Interventional Pain Management

Interventional radiology uses image-guided, innovative procedures to offer alternatives to many conventional pain management techniques.

These procedures typically combine a flexible tube, or catheter, with medical instruments, like cameras and surgical tools attached to a wire.

Inserted through an incision in an artery, usually in the thigh, we use imaging such as CT, MRI, fluoroscopy and ultrasound to guide the catheter to the exact spot in the body for diagnosis or treatment.

At University of Maryland Medical Center, our specialists also use interventional radiology to deliver medications for pain management.

Knee Osteoarthritis Treatment

If you have knee arthritis and are not ready for a knee replacement, geniculate artery embolization (GAE) can offer long-term pain relief without surgery.

This outpatient procedure uses X-rays or fluoroscopy to guide the catheter to the lining of the knee. We deliver medication that blocks blood flow to these arteries, reducing inflammation and reducing pain.

Compression Fracture Treatment

We provide minimally invasive, nonsurgical treatment for different types of spinal compression fractures.

Kyphoplasty

Also called balloon kyphoplasty, we use fluoroscopy to guide a needle with a balloon to the fractured vertebra. We inflate the balloon in the vertebra, which restores the vertebra’s height. To stabilize the bone, we remove the balloon and inject acrylic bone cement to prevent collapse.

Vertebroplasty

This procedure is similar to kyphoplasty but does not use a balloon. We use fluoroscopy to guide a needle to the broken vertebra and inject acrylic bone cement into the fractured bone.

More Interventional Pain Therapies

Nerve Block

This is the injection of anesthetic or anti-inflammatory medication to target pain relief to specific nerves. We use fluoroscopy or computed tomography (CT) to guide the needle to the proper location.

We may also use a nerve block as an additional anesthetic during surgery, as a way for a damaged nerve to heal, or as a diagnostic tool to help doctors locate a source of pain.

Pudendal Nerve Block

Pudendal nerve pain may include tingling or numbness in the buttocks, genitals or perineum. This diagnostic test can help locate the source of pain.

Occipital Nerve Block

This is a common pain relief treatment for migraines and chronic headaches. Anesthetic is injected on or near your occipital nerve which governs feeling in the back and on top of your head.

Medial Branch Block

This procedure injects an anesthetic near the small nerves connected to a facet joint, the connection between the spine's bones. Nerves pass through these joints to the spinal cord and on to the arms, legs and other parts of the body.

Facet Joint Block

This procedure can pinpoint the problem area between two or more vertebrae causing neck or back pain. A facet block is an injection of numbing medicine into one or more of these small joints. We also use diagnostic facet blocks for patients with arthritic pain in the facet joints.

Epidural Steroid Injection

This injection combines a steroid, anti-inflammatory medication, and a numbing agent to treat pain inside the spinal canal but just outside the covering of the spinal cord (epidural space). An epidural steroid injection provides pain relief by reducing the swelling of the nerves where they exit the spine. It does not correct the pre-existing problem (such as a herniated or bulging disc, arthritis, etc.) that caused the nerve inflammation.

Radiofrequency Nerve Ablation

Also called RFA, radiofrequency nerve ablation can relieve knee pain due to arthritis. We use fluoroscopy to guide a pair of needles to the proper location. An electric current passes through the needles, which heats them and burns the nerves, reducing pain. Before we do RFA, we may do a genicular nerve block as a diagnostic procedure to find the precise treatment area.