Bone and Joint Pain Relief through Interventional Radiology
Minimally invasive treatments for bone and joint pain relief are some of the newest developments by interventional radiologists to heal patients suffering from acute or chronic pain.
Genicular Artery Embolization for Knee Pain from Osteoarthritis
Osteoarthritis of the knee is a common cause of pain in people over the age of 60, affecting about one-third of Americans. Initially, pain is managed with conservative therapy, which includes corticosteroid injections, physical therapy, and anti-inflammatory medication. Despite being such a widespread condition, there are not many procedural alternatives to surgery after conservative therapy has failed. Most patients are left having to seriously consider getting a knee replacement, which requires significant rehabilitation and often leaves patients with less function than the native joint.
For patients with disabling pain related to knee osteoarthritis, genicular artery embolization is a new, promising outpatient procedure that reduces the discomfort and pain related to ongoing chronic inflammation within the knee joint. This is an outpatient endovascular procedure where blood flow is slowed to the areas of inflammation, breaking the cycle of related chronic pain.
Spinal Fracture Augmentation and Cement Fixation
Vertebral compression fractures and sacral insufficiency fractures are common causes of severe back pain in elderly individuals with decreased bone density, particularly women with osteoporosis. As bone density decreases, these fractures can occur with normal levels of stress on the bone, hence the name “insufficiency fractures.”
While people with such fragile bones may not notice when the fracture takes place, the subsequent pain experienced can be debilitating. It is often bad enough to keep people in bed for weeks, requiring narcotic medications.
Vertebral augmentation with cement fixation is a minimally invasive outpatient procedure in which a balloon or small device is used to restore height to the fractured vertebra, followed by injection of cement to stabilize the fracture. This procedure is often called kyphoplasty, for short. Kyphoplasty has some of the highest satisfaction rates among patients because of the drastic pain improvement, with many people having greater than 50% pain improvement overnight.
Adhesive capsulitis, also known as frozen shoulder, is a common cause of pain and stiffness of the shoulder. It often results from a period of inactivity of the affected arm, like immobilization after surgery or a fracture, but it can develop sometimes without a clear cause. The pain and loss in range of motion can be detrimental to a person’s daily living or occupational activities.
This condition is more often found in females and diabetics, and is best diagnosed with an MRI of the shoulder. All patients are initially managed conservatively with physical therapy, anti-inflammatory medication, and sometimes steroid injections. Like knee osteoarthritis, when conservative therapy fails, there are not many alternatives to surgery. Patients may be stuck in physical therapy for several years.
Arterial embolization of the shoulder is a new, minimally invasive outpatient procedure to improve pain and stiffness caused by adhesive capsulitis. It works by slowing down the blood flow that the chronic inflammation relies upon. This results in pain reduction, with an improvement of shoulder mobility.
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