Global Approach to the Patient with Pain in Interventional Radiology

The number of palliative procedures available to the interventional radiologist has rapidly expanded during recent years, and the need for continued implementation and innovation in this space is at an all-time high. The overuse of opioid analgesics has created a serious public health crisis, and the United States Centers for Disease Control and Prevention has called upon physicians to develop nonpharmacologic therapies for pain, stating clearly that procedures with adequate evidence of safety and efficacy are preferable to opioids for the management of chronic pain.[1] As interventional radiologists, we are uniquely equipped to deliver existing solutions and develop new alternatives through the application of advanced imaging guidance. Moreover, multiple percutaneous techniques have independently evolved in recent years for the management of cancer-related pain.[2] [3] [4]

The approach to a patient with pain who presents to interventional radiology can be simplified through the following algorithm ([Fig. 1]). Four categories of advanced interventional pain management techniques can be defined such that the options for therapy can be grouped to spine pain related to cancer, nonspine pain related to cancer, spine pain that is unrelated to cancer, and nonspine pain that is unrelated to cancer.

Fig. 1 Global approach to the patient with pain.

• References

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