When medication doesn't work or can't be used, there are still options to help control pain:
- Injections into a joint: Some people with osteoarthritis benefit from injections into a joint of either a corticosteroid (e.g., methylprednisolone, dexamethasone) to help reduce pain and inflammation or a lubricating material such as hyaluronic acid.
- Spinal cord stimulation (SCS): A procedure where an implanted device stimulates nerves near the spinal cord. SCS is only considered for specific conditions (e.g., complex regional pain syndrome) when traditional treatments are ineffective and when a trial of SCS has been successful.
- Implanted pain medication pumps: Pain medications can be delivered directly to nerves in the spinal cord. This procedure is only considered in certain circumstances and after a thorough assessment and review of the risks and benefits.
- Epidural injections: Local anesthetics or pain medication can be injected into the epidural space (the space outside of the dura around the spinal cord). For more information about epidurals, see our epidural article.
- Neuroablation: This procedure uses radiofrequency to destroy a nerve so that pain signals can no longer be transmitted. This can be done by injecting anesthetics such as lidocaine into a vein, into the space around the spinal cord (e.g., epidural), into the brain, or by surgery to destroy a nerve.
- Transcutaneous electrical nerve stimulation (TENS): TENS involves applying an electrical current to the skin which stimulates nerves.
These options are only considered for certain types of pain and very often when other pain management strategies have not effectively controlled pain. Talk to your doctor if you have any questions about these procedures.