Interventional pain treatment – overview of available procedures

Chronic pain has become dominant problem in recent years affecting not only patient quality of life but having economic impact and heavy burden on the health systems. The first line in pain management would be patient education, physical rehabilitation and pharmacotherapy. Unfortunately aforementioned treatment often appears incomplete and specialised, targeted pain interventions are warranted. With significant progress in pain medicine, the number of available and effective interventional procedures and techniques have increased. In this manuscript authors have carried out an up to date review of modern interventional techniques with emphasize of anatomy, level of advancement and complexity. Authors classified procedures according to anatomical location: head and neck, spine, upper and lower limb, trunk as well as pathophysiology: interventions in neuropathic pain, cancer pain including neuromodulation techniques. Whenever possible authors relied on evidence based medicine (EBM) but with emphasize of its limitation, especially in assessment of pain relief which remains patient subjective experience. In summary, reimbursement of up to date pain procedures, in the outpatient and hospital setting has been shown. It hopefully guide pain specialists to choose the right intervention and facilitate renumeration within NFZ fee schedule.