Pain Management Service Line

Welcome to the Pain Management service line of the Society of Interventional Radiology—Resident and Fellows Section. Interventional Radiology (IR) is assuming a critical, and evolving, role in a growing number of aspects of patient care. As physicians specializing in minimally invasive techniques, Interventional Radiologists encounter patients with a broad range of medical conditions including cancer, liver disease, musculoskeletal disease and vascular disease. These patients are often living with pain and reduced quality of life. Interventional Radiologists are often able to treat the underlying condition and ready to provide palliative treatments to these patients when needed.


Pain Management Service Line

Service Line Chair: Shiraz Rahim
Service Line Vice Chair: Ross Bittman

Active Service Line Members:
Shiraz Rahim
Ross Bittman
Omar Chohan
Chase Parsons
Barry Amos
Rudra Pampati
Asad Baig
Zachary Berman
Ahmed Abbas
Anouva Kalra-Lall
Stephen Belmustokov
Sanghun Kim
Ryan Leahy
Jerome Larson
Gregory Wade
Gautam Rao
Maunik Patel

Former Service Line Chairs:
Kamran Munawar (2016-2017)
David Maldow (2015-2016)
Dushyant Thakur (2014-2015)

Faculty Advisor:
Hemant Kalia

Procedural Education

In addition to procedures, Interventional Radiologists can work with primary care physicians and other specialists to optimize and monitor pharmacological therapy for patients as an adjuvant to procedures.

Please explore the content herein to learn more about IR’s role in pain management and palliation.

Clinical Education

Back Pain/Spine

  • Manchikanti L, Falco FJE, Singh V, Benyamin RM, Racz GB, Helm II S, Caraway DL, Calodney AK, Snook LT, Smith HS, Gupta S, Ward SP, Grider JS, Hirsch JA. An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain. Part 1: Introduction and General Considerations. Pain Physician. 2013;16:S1-S48.
  • Manchikanti L, Abdi S, Atluri S, Benyamin RM, Boswell MV, Buenaventura RM, Bryce DA, Burks PA, Caraway DL, Calodney AK, Cash KA, Christo PJ, Cohen SP, Colson J, Conn A, Cordner H, Coubarous S, Datta S, Deer TR, Diwan S, Falco FJ, Fellows B, Geffert S, Grider JS, Gupta S, Hameed H, Hameed M, Hansen H, Helm S 2nd, Janata JW, Justiz R, Kaye AD, Lee M, Manchikanti KN, McManus CD, Onyewu O, Parr AT, Patel VB, Racz GB, Sehgal N, Sharma ML, Simopoulos TT, Singh V, Smith HS, Snook LT, Swicegood JR, Vallejo R, Ward SP, Wargo BW, Zhu J, Hirsch JA. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician. 2013;16:S49-S283.
  • Manchikanti L, Singh V, Cash KA, Pampati V, Falco FJE. A Randomized, Double-Blind, Active-Control Trial of the Effectiveness of Lumbar Interlaminar Epidural Injections in Disc Herniation. Pain Physician. 2014;17:E61-E74.
  • Cohen SP, Hameed H, Kurihara C, Pasquina PF, Patel AM, Babade M, Griffith SR, Erdek ME, Jamison DE, Hurley RW. The Effect of Sedation on the Accuracy and Treatment Outcomes for Diagnostic Injections: A Randomized, Controlled, Crossover Study. Pain Medicine. 2014;15:588-602.
  • White RL, Cohen SP. Return-to-duty Rates among Coalition Forces Treated in a Forward-deployed Pain Treatment Center. A Prospective Observational Study. Anesthesiology. 2007;107:1003-1008.
  • Glaser SE, Shah RV. Root Cause Analysis of Paraplegia Following Transforaminal Epidural Steroid Injections: The ‘Unsafe’ Triangle. Pain Physician. 2010;13:237-244.
  • Candido KD. Spinal Injections for the Diagnosis and Treatment of Chronic Spinal Pain. ASA Refresher Courses in Anesthesiology. 2011;39(1):13-22.
  • Kallmes DF, Comstock BA, Heagerty PJ, Turner JA, Wilson DJ, Diamond TH, Edwards R, Gray LA, Stout L, Owen S, Hollingworth W, Ghdoke B, Annesley-Williams DJ, Ralston SH, Jarvik JG. A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures. New England Journal of Medicine. 2009;361:569-579.
  • Chen L, Black C, Hirsch JA, Beall D, Munk P, Murphy K. Vertebroplasty Trials: The Medium Is the Message. Journal of Vascular and Interventional Radiology. 2014;25(2):323-25.
  • Baerlocher MO, Saad WE, Dariushnia S, Barr JD, Mcgraw JK, Nikolic B. Quality Improvement Guidelines for Percutaneous Vertebroplasty. Journal of Vascular and Interventional Radiology. 2014;25(2):165-70.
  • Barr JD, Jensen ME, Hirsch JA, McGraw JK, Barr RM, Brook AL, Meyers PM, Munk PL, Murphy KJ, O’Toole JE, Rasmussen PA, Ryken TC, Sanelli PC, Schwartzberg MS, Seidenwurm D, Tutton SM, Zoarski GH, Kuo MD, Rose SC, Cardella JF. Position Statement on Percutaneous Vertebral Augmentation: A Consensus Statement Developed by the Society of Interventional Radiology (SIR), American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), American College of Radiology (ACR), American Society of Neuroradiology (ASNR), American Society of Spine Radiology (ASSR), Canadian Interventional Radiology Association (CIRA), and the Society of NeuroIntervenional Surgery (SNIS). Journal of Vascular and Interventional Radiology. 2014;25:171-181.

