Minimally Invasive Pain Management

  Pain can be a symptom of a disease, but it can also be a disease in its own right, and its treatment varies greatly depending on its pathological basis, such as pharmacotherapy, physical therapy, surgery, nerve block therapy, local block therapy, and microneedle therapy.  With the development of interventional radiology, many anesthesiologists have combined traditional nerve block therapy and puncture techniques to achieve unexpectedly good results. Under the guidance of medical imaging, a series of treatment operations are performed through catheters or puncture needles for various pain-related diseases. The diagnosis and treatment can be done through skin puncture or cannula without surgical incision, which is less invasive; multiple treatments can be performed without significant impact on the tissue structure of the pathway; accurate positioning, significant efficacy and high safety. This concept has been widely used. It is mainly used for: discogenic pain, image guided “disc dissolution” treatment with collagenase injection into the diseased disc.  Radiofrequency thermal coagulation treatment The radiofrequency generator is used to cause the ions in the tissue to vibrate and rub against the surrounding masses, generating a certain high temperature in the tissue, and the temperature change is monitored according to the thermistor of the exposed part of the electrode needle, and the thermal coagulation time is controlled by a timer to achieve the purpose of selective destruction. In the nerve tissue, nerve conduction block begins at 41~45℃, smaller nerve fibers that feel pain are blocked at 60℃, and these nerve fibers are destroyed at 70~75℃, but tactile function is preserved. Above 85℃, all nerve fibers are destroyed without selectivity. It can also be used for temperature-controlled destruction of the intervertebral disc, heating the collagen of the disc, causing it to shrink in size due to heat denaturation, causing it to retract and closing the fibrous annulus fissure to treat pain.  The above methods have been widely used, especially image-guided “disc dissolution” therapy, which has a long history and decades of experience at home and abroad. Radiofrequency treatment is a newcomer and is more widely used. For example: trigeminal neuralgia, intractable head and face pain, pain of small vertebral joint lesions, pulsating vascular pain in the head, hands and lower extremities, intervertebral disc decompression, tumor infiltration or compression pain, myofascial contracture and so on.  Another more commonly used and recognized minimally invasive pain treatment method is small needle knife therapy. It is a method of treatment for chronic soft tissue injuries and certain bone and joint diseases based on the theory of balance and imbalance of the human body at rest and in motion, with the advantages of centralized acupuncture and Western surgical treatment by Professor Zhu Hanzhang. It is particularly effective in the treatment of painful conditions caused by soft tissue adhesions and scarring.