Invasive techniques in pain management involve injections and/or placement of devices into the body. A multitude of invasive pain management therapies have been used to treat neck and back pain.

Some of the most popular interventional pain management techniques include:

Injections (also known as blocks)
Injections provide direct delivery of steroids or anesthetic into joints, ligaments, muscles, or around nerves. These injections may provide relief of pain (often temporary) and can be used to confirm if the injected structure is the source of the pain, clarifying the diagnosis. Epidural injections can provide temporary relief for upper extremity or lower extremity pain due to a pinched nerve in the spine.

Prolotherapy
This technique involves injection of an irritant solution to stimulate blood circulation and ligament repair at affected site. The effectiveness of this technique is not known.

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Radiofrequency radioablation
This procedure involves deadening of painful nerves via heat administered through a small needle. In carefully selected patients, this helps in approximately 60% of patients and lasts for months to years.

Surgically implanted electrotherapy devices
These are implantable spinal cord stimulators (SCS) and implantable peripheral nerve stimulators. Clinical data offers inconclusive findings on the effectiveness of SCS, but in general they are more effective for arm and leg pain than they are for localized spine pain. Spinal cord stimulators are expensive.

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Implantable opioid infusion pumps
These are surgically implanted pumps that deliver opioid agents directly to the spinal cord. These pumps are expensive. The appropriateness and effectiveness of these devices for treating chronic back pain is controversial.

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