Invasive Pain Management Techniques

Injections (also known as blocks)

Injections provide direct delivery of steroids or anesthetic into joints, ligaments, muscles, or around nerves. These injections may provide relief of pain (often temporary) and can be used to confirm if the injected structure is the source of the pain, clarifying the diagnosis. Epidural injections can provide temporary relief for upper extremity or lower extremity pain due to a pinched nerve in the spine.

Prolotherapy

This technique involves injection of an irritant solution to stimulate blood circulation and ligament repair at affected site. The effectiveness of this technique is not known.

Surgically implanted electrotherapy devices

These are implantable spinal cord stimulators (SCS) and implantable peripheral nerve stimulators. Clinical data offers inconclusive findings on the effectiveness of SCS, but in general they are more effective for arm and leg pain than they are for localized spine pain. Spinal cord stimulators are expensive.

Implantable opioid infusion pumps

These are surgically implanted pumps that deliver opioid agents directly to the spinal cord. These pumps are expensive. The appropriateness and effectiveness of these devices for treating chronic back pain is controversial.

Source: Spine Health