Interventional Pain Management

IPM Dr. Vaibhav Kamath Pain Specialist

Pain Management ,[object Object],[object Object]

Pain management: What is new? ,[object Object],[object Object],[object Object],[object Object]

Interventional Pain Management ,[object Object]

Case history-1 ,[object Object],[object Object]

Non-pharmacological methods Non-opioids Weak opioids +/- non-opioids +/- adjuvant Strong opioids Recovery Operation Treatment of Pain

Non-opioids Weak opioids +/- non-opioids Strong opioids Recovery Operation Treatment of Pain World of Misery Non-pharmacological methods

Non-opioids Weak opioids +/- non-opioids Strong opioids Recovery Operation Treatment of Pain IPM Non-pharmacological methods

IPM ,[object Object],[object Object]

[object Object],National Uniform Claims Committee Interventional Pain Management

Interventional Pain Management ,[object Object],Medicare Payment Advisory Commission

IPM IPM are group of procedures with different mechanism of actions ,[object Object],[object Object],[object Object]

Diagnostic Interventional Pain Management Procedures pain

[object Object],[object Object],Etiology of low back pain

104 patients low back pain without any identifiable cause ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Ref: Pang WW et al . Application of spinal pain mapping in the diagnosis of low back pain—analysis of 104 cases. Acta Anaesthesiol Sin 1998; 36:71-74.

120 patients low back pain without any identifiable cause ,[object Object],[object Object],[object Object],[object Object],[object Object],Ref: Manchikanti L et al. Evaluation of the relative contributions of various structures in chronic low back pain. Pain Physician 2001; 4:308-316.

Diagnostic IPM procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Therapeutic Interventional Pain Management Procedures pain

Therapeutic IPM procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Therapeutic IPM procedures for Spinal pain

Trigger point injection ,[object Object],[object Object],[object Object]

Epidural steroid injection ,[object Object],[object Object],[object Object],[object Object]

Selective nerve root/ Transforaminal epidural block ,[object Object],[object Object],[object Object],[object Object],[object Object]

Epidurogram ,[object Object],[object Object]

Epidurolysis ,[object Object],[object Object]

Provocative discography ,[object Object],[object Object],[object Object],[object Object],[object Object]

Percutaneous Disc Decompression/Discectomy ,[object Object],[object Object],[object Object],[object Object]

PDD: advantages ,[object Object],[object Object],[object Object],[object Object],[object Object]

Ozone Nucleolysis ,[object Object],[object Object],[object Object],[object Object]

Facet joint block/ RF neurotomy of medial branch ,[object Object],[object Object],[object Object]

SI joint Block/ Radio-Frequency Rhizotomy ,[object Object],[object Object]

Percutaneous Vertebroplasty ,[object Object],[object Object],[object Object],[object Object]

Lumber sympathetic block ,[object Object],[object Object]

Case history-1 ( Failed Back Surgery Syndrome) ,[object Object],Epidurolysis & transforaminal epidural block gave him significant improvement

Case history-2 (L4-L5 disc herniation) ,[object Object],Percutaneous Discectomy cured him.

Case history-3 (compression fracture of L2) ,[object Object],Percutaneous Vertebroplasty relieved her.

Case history-4 (Facet Joint Arthropathy) ,[object Object],Radio-Frequency Rhizotomy of Medial Br. of dorsal rami relieved the pain.

Summary ,[object Object],[object Object]

[object Object],[object Object],[object Object],Summary

What do we need? awareness Pain

Interventional Pain Management

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