guided interventions range from neurolysis for abdominal pain in pancreatic cancer and cryoablation of bone metastases producing pain.
Consultation with an Interventional Radiologist in the UMCNO IR Clinic is part of evaluation and management for patients who require interventions treatment of chronic pain. We work closely with Palliative Medicine physicians to provide a holistic approach to patients who are in pain.

Pain Treatments:

Cancer Related Pain
Celiac Plexus Neurolysis for Cancer-Related Abdominal Pain
Intercostal Nerve Block, Neurolysis and Cryoablation for Rib Pain
Bone Metastasis Cryoablation for Bone Pain

Musculoskeletal-Related Pain
Pelvic Botox Injections for Muscle Spasm
Post-Hernia Repair Nerve Block and Neurolysis (Inguinal Nerve)
Geniculate Nerve Block, Neurolysis and Ablation
Lumbar Symptathetic Block and Neurolysis
Intercostal Neve Block and Neurolysis
Phantom Limb Pain Block and Neurolysis
Stellate Ganglion Block and Neurolysis
Epidural, Facet and Other Spine Injections
Sacroiliac Joint Aspiration and Injections
Peripheral Joint Aspiration and Injections
Prosthetic Joint Aspiration for Diagnosis of Inflammation and Infection

Venous Disease
Varicocele Venography, Sclerotherapy and Embolization (for groin and testicular pain)
Pelvic Venous Insufficiency Venography, Sclerotherapy and Embolization (for pelvic pain in women)
Lower Extremity Venography, Venoplasty and Stent (for post-thrombotic syndrome, history of deep vein thrombosis/DVT, May Thurner Disease and venous valve incompetence)
Arteriovenous Malformation Treatment

Arterial Disease
Angiography, Atherectomy, Stent and Angioplasty for Critical Limb Ischemia and Peripheral Arterial Disease
Arteriovenous Malformation Treatment

  1. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016. JAMA. 2016;315(15):1624-1645. doi:10.1001/jama.2016.1464
  2. Wallace AN, McWilliams SR, Connolly SE, et al. Percutaneous Image-Guided Cryoablation of Musculoskeletal Metastases: Pain Palliation and Local Tumor Control. J Vasc Interv Radiol. 2016;27(12):1788-1796. doi:10.1016/j.jvir.2016.07.026