Pain Medicine: Science, Specialization, and Results
Evidence-based treatment performed by specialized physicians for effective chronic pain relief
What is Pain Medicine?
Pain Medicine is a medical specialty dedicated to the diagnosis and scientific treatment of all types of pain, whether acute or chronic. This area of medicine recognizes pain as a complex condition involving physical, neurological, and emotional aspects, requiring a multidisciplinary and individualized approach.
The pain specialist physician acts as an investigator of the origin of suffering, using advanced knowledge in neuroanatomy, pharmacology, and interventional techniques to provide effective and lasting relief, always based on scientific evidence.
The Role of the Pain Specialist Physician
Diagnostic Evaluation
- Detailed anamnesis with investigation of pain history
- Thorough physical examination and functional tests
- Interpretation of imaging and lab tests
- Precise identification of the anatomical origin of pain
Specialized Treatment
- Rational prescription of analgesics and adjuvants
- Image-guided interventional procedures
- Peripheral and central neuromodulation techniques
- Coordination of a multidisciplinary team
Patient-Centered Approach
At Intrador, our specialized physicians don't just treat symptoms. We investigate the root cause of pain, consider the impact on quality of life, and develop individualized therapeutic plans that respect the needs, limitations, and goals of each patient.
How we assess and treat
- Initial clinical screening
- Detailed medical history (anamnesis)
- Focused physical examination
- Request and review of complementary tests when indicated
- Definition of an individualized treatment plan
- Follow-up and periodic reassessments
Treatments are recommended individually based on diagnosis, clinical conditions, comorbidities, medication use, and patient preferences. Some techniques may not be indicated in specific clinical situations, which are assessed case by case during the medical consultation.
Lumbar Blocks: Evidence-Based Efficacy
Scientific data proves the effectiveness of interventional procedures
What is a Lumbar Block?
A lumbar block is a minimally invasive outpatient procedure in which a pain specialist physician injects medications (local anesthetics and anti-inflammatories) with millimeter precision near the nerves, joints, or structures responsible for lower back pain and sciatica.
The procedure is performed with image guidance (ultrasound or fluoroscopy), ensuring maximum safety and accuracy in the administration of drugs at the exact site of pathology.
Types of Lumbar Blocks
- Facet Block: For pain originating in the facet joints (spinal osteoarthritis)
- Epidural Block: For herniated discs and spinal canal stenosis
- Transforaminal Block: For specific radicular pain (sciatica)
- Erector Spinae Plane Block: For refractory deep musculoskeletal pain
- Pulsed Radiofrequency: Alternative with a superior safety profile compared to steroids
Proven Clinical Results
A systematic review of scientific studies published between 2013 and 2023 consistently demonstrated the clinical efficacy of lumbar blocks in treating chronic low back pain:
Scientific Evidence by Block Type
Erector Spinae Plane Block (Ahıskalıoğlu et al., 2017)
- Reduction in Visual Analogue Scale (VAS) from ≥7 to 2.3 immediately after procedure
- Maintenance of satisfactory results until 1 month of follow-up
- 100% efficacy in immediate and medium-term relief
- No complications reported in the prospective series
Pulsed Radiofrequency vs. Epidural Injection (Tejeda-Barreras et al., 2010)
- Similar efficacy between pulsed radiofrequency and epidural corticosteroids
- Radiofrequency showed a lower incidence of complications
- Only 2 minor puncture complications in the steroid group vs. zero in the radiofrequency group
- Both techniques promote significant improvement in the Roland-Morris Disability Questionnaire
Facet Chemical Rhizotomy (Abdallah and Proietti, 2023)
- 75% of patients obtained significant pain reduction
- 15 out of 20 patients moved from "intense pain" to "mild pain" (VAS 0-2)
- Near-zero morbidity and very low complication rate
- Functional improvement with return to daily activities
Interlaminar Epidural Block (Nunes et al., 2016)
- 75.8% of patients showed ≥80% pain reduction
- Efficacy maintained in weekly evaluations up to 180 days
- Indicated for protruding herniated discs with radicular involvement
- Safe procedure with no serious complications reported
Transforaminal Block (Sales et al.)
