The Importance of Accuracy, Technique, and Approach in Interventional Pain Management

Not all carpenters are created equal. Nor artists. Nor biologists. Nor bank tellers. The same is true of physicians. The educational background, real-world experience, and individual acumen dramatically affect the quality of medical providers across the spectrum. So too does the techniques they use, as well as their overall clinical strategies. In the world of interventional pain management, this could not be truer.

You’ve probably heard of epidural injections for pain, and it’s very likely that you’re only hearing half of the story. The epidural is simply a space adjacent to the spine. Commonly used in obstetrics to anesthetize women during childbirth, interventional spine physicians use this same void to accurately place anti-inflammatory medications adjacent to irritated spinal nerves. Unknown to most, there are a number of techniques for epidural injections that dramatically affect outcomes.

According to a 2016 study evaluating ESI’s performed on patients with bulging/prolapsed intervertebral discs, Transforaminal Epidural Steroid Injections were not only effective (90% improvement in study score) but significantly more efficacious than ESI’s performed via the more common interlaminar approach and the caudal approach. This improvement was reflected in not only the overall result, but it’s duration as well, with markedly better results at both 6 months and 1 year after the injection.

When clinically feasible, Restore Medical Partners physicians utilize the transforaminal approach far more often. This approach also gives them options when the patient has already undergone spine surgery and the epidural space is compromised. Utilizing highly skilled x-ray guidance professionals and evaluating the spread and flow of the contrast, Restore Medical Partners providers are able to far more accurately assess and treat radicular pain. The key advantage of the transforaminal approach is the ability to place medication much closer to the affected area than with other techniques. The improved immediate results allow patients to more easily undergo the needed therapy following their injection, but TFESI’s have also been shown to improve outcomes even in instances when the patient does ultimately require spine surgery.

This delivery can prove to be a game changer for those suffering from radiating pain who need to get through targeted physical therapy. It’s easy to forget the importance of physical therapy in conjunction with interventional techniques. Many patients require a balanced combination of both to achieve ideal results.

Instead of simply assessing ESI relief statistics 1 year after the injection with no controlled variables, we should be looking at the results of combined approaches. For example, simply changing a tire on your car and not rotating the others will cause the same tire to wear out faster. The spine really is no different. Today’s pain management techniques have shown very clearly that accuracy, technique, and a combined approach with both interventional procedures and physical therapy is the most effective strategy for reducing back pain and achieving increased quality and functionality.

Utilizing a comprehensive approach is the cornerstone of Restore Medical Partners clinical philosophy and is practiced universally by all our physicians and midlevel providers. If you suffer from radiating back pain, speak to your doctor today.