Interventional Pain Medicine: What Sets It Apart

What Is Interventional Pain Medicine? A Physician's Evidence-Based Approach

By Jacqueline Weisbein, D.O.
Double Board-Certified in Physical Medicine & Rehabilitation and Pain Medicine

Quick Insights

Interventional pain medicine is a subspecialty focused on diagnosing and treating chronic pain using minimally invasive, image-guided procedures. Unlike traditional pain management that relies primarily on medications, a pain management doctor trained in interventional techniques targets specific pain generators identified through diagnostic testing. This approach often employs imaging guidance to deliver precise treatments directly to nerves, joints, or vertebral structures causing pain.

Key Takeaways

• Diagnostic nerve blocks predict which patients will respond to radiofrequency ablation before permanent treatment.
• Basivertebral nerve ablation shows sustained pain relief and functional improvement at five-year follow-up.
• Advanced spinal cord stimulation outperforms traditional neuromodulation in randomized trials for chronic back pain.
• Pooled three-year data demonstrates reduced opioid use and fewer downstream surgeries after targeted interventions.

Why It Matters

When you've tried physical therapy, injections, and medications without relief, understanding what makes interventional care different offers hope. For Napa residents dealing with chronic pain, this approach may help you return to activities you've given up—sleeping through the night, working without constant breaks, or playing with your children. Knowing that your pain has a specific, treatable source can reduce the anxiety that relief will never last.

Introduction

As a double board-certified pain physician, I've spent years helping patients understand their treatment options. Learn more about my background as Dr. Jacqueline Weisbein, DO—board-certified pain management physician.

Many people try physical therapy, medications, and standard injections without knowing that interventional pain medicine offers a fundamentally different approach. A pain management doctor trained in interventional techniques uses advanced diagnostics and image-guided procedures to identify and treat specific pain generators—not just mask symptoms.

Research demonstrates that radiofrequency denervation and other targeted interventions can provide lasting relief when conservative care hasn't worked. At Napa Valley Orthopaedic Medical Group, I perform these procedures myself, using fluoroscopy and ultrasound guidance to pinpoint exactly what's causing your pain. Serving patients from Yountville to American Canyon and throughout the Napa Valley, I focus on evidence-based interventional approaches that restore function and quality of life.

This article explains what sets interventional pain medicine apart and whether this approach might help you move forward.

How Napa Pain Management Doctors Diagnose Pain Differently

I approach diagnosis differently than many physicians you may have seen.

Instead of relying solely on imaging or physical exams, I use diagnostic injections to pinpoint the exact source of your pain. Research demonstrates that diagnostic facet blocks predict which patients will respond to radiofrequency ablation before we perform permanent treatment.

This precision matters because chronic pain often has multiple potential sources. Your MRI might show arthritis in three different joints, but only one may be causing your symptoms.

I perform these diagnostic procedures under fluoroscopy or ultrasound guidance. This image-guided approach ensures I'm targeting the exact structure we suspect is generating your pain.

When a diagnostic block provides significant temporary relief, we know we've identified the right pain generator. This evidence-based selection process means you won't undergo treatment that's unlikely to help.

Interventional care may not be suitable for all patients. If diagnostic testing does not identify a specific pain source, or if the pain is non-structural, alternative treatments may be more appropriate.

In my Napa practice, I've found that careful diagnostic work often changes the treatment path entirely. What initially appeared to be disc pain might actually originate from facet joints or the sacroiliac joint.

The diagnostic approach in interventional pain medicine differs from traditional medication management.

Evidence-Based Procedures That Target Pain at Its Source

Once we've identified your specific pain generator, I can offer targeted interventional procedures.

Radiofrequency ablation uses heat to interrupt nerve signals from painful facet joints or the sacroiliac joint. The procedure creates a controlled lesion on the nerve, potentially stopping pain transmission for an extended period.