Palliative Interventions

  • Narayanan G, Pezeshkmehr A, Venkat S, Guerrero G, Barbery K. Safety and Efficacy of the PleurX Catheter for the Treatment of Malignant Ascites. Journal of Palliative Medicine. 2014;17.
  • Patel IJ, Pirasteh A, Passalacqua MA, Robbin MR, Hsu DP, Buethe J, Prologo JD. Palliative Procedures for the Interventional Oncologist. American Journal of Roentgenology. 2013;201:726-735.
  • Prologo JD, Passalacqua M, Patel I, Bohnert N, Corn DJ. Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience. Skeletal Radiology. 2014 Jun 28 (epub ahead of print).
  • Rana MV, Candido KD, Raja O, Knezevic NN. Celiac Plexus Block in the Management of Chronic Abdominal Pain. Current Pain and Headache Reports. 2014;18:394.
  • Roebuck DJ. Interventional radiology in paediatric palliative care. Pediatric Radiology. 2014;44:12-17.
  • Sugawara S, Sone M, Arai Y, Sakamoto N, Aramaki T, Sato Y, Inaba Y, Takeuchi Y, Ueno T, Matsueda K, Moriguchi M, Tsushima T. Radiological Insertion of Denver Peritoneovenous Shunts for Malignant Refractory Ascites: A Retrospective Multicenter Study (JIVROSG-0809). Cardiovascular and Interventional Radiology. 2011;34:980-988.
  • Tian Q, Wu C, Gu Y, He C, Li M, Cheng Y. Combination Radiofrequency Ablation and Percutaneous Osteoplasty for Palliative Treatment of Painful Extraspinal Bone Metastasis: A Single-Center Experience. Journal of Vascular and Interventional Radiology. 2014;25:1094-1100.
  • Vogl TJ, Lindemayr S, Naguib NN, Gurung J, Nour-Eldin NA, Zangos S, Mbalisike EC. Nonselective Transarterial Chemoperfusion: A Palliative Treatment for Malignant Pleural Mesothelioma. Radiology. 2013;266(2):649-656.

Survival Guides

Pain Management Survival Guides:

Click here for Pain Management Survival Guides
Topics Include:
RFA for osteoid osteoma
Lumbar epidural steroid injection
Celiac/hypogastric plexus block
Spinal facet procedure
Catheter drainage of intrathoracic collections
Arterial embolization of hypervascular bone tumors
Cryoablation of sternal metastases for pain palliation
Microwave thermal ablation of spinal metastatic bone tumors
Embolization of intraosseous AVM
Sacroiliac joint injection
CT-guided percutaneous osteoplasty for painful malignant extravertebral bone lesions
Tracheobronchial stenting
Esophageal stenting
Catheter drainage of symptomatic intrathoracic collections
Endovenous laser ablation
Lymphocele drainage and sclerosis
Stent for malignant biliary/colorectal obstruction
Iliofemoral vein stent placement in cancer patients with lymphedema
Gastroduodenal stenting for palliation of unresectable malignant obstructions
Pudendal/geniculate nerve block

Spinal cord stimulator implants

Other Resources

Vorenkamp KE. Interventional Procedures for Facial Pain. Current Pain and Headache Reports. 2013;17(1).

Manchikanti L, Falco FJE, Benyamin RM, Caraway DL, Kaye AD, Helm II S, Wargo BW, Hansen H, Parr AT, Singh V, Swicegood JR, Smith HS, Schultz DM, Malla Y, Hirsch JA. Assessment of Bleeding Risk of Interventional Techniques: A Best Evidence Synthesis of Practice Patterns and Perioperative Management of Anticoagulant and Antithrombotic Therapy. Pain Physician. 2013;16:SE261-SES318.

Journal Primer

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