What Is Interventional Pain Management? A Comprehensive Guide

By Dr. Ara Deukmedjian, MD

Board-Certified Neurosurgeon, Deuk Spine Institute

Medically reviewed on March 12, 2026

Medical Disclaimer: This content is for educational purposes only and does not constitute medical advice. Individual results may vary. Always consult with your healthcare provider about your specific condition and treatment options.

✓ Interventional pain management is a specialized medical discipline that diagnoses and treats chronic pain using targeted, minimally invasive procedures rather than long-term opioids or major surgery.

✓ The most common conditions treated include herniated discs, sciatica, facet joint pain, spinal stenosis, sacroiliac joint dysfunction, and neuropathic pain.

✓ Common procedures include epidural steroid injections, nerve blocks, radiofrequency ablation (RFA), spinal cord stimulation (SCS), and facet joint injections. 

✓ A 2024 review in Cell Reports Medicine confirmed that combining interventional, behavioral, and physical therapies produces the best long-term outcomes for chronic pain.

✓ For patients with a correctable structural cause, minimally invasive spine surgery such as Deuk Laser Disc Repair® at Deuk Spine Institute may offer a permanent cure rather than ongoing pain management 

✓ Deuk Spine Institute offers a free MRI review to help patients understand their diagnosis and identify the best path to becoming pain free. 

Chronic pain is one of the most widespread and undertreated health conditions in the United States. According to the World Health Organization, low back pain alone is the leading cause of disability worldwide, affecting an estimated 619 million people globally as of 2020. ¹ In the United States, more than 50 million Americans live with chronic pain, with roughly 20 million experiencing high-impact chronic pain that limits work, social life, and basic daily activities. Back pain and neck pain are consistently among the leading causes of disability and lost productivity in the country.

If you have been struggling with pain that has not responded to rest, physical therapy, or anti-inflammatory medications, your physician may have recommended an interventional pain management specialist. But what does that term actually mean? What do these doctors do, what techniques do they use, and when does their approach make more sense than spine surgery?

This comprehensive guide answers those questions using the expertise of the Deuk Spine Institute team and the latest published medical research. Whether you are newly diagnosed or have been managing pain for years, this resource is designed to help you make informed decisions about your care.

Interventional pain management is a discipline of medicine devoted to the diagnosis and treatment of pain-related disorders, principally through the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

In practical terms, an interventional pain physician uses procedures such as injections, nerve blocks, and implantable devices to interrupt pain signals before they reach the brain. The goal is not merely to mask pain with medication, but to identify the precise anatomical structure generating the pain and treat it directly.

Unlike general pain management, which may rely heavily on prescription medications, interventional pain management emphasizes an accurate diagnosis before treatment begins. A detailed evaluation and targeted diagnostic procedures help the physician identify the specific disc, nerve, facet joint, or soft tissue that is the pain generator. Once identified, the appropriate interventional technique is deployed to reduce or eliminate the pain signal at its source.

A major 2024 review published in Cell Reports Medicine by researchers at NYU Grossman School of Medicine confirmed that the modern standard of care for chronic pain involves a multimodal approach combining pharmacological, interventional, behavioral, and physical therapies. ²This research underscores what leading pain physicians have long advocated: no single treatment works for every patient, and a thoughtful combination of strategies consistently produces the best outcomes.

Interventional pain management specialists come from several medical backgrounds, and their training pathways reflect the complex, multidisciplinary nature of chronic pain care.

The majority of interventional pain physicians have completed a five-year residency in anesthesiology, followed by a one-year fellowship specifically in pain medicine. Physicians trained in physical medicine and rehabilitation (physiatry) can also enter this specialty through a dedicated fellowship. In some cases, neurologists and sports medicine specialists choose to subspecialize in interventional pain management as well.

What distinguishes true interventional specialists from general practitioners is their procedural training. Fellowship-trained doctors have hands-on experience with image-guided injections, nerve ablation techniques, spinal cord stimulation, and other advanced procedures that require years of supervised training to master safely.

It is also important to understand the difference between an interventional pain specialist and a medical pain management specialist. Medical pain management doctors, such as primary care physicians or internists, primarily manage chronic conditions with medications including opioids. An interventional specialist, by contrast, uses procedures to treat the structural source of pain. Patients who have been prescribed long-term pain medications by a general physician but have never had a procedural evaluation may benefit significantly from an interventional consultation.