For vertebrogenic low back pain—pain originating from damaged vertebral endplates—I perform basivertebral nerve ablation. Long-term follow-up data indicates that this procedure provides sustained pain relief and functional improvement at five-year follow-up.

Clinical studies tracking patients over time show consistent improvements across multiple cohorts, supporting this mechanism-driven approach.

Spinal cord stimulation offers another option for patients with neuropathic pain or failed back surgery syndrome. Advanced systems deliver targeted electrical signals that modify pain perception at the spinal cord level.

For spinal stenosis causing leg pain and walking limitations, minimally invasive procedures may be used to remove small portions of thickened ligament. This approach aims to alleviate nerve compression without requiring major surgery. Explore more about minimally invasive back pain procedures available at my practice.

Each procedure targets a specific anatomical structure, often identified through diagnostic testing.

The goal isn't just pain reduction—it's restoring function so you can return to activities that matter to you.

Who Benefits Most from Interventional Pain Care in Napa?

Interventional pain medicine works best for specific patient populations.

Patients who have tried conservative care without adequate relief may consider interventional procedures.

You're seeking alternatives to major spine surgery or long-term opioid use. You have a specific diagnosis—facet joint pain, sacroiliac joint dysfunction, vertebrogenic pain, or neuropathic pain—confirmed through diagnostic testing.

Published evidence suggests that appropriately selected patients achieve moderate-to-strong functional gains with targeted interventions.

Interventional care is not first-line treatment. You should have already completed physical therapy and tried appropriate medications before considering these procedures.

Some patients aren't appropriate candidates. If you have acute pain that's likely to resolve with conservative care, interventional procedures may be premature.

If diagnostic testing doesn't clearly identify a treatable pain generator, outcomes become unpredictable. Patients with unrealistic expectations—hoping for complete pain elimination or immediate return to all activities—may be disappointed.

In my practice, I emphasize that these procedures work best when integrated with ongoing physical therapy, lifestyle modifications, and appropriate medications. They're tools within a chronic pain treatment options strategy, not standalone solutions.

The right candidate understands this multimodal approach and commits to the work required for optimal outcomes.

What This Procedure Does Not Address

Interventional pain medicine has important limitations you should understand.

Systematic review findings show that radiofrequency ablation has no randomized controlled trial evidence for coccygeal pain. This procedure is not indicated for tailbone pain based on current high-quality research.

Interventional procedures target specific, validated pain generators. They don't address all causes of chronic pain.

If your pain stems from widespread inflammation, central sensitization, or psychological factors, targeted nerve ablation won't provide the relief you're seeking. These procedures work by interrupting pain signals from specific anatomical structures.

Careful diagnostic evaluation determines whether you're an appropriate candidate. When imaging and diagnostic blocks don't clearly identify a treatable source, interventional procedures become less predictable.

I'm transparent about these limitations during consultations. Understanding what these procedures can and cannot address helps you make informed decisions about your care.

Long-Term Outcomes and What to Expect

Realistic expectations matter when considering interventional pain care.

Many procedures provide noticeable relief within two to four weeks. Radiofrequency ablation typically offers six to twenty-four months of benefit before nerves regenerate and pain may return.

Implanted devices like spinal cord stimulators can provide relief for years, though they require occasional programming adjustments and battery replacements.

Extended outcomes analysis demonstrates sustained improvements and reduced opioid use at three-year follow-up for basivertebral nerve ablation. These long-term results remained consistent with earlier findings.

The goal is improved function—better mobility, reduced medication dependence, enhanced quality of life. Most patients don't achieve complete pain elimination, but significant functional gains are common.

Some patients need repeat procedures when initial treatments wear off. This doesn't mean the procedure failed—it means we successfully identified and treated your pain source, and repeating the intervention can restore relief.

In my Napa practice, I've observed that patients who combine interventional procedures with physical therapy and lifestyle modifications achieve the best long-term outcomes. The procedures create a window of reduced pain that allows you to rebuild strength and function.

