Interventional Pain Management (IPM) as Pain Management Therapy

Hello Hermina Friends, Every human being has experienced pain, whether it is mild or severe. Not a few people think that this pain is a normal symptom, so it is easy to cure by just taking certain medicines.

However, you need to know that pain can be a complex symptom. In general, the degree of pain is individual and is greatly influenced by genetic factors, cultural background, age and gender. Then, no less important, pain can have a big impact on both the sufferer and the people around him.


These symptoms can cause sleep disturbances, decreased productivity, high rates of absenteeism from work, inability to carry out activities, and even dependence on other people

So far, pain management has only focused on the use of anti-pain medications. There are also those who choose therapy or surgical procedures. Unfortunately, not all cases of pain can be treated with these two solutions. Pain that lasts for a long time or chronic pain is often difficult to manage, requiring high doses of medication or opioid drugs whose use needs to be closely monitored. Not all cases of pain that fail treatment can undergo operative therapy due to various considerations such as the risk of anesthesia, the risk of surgery, patients who are not ready. In this condition, therapy with the Interventional Pain Management (IPM) modality or pain intervention has a vital role.

IPM not only aims to relieve the severity and duration of pain, but also improves the patient's ability to carry out daily activities and the ability to deal with the onset of pain. IPM is carried out by specialist doctors who have competence and certification in the field of pain intervention. IPM services provided can be in the form of:

- Ultrasound guided musculoskeletal injection, namely injecting medication into painful muscles and joints while being guided by ultrasound so that it hits the target.

- Epidural block steroid injection, which is the injection of corticosteroid drugs into the epidural cavity in the spinal area to relieve inflammation of the nerves and spinal discs (intervertebral discs).‎

-  Radiofrequency ablation, where the nerve endings that cause pain are heated using electrical currents produced by radio waves so that painful stimulation in the area can be stopped.

- Regenerative medicine with prolotherapy and PRP which can regenerate injured cells and tissue such as torn ligaments and meniscus.

Interventional Pain Management (IPM) Techniques



There are 3 techniques that can be used to implement IPM. Choosing the perfect technique depends on the type of pain, health condition, and the severity of the patient's pain. The three techniques in question include:

1. Inject medication at the location causing the pain

Injections can be in the form of steroids which are useful for completely reducing inflammation at the origin of the pain. Apart from steroids, regenerative medicine (Platelet Rich Plasma & Prolotherapy) can also be given, namely medicine that repairs tissue structure, for example muscles & tendons that are damaged and the source of pain. The administration of this medication must be done using sensory guidance such as ultrasound & C-Arm so that it is precisely at the origin of the pain.

 2. Nerve Block

Nerve blocks disrupt nerve signals to the brain that help relieve pain. Nerve blocks are performed using ultrasound & C-Arm guidance to the nerves where the pain originates, as a result it can reduce pain that lasts several weeks or months. In some cases, it can even be a permanent block, depending on the technique & medication used.

 3. Radiofrequency Ablation/Neuromodulation

Radiofrequency waves are used to deactivate/calm the nerve tissue that transmits pain signals, as a result the pain signals emitted from the origin of the pain are reduced. These radiofrequency waves are produced by a special device & delivered through a needle which is directed towards the nerve where the pain originates using ultrasound & C-Arm guidance.

Hermina Mekarsari Hospital has internationally certified pain intervention specialist doctors, namely the World Institute of Pain (WIP), which is one of the leading pain intervention certification institutions in the world with a fairly difficult certification exam pass rate (50-60%). Immediately check for complaints of chronic pain to get the best treatment to get optimal results

Referensi :

1. dr. Adimas Nofrianto, Sp.OT

2. Treatment of Chronic Pain by Interventional Approaches : The American Academy of Pain Medicine. 2015

3. Philip Peng, Roderick Finlayson, Sang Hoon Lee, Anuj Bhatia. Ultrasound for Interventional Pain Management : An Illustrated Procedural Guide. 2020