Understanding Interventional Pain Procedures: What Patients Can Expect

Interventional pain procedures offer targeted relief for patients whose pain hasn't responded adequately to conservative treatments. While the thought of any medical procedure can feel intimidating, understanding what these treatments involve and what to expect can ease anxiety and help you make informed decisions about your care.

What Are Interventional Pain Procedures?

Interventional pain procedures are minimally invasive treatments that target specific sources of pain. Unlike oral medications that affect your entire body, these procedures deliver treatment directly to the pain source—whether that's an inflamed nerve, irritated joint, or damaged tissue. Most are performed on an outpatient basis using imaging guidance to ensure precision and safety.

These procedures serve multiple purposes: providing diagnostic information about pain sources, delivering therapeutic relief that can last weeks to months, and in some cases, offering long-term solutions that reduce or eliminate the need for ongoing medication.

Common Interventional Procedures

Epidural Steroid Injections

Epidural steroid injections deliver powerful anti-inflammatory medication into the space around spinal nerves. They're particularly effective for herniated discs, spinal stenosis, and sciatica—conditions where nerve irritation causes pain radiating into the arms or legs.

During the procedure, you'll lie on your stomach or side while the physician uses fluoroscopy (real-time X-ray) to guide a small needle into the epidural space. After confirming proper placement with contrast dye, the medication is injected. The entire process typically takes 15-30 minutes.

Many patients experience relief within a few days as inflammation decreases, though it can take up to two weeks to feel maximum benefit. Relief duration varies—some patients enjoy months of improvement, while others may need periodic repeat injections.

Facet Joint Injections and Medial Branch Blocks

The facet joints are small joints in your spine that can become painful due to arthritis or injury. Facet joint injections place medication directly into these joints, while medial branch blocks target the tiny nerves supplying these joints.

These procedures help both diagnose and treat facet-related pain. If a medial branch block provides significant temporary relief, you may be a candidate for radiofrequency ablation—a longer-lasting treatment we'll discuss shortly.

The injection process is similar to epidurals, using imaging guidance for accurate needle placement. You might feel pressure or temporary discomfort during injection, but this quickly subsides.

Radiofrequency Ablation (RFA)

Radiofrequency ablation uses heat energy to interrupt pain signals from specific nerves. It's commonly used for facet joint pain, sacroiliac joint pain, and certain types of knee arthritis pain.

After numbing the skin, the physician inserts a special needle near the target nerve using fluoroscopic guidance. A radiofrequency current heats the needle tip, creating a small lesion on the nerve that prevents it from transmitting pain signals. The nerve eventually regenerates—typically after 6-12 months—but during that time, many patients experience significant pain relief.

The procedure takes 30-60 minutes depending on how many nerves are treated. Some patients notice immediate improvement, while others experience gradual relief over several weeks as inflammation subsides.

Trigger Point Injections

Trigger points are tight knots in muscles that cause localized pain and sometimes refer pain to other areas. Trigger point injections release these knots by injecting local anesthetic, sometimes combined with a small amount of steroid, directly into the tender point.

This quick procedure—often taking just minutes—can be performed during a regular office visit without imaging guidance. Many patients feel immediate relief as the muscle relaxes, though some soreness at the injection site is common for a day or two.

Spinal Cord Stimulation

For severe chronic pain that hasn't responded to other treatments, spinal cord stimulation offers an advanced option. This therapy involves implanting a small device that sends mild electrical pulses to the spinal cord, interrupting pain signals before they reach the brain.

The process begins with a trial period where temporary leads are placed to ensure the therapy works for you. If successful, a permanent system is implanted in a minor surgical procedure. Patients control the stimulation with a remote control, adjusting settings as needed throughout the day.

Preparing for Your Procedure

Before the Procedure

Your physician will provide specific instructions, but general preparation typically includes:

• Arranging for someone to drive you home, as you may receive sedation
• Fasting if sedation will be used—usually nothing to eat or drink after midnight before morning procedures
• Discussing medications with your doctor—some may need to be temporarily stopped
• Wearing comfortable, loose-fitting clothing
• Leaving jewelry and valuables at home

If you take blood thinners, your doctor will provide guidance on when to stop them before the procedure to minimize bleeding risk.

During the Procedure

Most interventional procedures follow a similar pattern. You'll be positioned comfortably on a procedure table, monitoring equipment will track your vital signs, and the injection site will be thoroughly cleaned and sterilized. Local anesthetic numbs the skin, and most physicians offer additional sedation if you're anxious.

Throughout the procedure, you'll be able to communicate with your doctor. You might feel pressure or brief discomfort, but severe pain is uncommon. The imaging equipment used for guidance looks imposing but simply helps ensure precise needle placement.

After the Procedure

Following most injections, you'll rest briefly while staff monitor you. Some temporary numbness or weakness in your legs is normal after certain spinal injections and resolves within a few hours. You'll receive discharge instructions covering activity restrictions, which are typically minimal—often just avoiding strenuous activity for a day or two.

Plan for a quiet remainder of the day after your procedure. Some injection site soreness is normal and can be managed with ice and over-the-counter pain relievers as recommended by your physician.

Setting Realistic Expectations

Not everyone achieves the same degree of relief from interventional procedures. Some patients experience dramatic improvement, while others notice more modest benefits. The diagnostic information gained from procedures often proves valuable even when pain relief is limited, helping guide your treatment plan moving forward.

Most interventional procedures are part of a comprehensive pain management strategy. They work best when combined with physical therapy, lifestyle modifications, and other treatments your doctor recommends.

Potential Risks and Complications

While generally safe, all procedures carry some risk. Common minor side effects include temporary soreness at the injection site, headache, or slight increase in pain for a day or two. Serious complications like infection, bleeding, or nerve damage are rare but possible.

Your physician will discuss specific risks relevant to your procedure during the consent process. Don't hesitate to ask questions about anything you don't understand.

Moving Forward

Interventional pain procedures represent valuable tools in the pain management toolbox. They offer targeted relief with minimal invasiveness, often helping patients reduce medication use, improve function, and enhance quality of life. By understanding what these procedures involve and maintaining realistic expectations, you can approach them with confidence, knowing you're taking an active step toward better pain control and improved daily living.