Tag: radiofrequency ablation

  • Medial Branch Block and Radiofrequency Ablation

    Medial branch blocks and radiofrequency ablation are two types of procedures used to diagnose and manage pain in the spine, particularly in the back and neck. Medial branch blocks involve the injection of an anesthetic near the medial branches of spinal nerves, which supply sensation to the facet joints. The goal is to temporarily block the pain signals to determine if it is originating from the facet joints. If the test is positive, then radiofrequency ablation may be indicated. This procedure involves the use of radiofrequency energy to destroy the medial branches, thus interrupting the pain signals and providing pain relief for longer periods

    This is a presentation I presented at “Ultrasound and C-Arm Guided Radiofrequency Ablation Pain Management Course” at University Kebangsaan Malaysia in 2022. I summarized and made a step-by-step guide for C-arm medial branch block and RFA.  


  • Prolotherapy

    Prolotherapy is a type of pain management therapy that involves the injection of dextrose (a type of sugar) and sometimes other substances into injured or painful areas of the body. It is used to treat musculoskeletal pain, such as arthritis, tendinitis, and back pain. The injections are designed to promote the growth and healing of damaged tissue, strengthening and stabilizing joints and reducing pain in the process. Prolotherapy is considered a natural alternative to surgery, and is generally safe and well-tolerated. While it is still considered an emerging therapy, many people have experienced significant pain relief from treatment, often with fewer side effects than traditional pain management approaches.

    Here is my study notes on Prolotherapy


  • Patient Safety for C-Arm Guided Interventional Pain Management

    C-arm guided interventional pain management procedures, such as epidural injections and nerve blocks, can be effective in relieving chronic pain, but they also carry potential risks for patient safety. To minimize these risks, healthcare providers should follow best practices for patient safety.


  • Pain Intervention for Low Back Pain

    This is a presentation I made for an introduction about pain intervention. It has some basic general information about some common low back pain condition and the role of interventional pain management. 


  • Practical Low Back Pain Examination & Diagnosis

    Low back pain is a common problem that affects many people. A thorough examination is important for identifying the underlying cause of the pain. The examination should include taking a detailed history of the patient’s symptoms, including how the pain started, the location of the pain, the duration of the pain, and any related symptoms such as leg pain, numbness or tingling.

    I have summarized some of the most common LBP conditions found in practice: lumbar facet pain, sacroiliac joint pain, discogenic pain, and lumbosacral radicular pain. I hope this can be a practical guide to diagnose the patient’s source of pain. 


  • Genicular Radiofrequency Ablation for Knee Osteoarthritis

    Genicular radiofrequency ablation (GRF) is a minimally invasive procedure used to alleviate pain associated with knee osteoarthritis. The procedure involves targeting specific nerves that transmit pain signals to the knee joint with a small electrode that delivers radiofrequency energy to create heat and destroy the targeted nerves. This can provide long-term relief by interrupting the pain signals to the brain.

    GRF is typically performed as an outpatient procedure, with patients typically experiencing minimal pain or discomfort during and after the procedure. It is considered a safe and effective treatment option for those who have not responded well to other treatments such as medication or physical therapy. However, as with any medical procedure, there are potential risks and complications that should be discussed with a healthcare provider, including infection, bleeding, and nerve damage.

    Overall, GRF provides a promising alternative for those seeking relief from knee osteoarthritis symptoms without the need for invasive surgery.

    This is a topic I presented for a webinar “All You Need to Know About Knee Osteoarthritis” on 16 April 2023, by PERDOSRI JATIM. 


  • Discogenic Lumbar Pain

    Discogenic lumbar pain refers to lower back pain caused by damage or injury to the intervertebral discs, which are the flexible, fibrous cushions that separate each vertebrae of the spine. Discogenic lumbar pain can occur due to degenerative changes to the discs or acute injury, leading to herniation or bulging of the disc. This can put pressure on the nerves in the spinal cord or cause inflammation, leading to pain, stiffness, weakness, and numbness in the lower back, buttocks, and legs. Discogenic lumbar pain often presents as chronic and persistent discomfort that may worsen with movement or physical activity.

    This file is a summary I made from one of the pain textbook “Evidence-based  Interventional Pain Medicine according to Clinical Diagnoses” which I would recommend to anyone interested in pain intervention. I’ve summarized the basic patophysiology, diagnosis and interventional treatment, but the book only covers rami communican block technique. I’ve had many questions asking about intradiscal radiofrequency and injections, which some journals show promising results, I might make some notes on that in the future. 


  • Sacroiliac Joint Pain Diagnosis & Interventional Pain Management

    Sacroiliac joint pain is a common cause of low back pain and can be challenging to diagnose due to its complex anatomy and variable symptoms. A thorough medical history and physical examination, imaging studies, and diagnostic injections are crucial components of a comprehensive evaluation for sacroiliac joint pain. Interventions for the diagnosis and management of sacroiliac joint pain include corticosteroid and anesthetic injections, radiofrequency ablation, and minimally invasive surgical techniques.

    I have made a basic summary for sacroiliac joint pain diagnosis and the interventional pain techniques for intraarticular injection and radiofrequency ablation.


  • Basic C-Arm Technique for IPM

    C-arm fluoroscopy is an imaging technique frequently used in interventional pain management procedures. Before starting the procedure, the area of interest is assessed and the patient is positioned on the table in a way that optimizes access to the target structure and minimizes unnecessary radiation exposure. The C-arm is then positioned accordingly to obtain the desired image. The image can be adjusted for contrast, brightness, and magnification to maximize visualization of the target area. During the procedure, the use of intermittent fluoroscopy is recommended to further reduce radiation exposure. Additionally, proper radiation safety protocols such as shielding and minimizing the operator’s proximity to the radiation source should be followed. Overall, the use of C-arm fluoroscopy in interventional pain management procedures can improve outcomes and increase safety for both the patient and the operator. This presentation is the basics I present for c-arm guided workshops.


  • Lumbar Facet Joint Pain

    Lumbar facet joint pain is lower back pain caused by damaged or degenerated spine joints. These joints provide stability and mobility to the spine. Joint damage leads to lower back pain, stiffness, and discomfort, caused by arthritis, injury, or wear and tear. This was a presentation I made covering the basics of lumbar facet joint pain and the interventional c-arm guided treatment.