Every action has risks and benefits. In the medical world, every medication has risks, and sometimes the risk of doing nothing is worse than treating the issue. This is especially true in many medical conditions such as hypertension or diabetes. The same goes for pain medicine. There are risks and benefits for everything that is done, but there are also many alternatives to treat any particular problem. Choosing the right treatment plan is an individualized decision between the patient and the physician.
Interventional pain treatment has risks and benefits, and there are well known complications from most procedures. The main risks are fairly clear, but there are four complications that arise more often than others. They are:
- Infection. Whenever the skin is broken, this is a possibility, and is prevented usually by cleansing the skin with alcohol or special antibacterial soap.
- Bleeding. Most procedures are done with a fairly small needle. If a patient is not on a blood thinner or does not have a bleeding disorder, this complication is uncommon.
- Allergic reaction. This is rare, but if it does occur, it can be treated.
- Damage to another critical structure with the interventional equipment. This can usually be avoided by taking routine precautions and by having a skilled physician preform the procedure.
Recently, a study was done recording complications from many of the common injection type procedures preformed by pain physicians. Almost 20,000 procedures were done, and the rate of anything abnormal was found to be less than two percent. The most common minor problem was a vasovagal reaction (Feeling like one is going to faint). The next most common issue was an increase in pain, which resulted in the procedure being stopped prior to completion. Other notable problems included one serious allergic reaction (1 in 20,000), and 10 dural punctures (1 in 2000). There were no major complications resulting in any serious injury or permanent neurologic damage.
Treating pain is a complex problem. For every problem, there are often multiple options and pathways to improvement. Sometimes, the pain physician may suggest an interventional procedure to help one improve function and decrease pain. As noted above, the risks of most of these procedures are extremely small. The most common issues are feeling faint or light headed and having increased pain during the procedure and temporary increased symptoms. An experienced interventionalist will make the procedure beneficial and minimize risk to the patient.
Thomas Cohn, MD
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