Interventional pain management physicians treat a wide spectrum of painful conditions, the majority of which originate in the spine. The most common diagnoses include:

• Herniated or bulging discs: A disc that presses on an adjacent nerve root, producing arm pain (cervical radiculopathy) or leg pain (lumbar radiculopathy) in addition to neck or back pain.
• Sciatica: Radiating pain, numbness, or tingling that travels from the lower back down the buttock and into the leg, typically caused by compression of the sciatic nerve.
• Facet joint pain: Degenerative changes in the small joints between vertebrae that can cause localized or referred spinal pain, often worsened by extension movements.
• Spinal stenosis: Narrowing of the spinal canal that compresses the spinal cord or nerve roots, producing pain, weakness, and difficulty walking.
• Degenerative disc disease: Age-related breakdown of the intervertebral discs that causes chronic axial back or neck pain, often combined with radicular symptoms.
• Sacroiliac joint dysfunction: Pain originating from the joint that connects the sacrum to the pelvis, frequently misdiagnosed as lumbar disc disease.
• Complex regional pain syndrome (CRPS): A chronic pain condition most commonly affecting an arm or leg after injury or surgery, characterized by disproportionate pain, swelling, and autonomic changes.
• Neuropathic pain: Pain arising from nerve damage or abnormal nerve function, which often does not respond well to standard over-the-counter medications.
• Post-surgical pain: Ongoing pain following spine surgery, including failed back surgery syndrome, which affects an estimated 10 to 40 percent of patients who undergo lumbar spine procedures.

Neck and back pain together account for the vast majority of cases managed by interventional pain physicians. If chronic neck or back pain has not responded to conservative treatment over a period of weeks to months, an interventional evaluation is a well-supported next step.

Interventional pain management physicians have a broad and growing toolkit. A 2025 systematic review and network meta-analysis published in The BMJ evaluated the comparative effectiveness of common interventional procedures for chronic non-cancer spine pain. And found that targeted, image-guided approaches consistently outperform non-specific treatments for both short- and long-term pain relief. ³ Rather than applying one-size-fits-all treatments, specialists select procedures based on precise diagnosis, patient anatomy, and treatment history.

One of the defining characteristics of high-quality interventional pain management is the multidisciplinary model of care. Rather than relying on a single treatment, the best programs coordinate treatment across multiple specialties to address every dimension of a patient's pain experience.

A comprehensive pain management program typically coordinates care across the following areas:

• Physical therapy and rehabilitation to restore strength, flexibility, and functional movement
• Psychological support including cognitive behavioral therapy (CBT), which is a proven evidence-based intervention for chronic pain
• Nutritional and lifestyle guidance, since anti-inflammatory dietary patterns and regular aerobic exercise have documented pain-reducing effects
• Interventional procedures to address the structural or neurological source of pain
• Surgical consultation when imaging reveals a correctable problem that requires a more definitive solution

A long-term prospective study published in the Journal of Clinical Medicine (2025) followed patients with chronic spinal pain over four years following interventional procedures. ⁷ Patients who consistently participated in physical therapy alongside their interventional treatments had significantly better outcomes in pain intensity, disability scores, and quality of life compared to those who did not. This confirms what experienced pain physicians have consistently observed: interventional procedures deliver their best results as part of a coordinated, patient-centered treatment plan.

Find out how Dr. Deuk can permanently ease your back pain. Starting with a quick, 10-minute free virtual consultation.

Interventional pain management is a field defined by the expertise and dedication of its physicians. Below are several recognized leaders in this specialty who exemplify the high standard of care patients deserve.

A question patients frequently ask is: when is pain management the appropriate choice, and when should surgery be considered?

Interventional pain management is generally the right first step when:

• Pain is moderate and has not fully responded to conservative care including rest, anti-inflammatories, and physical therapy
• Imaging shows nerve irritation or inflammation that may respond to targeted injections or nerve blocks
• The goal is to delay or avoid surgery while managing symptoms and building function
• Procedures are being used as diagnostic tools to confirm the precise pain source before committing to surgery

Surgery becomes the appropriate conversation when:

• Imaging reveals a structural problem such as a herniated disc, spinal stenosis, or significant disc degeneration causing nerve compression
• Interventional treatments are providing progressively shorter and less effective relief over time
• Neurological symptoms are present, including progressive muscle weakness, numbness, or loss of bladder or bowel control
• The structural problem is correctable with a minimally invasive procedure that addresses the root cause rather than the symptoms

At Deuk Spine Institute, interventional pain management and surgical expertise work together under one roof. Pain management procedures often serve as both treatment and diagnosis, helping to clarify whether a patient is a candidate for surgery and ensuring that surgical decisions are based on the most complete picture possible.

Deuk Laser Disc Repair®, the signature minimally invasive procedure developed by Dr. Ara Deukmedjian, has a 95 percent success rate with no surgical complications across thousands of procedures. For appropriately selected patients, it offers a permanent cure rather than a cycle of ongoing treatments.

Dr. Ara Deukmedjian, known to his patients and colleagues as Dr. Deuk, is a world-renowned board-certified neurosurgeon and the founder of Deuk Spine Institute in Florida. He is a pioneer in minimally invasive, laser, and endoscopic spine surgery for the treatment of neck, back, and thoracic pain, and has performed thousands of successful procedures with an unmatched safety record.

