What can interventional pain therapy achieve?

A long path to help 2:01Now playing

Many people live with pain for a long time and go from one medical specialty to the next. Elif Can describes how burdensome this search can be. For the interventional radiologist, treatment therefore involves more than just the procedure: She wants to understand the symptoms and accompany the people. Even if she cannot offer a suitable procedure herself, her task does not end.

Two paths to the target region 7:37Now playing

The tools are small: thin hollow needles and fine plastic tubes, known as catheters. CT or ultrasound help guide a needle precisely to the selected structure. Catheters are advanced through blood vessels under image guidance.

1. The target structure is identified based on symptoms and imaging. 8:53

2. The hollow needle is placed under image guidance; subsequently, its sharp inner core is removed. 9:08

3. Through the needle, contrast medium for verification or medication can be administered. 10:15

Test first, then decide 13:15Now playing

In the case of nerve pain, a local anesthetic can initially show whether the suspected structure is actually contributing to the pain. You are awake during this and can provide feedback. The effect of this test block is temporary. Depending on the situation, repeated blocks or procedures that denervate selected nerve structures using heat, cold, or medical alcohol are options.

In the case of tumor pain, the tumor itself or its supplying blood vessels can also be treated. Elif Can mentions heat, cold, and targeted vessel occlusion. She rates the data on the local treatment of tumor pain as good.

Pelvic pain that is not visible on images 28:41Now playing

Elif Can tells of a young doctor with pudendal neuralgia, i.e., pain in the area of the pudendal nerve in the pelvis. Intercourse and cycling were painful, daily life suffered, and his relationship fell apart. He had sought help from various medical specialties. In an MRI, there is not necessarily anything abnormal to be seen with this condition.

In the described case, the nerve was blocked under CT guidance. The patient felt immediate relief, hugged a staff member, and cried. Later, he returned about every three months for another block. It is an individual case history, not a guarantee for other patients.

When the knee continues to hurt 36:26Now playing

Another patient continued to have pain despite having an artificial knee joint. Using his example, Elif Can explains joint embolization: small, newly formed blood vessels in the painful area are specifically closed off via a catheter. The procedure is also used for osteoarthritis without an artificial joint. In this, radiology works together with orthopedics.

Encouraging data, but no panacea 44:33Now playing

Peter Minko reports on a summary of studies to date with good results. At the same time, he emphasizes the high placebo effect in osteoarthritis and the importance of controlled studies. Elif Can describes joint embolization as a relatively young procedure. In cases of very advanced wear, when bone meets bone and the joint axis is significantly changed, she sees limits.

Physiotherapy and other accompanying measures remain part of the treatment. The goal is also personal: for some people, even partial pain reduction represents an important improvement. A pain scale helps with comparison before and after therapy but does not capture every individual experience.

Why the options often remain unknown 49:30Now playing

According to Elif Can, the procedures are often found at specialized centers and are not in view everywhere. She also sees radiology as having a responsibility to make its options more visible. Peter Minko describes the specialty as a bridge between different medical fields: findings can be consolidated and appropriate treatment paths shown. Pain medicine remains a joint task.

Myth or truth? 1:05:19Now playing

To conclude, Elif Can assesses common statements: about unremarkable MRI scans, cortisone, opioids, general anesthesia, and artificial knee joints.