Gaining guided access to nerves to block pain
Aria's radiology specialists offer a number of interventional procedures to directly control pain:
These interventionalists use their radiologic expertise to exactly locate points of intervention with nerves causing chronic pain.
• epidural steroid injections. With a small injection of contrast agent, interventionalists can use x-rays to image the epidural area of the spine in a procedure called epidurography. This provides greater assurance of placing the injection needle into the proper location to accurately deliver steroid medications to inflamed areas in the spine or its nerves. The interventional team can use this technique, for example, to treat spinal nerves compressed by herniated disks, in order to speed healing and recovery, and decrease pain.
• nerve root injections. The specialists also routinely inject contrast agent into a selected spinal nerve root and use various forms of angiography to insure that the injection needle is in the proper position to place steroids or pain medications into the nerve root. They may inject these medications to decrease swelling and activity in compromised nerves.
• steroid injections in other locations. Interventional radiologists can use these same techniques to locate nerves in other locations or to image joint spaces and administer steroids or pain medications into these areas.
• permanent nerve blocks. Interventionalists may also use image guidance to locate and permanently block nerves by chemical injection or radiofrequency ablation in various locations in the body. In these procedures, a portion of the nerve is destroyed so that it can no longer carry pain signals. An example of this is blocking the celiac (solar) plexus, located at the bottom of the chest, to control cancer pain, including from pancreatic or upper gastrointestinal cancer.
Guiding the various pain relief procedures with imaging makes these procedures safer to undergo. Diagnostic steps that precede or accompany these pain procedures may include an MR imaging study, a CT scan, or a variety of x-ray procedures including a discogram, myelogram, arthorgram, or other orthopedic tests or neurologic tests.