Not every patient responds equally. Individual anatomy, pain mechanisms, and overall health influence outcomes.

I follow patients long-term to monitor results and adjust treatment plans as needed. This ongoing relationship ensures you receive appropriate care as your condition evolves.

A Patient's Perspective

As a pain physician, I've learned that patient experiences often reveal what matters most about our care approach.

One of my patients, Hanna, recently shared her journey finding relief after years of weather-related migraines that multiple physicians couldn't resolve. She had tried various medications and seen different specialists without improvement.

"Dr Weisbein is a wonderful doctor. She's very kind, compassionate and patient. She listens to me, understands my issues, and I don't feel rushed or uncomfortable. She has a very warm bedside manner, and she answers all my questions in a clear and straightforward fashion. She really goes above and beyond to provide help. She is very knowledgeable and up to date on the latest research. She suggested a new kind of medication to help with my weather-related migraines. I had spent years living with this condition, seeing various physicians and taking different meds that weren't helping. Dr Weisbein is the first doctor that suggested a totally new approach, and it worked. She is the best!"

— Hanna

This is one patient's experience; individual results may vary.

What Hanna's story illustrates is the value of staying current with research and taking time to understand each patient's unique situation. When standard approaches haven't worked, exploring evidence-based alternatives can make all the difference.

Conclusion

Interventional pain medicine offers a fundamentally different approach when conservative treatments haven't worked. As a double board-certified physician in Pain Medicine and Physical Medicine & Rehabilitation, I use diagnostic precision and image-guided procedures to target specific pain generators—not just mask symptoms. Research shows that advanced spinal cord stimulation and other targeted interventions provide durable relief for appropriately selected patients. At Napa Valley Orthopaedic Medical Group, I perform these procedures myself, combining evidence-based evaluation frameworks with personalized care. Whether you're in St. Helena, Yountville, or American Canyon, you're not alone—and you're not out of options. Schedule a consultation today to explore personalized pain management options that may help you reclaim your quality of life.

Nearby medical facilities in the region include Providence Queen of the Valley Medical Center. Local hospitals such as Adventist Health St. Helena also serve the broader Napa community.

This article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

Frequently Asked Questions

What makes interventional pain medicine different from what I've already tried?

Interventional pain specialists use diagnostic injections to pinpoint your exact pain source before treatment. We perform image-guided procedures that target specific nerves, joints, or vertebral structures causing your pain—not just prescribe medications. This precision means you won't undergo treatment unlikely to help. Many of my patients come to me after years of feeling dismissed—we take a different approach here, using evidence-based diagnostics to identify treatable pain generators.

How long do interventional procedures typically provide relief?

Relief timelines vary by procedure and individual response. Radiofrequency ablation usually provides six to twenty-four months of benefit before nerves regenerate. Spinal cord stimulators can offer relief for years with occasional programming adjustments. Basivertebral nerve ablation shows sustained improvements at three-year follow-up. The goal isn't complete pain elimination—it's restoring function so you can return to activities that matter. Some patients need repeat procedures when initial treatments wear off, which doesn't mean failure.

What happens if interventional treatment doesn't work for me?

Not every patient responds equally to interventional care. If a procedure doesn't provide expected relief, we reassess your diagnosis and explore alternative approaches. This might include different interventional techniques, adjustments to your multimodal care plan, or referral to complementary specialists. I follow patients long-term to monitor results and adjust treatment as your condition evolves. The right treatment can restore more than comfort—it can restore confidence, mobility, and hope.

Where can I find a pain management doctor in Napa?

Dr. Jacqueline Weisbein at Napa Valley Orthopaedic Medical Group offers physician-guided interventional pain medicine tailored to your wellness goals. Located in Napa, our practice provides personalized, evidence-based care in a supportive environment. Schedule your consultation today to experience advanced pain management with a double board-certified specialist.