Is there a role for procedural interventions in neuropathic pain?
Yes. Procedures are particularly appropriate when trials of oral medications have failed to provide adequate relief or medications cause undesirable or intolerable side effects. Peripheral nerve blocks, neuraxial nerve blocks, sympathetic blocks, implanted spinal cord stimulators, and implanted intrathecal catheters may all have a role. Unfortunately, literature supporting interventional procedures for neuropathic pain in particular is limited. Given the lack of quality data and consensus, no strong recommendations can be made, but there is sufficient evidence to support consideration of some specific procedures for selected neuropathic pain states.