ABSTRACT
Evidence is sufficient to determine effects on health outcomes, but the strength of the evidence is limited by the number, quality, or consistency of the individual studies, generalizability to routine practice, or indirect nature of the evidence on health outcomes. The majority of Interventional Pain Medicine specialists are anesthesiologists, many of whom have done a fellowship for additional certification in interventional pain medicine. There are currently an increasing number of physiatrists and neurologists who can take a pain fellowship which gives them the ability to perform interventional procedures. Neurolytic blocks have long been used for the management of cancer pain. It is noted that neurolysis should be used for non cancer pain only after a patient has failed an aggressive interdisciplinary pain management program. Minimally invasive nuclear decompression using nucleoplasty can be used prior to fusion or arthroplasty, but the evidence does not support the current device for the treatment of back pain alone.
