Interventional Pain Management: A Patient Guide to Procedures

If you've been living with chronic pain and conservative treatments haven't provided adequate relief, your doctor may have mentioned interventional pain management. But what does that actually mean — and what can you expect?

At Newport Pain Management in Newport Beach, we've been performing interventional procedures for Orange County patients since 1995. This guide explains the most common procedures, how they work, and what patients typically experience.

Interventional pain management uses minimally invasive procedures — typically injections or small implanted devices — to directly target the source of pain. Unlike medications that work systemically throughout the body, interventional techniques deliver treatment precisely where it's needed.

These procedures serve two purposes:

1. Diagnostic — confirming the source of pain when imaging alone isn't definitive
2. Therapeutic — providing pain relief, often for months or longer

All procedures at Newport Pain Management are performed under fluoroscopic (real-time X-ray) or ultrasound guidance to ensure precise, safe needle placement.

Epidural steroid injections (ESIs) are most commonly used for:

• Herniated disc pain
• Sciatica (pain radiating down the leg)
• Spinal stenosis
• Radiculopathy (nerve root compression causing arm or leg pain)

The epidural space is the area surrounding the spinal cord and nerve roots. Injecting corticosteroid medication into this space reduces inflammation around compressed nerves, relieving pain and allowing healing.

• The procedure takes approximately 15-30 minutes
• You'll lie on a procedure table; the skin is cleaned and numbed with local anesthetic
• Under fluoroscopic guidance, a needle is carefully positioned in the epidural space
• A small amount of contrast dye confirms correct placement, then the steroid is injected
• Most patients feel minimal discomfort during the procedure
• You may experience temporary soreness at the injection site for 1-2 days
• Pain relief typically begins within 3-7 days and may last weeks to months

Nerve blocks target specific nerves or nerve groups that are transmitting pain signals. Common types include:

• Medial branch blocks — for facet joint pain in the neck or back
• Selective nerve root blocks — for radicular (nerve root) pain
• Sympathetic nerve blocks — for complex regional pain syndrome (CRPS) or visceral pain
• Peripheral nerve blocks — for pain in specific body regions

A local anesthetic (and sometimes a steroid) is injected near the targeted nerve. This temporarily interrupts pain signal transmission. Diagnostic blocks use short-acting anesthetic to confirm the pain source; therapeutic blocks provide longer-lasting relief.

• Procedures typically take 15-30 minutes
• You may feel immediate numbness or warmth in the affected area
• Diagnostic blocks help us confirm whether a specific nerve is your pain source
• Therapeutic blocks can provide relief lasting days to months

RFA is typically performed after diagnostic nerve blocks confirm that facet joints are a significant pain source. It's used for:

• Cervical (neck) facet joint pain
• Lumbar (low back) facet joint pain
• Sacroiliac joint pain (with appropriate technique)

Radiofrequency ablation uses heat generated by radio waves to disable the small nerve fibers (medial branch nerves) that carry pain signals from the facet joints. By interrupting these pain pathways, RFA provides relief that typically lasts 9 to 18 months. As nerves regenerate, the procedure can be repeated.

• The procedure takes approximately 30-60 minutes
• Multiple needle placements are made along the target nerves
• Each nerve is treated with a brief application of radiofrequency energy
• You may experience temporary soreness for 1-2 weeks after the procedure
• Full benefit is typically felt within 2-4 weeks
• Relief duration varies but averages 9-18 months

The sacroiliac (SI) joints connect the base of the spine to the pelvis. SI joint dysfunction is a frequently overlooked cause of low back, buttock, and sometimes leg pain.

Under fluoroscopic guidance, a needle is placed into the SI joint and a combination of local anesthetic and corticosteroid is injected. This both confirms the SI joint as a pain source and provides therapeutic relief.

Spinal cord stimulation (SCS) is reserved for patients with chronic, refractory pain who have not responded adequately to other treatments. It is particularly effective for:

• Failed back surgery syndrome
• Complex regional pain syndrome (CRPS)
• Chronic radicular pain
• Peripheral neuropathy

A small device is implanted near the spinal cord. It delivers mild electrical impulses that modulate pain signals before they reach the brain — essentially replacing the sensation of pain with a gentle tingling or, with newer systems, no sensation at all.

The process begins with a trial period using temporary leads. If the trial is successful (typically defined as 50% or greater pain reduction), a permanent system is implanted.

Before any interventional procedure at Newport Pain Management, we will:

• Review your medical history and current medications
• Discuss any blood thinners or anticoagulants that may need to be temporarily held
• Explain the procedure, risks, benefits, and alternatives
• Answer all your questions

On the day of your procedure:

• Arrange for a driver — you should not drive yourself home
• Wear comfortable, loose-fitting clothing
• Follow any specific fasting instructions provided
• Bring your insurance card and a list of current medications

Interventional pain procedures have an excellent safety record when performed by trained specialists using image guidance. As with any medical procedure, there are potential risks, which we discuss thoroughly during your consultation.

Our board-certified specialists have performed thousands of these procedures for Orange County patients over nearly three decades. We use the highest standards of sterile technique and imaging guidance to maximize safety and effectiveness.

If you're wondering whether an interventional procedure might help your pain, the first step is a consultation. We'll review your history, examine you, and discuss whether you're a candidate — and if so, which procedure is most appropriate for your specific condition.

We accept Medicare, most PPO plans, and many major insurance carriers.

Call Newport Pain Management at 949-759-8400 to schedule your consultation in Newport Beach. Relief may be closer than you think.