Dr. Deuk is a member of the Congress of Neurological Surgeons (CNS) and the American Association of Neurological Surgeons (AANS). He has served as Surgery Department Chair at Parrish Medical Center and has received the Patients Choice Award for multiple consecutive years.

His signature procedure, Deuk Laser Disc Repair®, is the most advanced minimally invasive laser spine surgery in the world. Unlike traditional open spine surgery or total disc replacement, Deuk Laser Disc Repair® preserves disc anatomy, eliminates the pain source directly, and has demonstrated a 95 percent success rate with zero surgical complications. It is a genuine alternative for patients who have been told their only option is major surgery.

Dr. Deukmedjian personally reviews each patient's MRI during the free Deuk Spine Exam, ensuring that every recommendation is grounded in accurate diagnosis rather than assumptions or incomplete imaging interpretation. At Deuk Spine Institute, patients benefit from the full continuum of spine and pain care, from the most conservative interventional options to the most advanced surgical solutions.

The utilization of interventional pain management in the Medicare population has shifted significantly in recent years. A 2025 analysis published in Pain Physician examined trends from 2019 to 2024 and found notable changes in procedure volume and access patterns, reinforcing the importance of patients proactively seeking specialized evaluation rather than waiting for a referral. ⁸ You should consider a consultation with an interventional pain management specialist if any of the following apply:

• Your back or neck pain has persisted for more than 6 to 12 weeks despite conservative treatment
• Over-the-counter medications, physical therapy, or rest have not provided lasting relief
• Pain is significantly affecting your ability to work, sleep, or carry out daily activities
• You are experiencing radiating pain, numbness, or tingling into an arm or leg
• Your primary care physician or a specialist has recommended a formal pain management evaluation

In most cases, you do not need a referral to see an interventional pain specialist, though your primary care doctor can help facilitate the process by sharing relevant imaging and medical records.

Arriving well prepared helps your pain physician make the most accurate diagnosis in the shortest time possible. Before your appointment, consider the following:

• Keep a pain journal for one to two weeks noting when pain occurs, what makes it better or worse, where it radiates, and how it affects your daily life
• Gather all recent imaging including MRI scans, CT scans, and X-rays. Bring hard copies if digital transfer has not been arranged in advance
• List all current medications, supplements, and over-the-counter drugs
• Write down previous treatments including injections, surgeries, and physical therapy programs, along with how well each worked
• Prepare a list of questions. Common ones include: What is causing my pain? What procedures do you recommend and why? How long will relief last? What are the risks?

Confirming that your physician has completed a fellowship specifically in pain management is an important step. The interventional pain field advances rapidly, and fellowship-trained specialists have access to cutting-edge techniques and evidence-based protocols that general practitioners do not.

Chronic neck and back pain do not have to define your daily experience. Whether your path forward involves interventional pain management procedures, minimally invasive spine surgery, or a thoughtful combination of both, Deuk Spine Institute has the expertise, the technology, and the multidisciplinary team to help you find lasting relief.

Schedule your Free MRI Review and Deuk Spine Exam today. Dr. Ara Deukmedjian and the Deuk Spine Institute team will personally review your imaging, assess your symptoms, and provide you with an honest diagnosis and a clear set of treatment recommendations. Call 1-800-FIX-MY-BACK or request your consultation online.

1.  World Health Organization (2023). Low Back Pain Fact Sheet.
2.  Wang X et al. (2024). Clinical pain management: Current practice and recent innovations. Cell Reports Medicine. PMC11513809.
3. Wang et al. (2025). Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis. BMJ. https://doi.org/10.1136/bmj-2024-079971
4.  Artuç, S. E., & Kamacı, G. K. (2025). Radiofrequency ablation for musculoskeletal pain: A bibliometric analysis of global research trends (2000–2024). Pain Physician, 28(Supplement 7), S157–S168.https://pubmed.ncbi.nlm.nih.gov/41481873/
5. Journal of Clinical Medicine (2025). Innovations in Spinal Cord Stimulation: Closed-Loop vs. Open-Loop SCS.
6. Manchikanti et al. (2025). Comprehensive Evidence-Based Guidelines for Regenerative Therapies in Chronic Low Back Pain: 2025 Update. Pain Physician. PMID: 41481869.
7. Baroncini A et al. (2025). Long-Term Follow-Up of Spinal Interventional Pain Procedures and Physical Therapy Compliance. Journal of Clinical Medicine.
8. Manchikanti et al. (2025). Updated Analysis of Decline of Interventional Pain Management Utilization in Medicare Beneficiaries 2019-2024. Pain Physician. PMID: 41481870.