Expert Insights Series: IR in Pain Management 2025
This deep dive into advanced interventional pain management is designed to equip interventional radiologists with the knowledge and skills needed to perform a range of procedures for treating patients with pain.
About
This deep dive into advanced interventional pain management is designed to equip interventional radiologists with the knowledge and skills needed to perform a range of procedures for treating patients with pain. The availability and evolution of these procedures have rapidly expanded in the last decade in response to growing demand.
This comprehensive, self-paced 7-week course includes a blend of lectures, podcasts, case-based learning modules, technique descriptions, evidence, and supplementary materials focused on practice building.
Course objectives
- Learning objective 1: Logically organize and describe the rapidly expanding number of available procedures to treat patients with pain in interventional radiology.
- Learning objective 2: Provide context and practice building guidance for interventional radiologists interested in meeting growing demand for advanced interventional pain procedures, including associated clinical care.
- Learning objective 3: Provide selection criteria, efficacy evidence, and technique descriptions of procedures performed in interventional radiology for the management of patients with pain.
Curriculum
Week 1: Spine Injections and Augmentations - Epidurals (transforaminal, midline, cervical, lumbar, CT, fluoro) Plexus injections, synovial cysts, intercostal nerves, facet injections, vertebroplasty, kyphoplasty, implantable augmentation devices.
Faculty: John Smirniotopoulos, MD, Charles Gilliland, MD, FSIR
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Learning objective 1: Understand the importance and utility of a dermatomal map and be able to isolate the patient’s affected culprit dermatome(s) using physical exam and a thorough pain history such that interlaminar ESI, transforaminal ESI, facet injections, synovial cyst interventions, and more may be used to specifically manage pain generators.
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Learning objective 2: Discuss the indications, technique, evidence, evolution, and application of spinal augmentation techniques.
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Learning objective 3: Understand the relevant anatomy, technique, and tools required to perform the variety of blocks in and around the spine.
Week 2: Spine Ablations - BVNA, Medial Branch, Pulsed RF
Faculty: Junjian Huang, MD
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Learning objective 1: Understand indication and technique for medial branch block and ablation.
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Learning objective 2: Understand indication and technique for basivertebral nerve ablation.
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Learning objective 3: Discuss differences between standard, cooled, and pulsed RF.
Week 3: Tumor Ablations - Spine, Non-Spine
Faculty: Alan Alper Sag, MD
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Learning objective 1: Discuss indications, tools, and procedure for vertebral body malignancy.
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Learning objective 2: Discuss indications, tools, and procedure for extra-spinous malignancy.
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Learning objective 3: Briefly discuss practice building with oncology, orthopedics, and palliative care to grow this field.
Week 4: Nerve Interventions - Neoplastic, Non-neoplastic (knees, hips, shoulders, cryo, alcohol via cross sectional guidance)
Faculty: Felix Gonzalez, MD; J. David Prologo, MD, FSIR,
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Learning objective 1: Discuss indications and procedure steps for genicular nerve block/ablation, hip nerve block/ablation, sacroiliac joint nerve block/ablation, shoulder nerve block/ablation.
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Learning objective 2: Discuss nerve ablations and neurolysis for pudendal, intercostal, mixed nerves as well as celiac/splanchnic plexus, superior hypogastric plexus, ganglion impar in the setting of cancer.
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Learning objective 3: Explore the mechanisms of effect of neurolytic options (cryo, alcohol, heat), their pros and cons, applications, and outcomes – including potential neuroregeneration)
Week 5: Spine Implantables - stimulators and pumps.
Faculty: J. Dana Dunleavy, MD; Dr. Jorge Zoltchenko
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Learning objective 1: List the options for spinal implantables (stimulators and intrathecal pumps). Understand the indications and work-up of patients who may benefit from them.
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Learning objective 2: Understand technique for placement of a spinal cord stimulator and the relevant follow-up.
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Learning objective 3: Understand technique for placement of a intrathecal pump and the relevant follow-up.
Week 6: Biologics and Embotherapy
Faculty: Osman Ahmed, MD
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Learning objective 1: List the different injectable biologic agents (platelet-rich plasma, bone marrow aspirate concentrate, stem cells, amniotic membrane-based products, etc), and their applicable targets/disease states.
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Learning objective 2: Explore beyond our borders how biologics are being used and marketed through famous athletes and/or celebrities and potential evidence-based applications for the interventional radiologist.
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Learning objective 3: Identify the disease states (and the relevant clinical work-up), embolization targets, and procedural techniques for MSK embolotherapy.
Week 7: Practice Building
Faculty: Shantanu Warhadpande, MD
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Learning objective 1: Descaribe the opportunities for interventional radiologists to enter the pain management space.
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Learning objective 2: Delineate techniques for building referral patterns to interventional radiology for the management of pain.
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Learning objective 3: Provide mitigation strategies to manage competition, address demand, and establish kinetic longitudinal care models for an advanced interventional pain practice.