Options for Interventional Radiology in Patients Experiencing Neuropathic Chronic Pain

 

Background: Procedures, using interventional radiology procedures, gaining more acceptance in being used to mitigate neuropathic chronic pain, are being increasingly used to mitigate chronic pain. In addition to established therapies, such as thermal bone lesion ablation, kyphoplasty, and chemical neurolysis, ongoing research has shown promising results for the use of embolization in treatment of osteoarthritic knee pain and chronic pain secondary to adhesive shoulder capsulitis. This work will focus on some of the most common interventional radiology pain procedures, as well as provide insight into future pain relieving embolization.

Materials and Methods: Established therapies, such as chemical neurolysis, are well documented. During neurolysis, chemicals, such as dehydrated alcohol or phenol, are utilized to target the nerve in question. This creates long-lasting and sometimes permanent interruption of pain transmission. However, this is not without its complications.

Results: Neurolytic treatments and nerve blocks are often resorted to when methods, such as opioids, do not bring the desired relief to afflicted individuals. These treatments are also options for when systemic pharmacotherapy side effects are debilitating. Often times, the chronic pain is resultant from underlying cancer diagnoses. The most efficacious injection treatments in interventional radiology are celiac plexus neurolysis, splanchnic nerve neurolysis, hypogastric plexus blocks, and stellate ganglion neurolysis.

Conclusions: The established IR procedures used to combat chronic pain include cold ablation, heat ablation, nerve block and, in particular, chemical neurolysis. Initial AC embolization results have shown positive effects, such as statistically significant improvement, in pain scores at 1-, 3-, and 6-month intervals after treatment. Alongside pain reduction, patients also report improved lifestyle metrics, such as an increased capacity to complete activities of daily living.

Publication History

Article published online:
14 December 2021

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