- 52% improvement in the intervention group vs. 50% in controls at 3 weeks
- Reduction of Oswestry Disability Index from 61.68 to functional levels
- Double-blind study showed that local anesthetic alone already provides benefits
- Well-tolerated procedure with no discontinuations due to adverse events
Comparative Analysis of Techniques
The narrative review by Yugcha-Quiquintuña (2025) analyzed studies from 2013 to 2023 on lumbar facet blocks, concluding that:
- There is no significant difference between ultrasound and fluoroscopy as image guidance methods
- Combined treatments did not show superiority over isolated blocks
- Patients without Modic changes (vertebral degenerative changes) show better results
- Repeated procedures are often necessary to maintain benefit
- Significant reduction in VAS and Oswestry Disability Index in multiple studies
Safety Profile
Scientific literature is consistent in demonstrating that lumbar blocks performed by pain specialists show an excellent safety profile:
- Complications are rare and predominantly mild
- Most common adverse effect: transient pain at the puncture site
- Image guidance significantly reduces risks
- Discontinuation rate due to adverse events: virtually zero
- Pulsed radiofrequency demonstrates an even safer profile than steroids
The review by Yugcha-Quiquintuña (2025) identified adverse events in multiple studies: injection site pain (5 cases), transient pain increase (2 cases), vasovagal reactions (26 cases), and extremely rare serious infectious complications (7 cases of infectious spondylitis and 1 of spinal aspergillosis in thousands of procedures analyzed). The vast majority of complications were classified as minor and self-limiting.
Effect Duration and Procedure Repetition
The average duration of pain relief after lumbar blocks varies between 3 to 4 weeks, as shown by studies from Ahıskalıoğlu et al. (2017) and the review by Yugcha-Quiquintuña (2025). However, the duration is influenced by several factors:
- Pathology type: Facet pain tends to respond better than discogenic pain
- Structural changes: Modic changes reduce efficacy
- Medications used: Corticosteroids can extend effect duration
- Rehabilitation adherence: Concomitant physical therapy prolongs benefits
Important: Repeated procedures are often necessary and recommended to maintain therapeutic effect. Literature shows that series of blocks provide cumulative relief and can allow the patient to actively participate in rehabilitation programs that would be impossible with initial intense pain.
When to Seek a Pain Doctor in Recife?
Clinical Indications
- Persistent pain for more than 3 months (chronic pain)
- Therapeutic failure with conventional painkillers
- Significant functional limitation
- Pain radiating to limbs (sciatica, cervicobrachialgia)
- Interference with sleep and quality of life
Treatable Conditions
- Chronic low back pain and facet pain
- Lumbar and cervical herniated disc
- Spinal canal stenosis
- Fibromyalgia and myofascial pain
- Peripheral neuropathies
Intrador in Recife
Multidisciplinary pain clinic in Pernambuco, with almost 10 years of experience and units registered with CRM-PE (Types II and IV).
Scientific References
- Ahıskalıoğlu A, Alici H, Çiftçi B, Çelik M, Karaca O. Continuous Ultrasound Guided Erector Spinae Plane Block for the Management of Chronic Pain. Anaesthesia Critical Care & Pain Medicine, 2017.
- Tejeda-Barreras M, Rodriguez-Celaya C, Santillana-Macedo MA. Chronic Low Back Pain Treatment with Pulsed Radiofrequency and Epidural Steroid Application: Comparative Study. , 2010.
- Yugcha-Quiquintuña D. Treatment of Low Back Pain with Lumbar Facet Joint Block: Literature Review. 593 Digital Publisher CEIT, 2025.
- Sales EJF, Oliveira THQ, Barbosa MO. Effectiveness of Foraminal Nerve Root Block in Relieving Sciatic Pain Due to Lumbar Disc Herniation: A Prospective, Controlled, Randomized, Double-Blind Study. Scientific Initiation Program - PIC/UniCEUB.
- Abdallah OMM, Proietti SB. Facet Joint Block in Chronic Low Back Pain. Contribuciones a Las Ciencias Sociales, 2023.
- Nunes RCS, Pontes E, Costa I. Evaluation of Epidural Blockade as Therapy for Patients with Sciatica Secondary to Lumbar Disc Herniation. Revista Brasileira de Ortopedia, 2016.
- Ferreira APVS, Silveira D, Azevedo A, et al. Epidural Blockade in Chronic Pain Control. , 2020.
Clinically Reviewed by:
Dr. Helio Widson Alves Pinheiro
Pain Medicine | Acupuncture
CRM/PE 21167 | RQE 2217, 2808
This content is informative and does not replace individual medical evaluation.
See full credentials
Fundador da Clínica Intrador, médico especialista em Medicina da Dor e Acupuntura, com atuação em tratamentos intervencionistas e neuromodulação.
Note: This content is for educational and informational purposes only. The information is based on scientific evidence and the clinical practice of the Intrador team, but it does not replace individualized medical evaluation. Conduct, indications, and treatments must be defined after medical consultation.
Clinical reviewer: Dr. Helio Widson Alves Pinheiro · Pain Medicine | Acupuncture · CRM/PE 21167 | RQE 2217, 2808
Published on: January 17, 2026
Reviewed on: January 29, 2026
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