Which criteria should be met by practitioners who perform therapeutic injections for pain management?

Updated: Jun 19, 2018
  • Author: Anthony H Wheeler, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Answer

Answer

Numerous technical and medical factors are pertinent to avoid potential pitfalls or complications when considering application of injections for the many indications outlined in the introduction. Historically, these procedures have been used empirically, often resulting in variable or temporary benefit, despite risk and potential complications. For these reasons, some of the basic clinical principles for use and safety are reviewed.

Practitioner criteria

A practitioner who intends to perform therapeutic injections should be qualified by education, training, and experience to diagnose and manage the specific disorder(s) to be treated, including the capacity to determine whether diagnostic evaluation has been complete and that verification of the disorder to be treated has been conclusive. Knowledge of the natural history and expected clinical course of these disorders should influence the practitioner's judgment as to what procedure should be performed, necessity of the procedure, and likelihood of success, and lead to true informed consent.

The treating practitioner should be aware of alternative or accessory therapies that can be applied before or following procedural intervention, and which may enhance the efficacy of treatment. Knowledge of the advantages, disadvantages, and limitations of each procedure, and the ability to manage complications, should be considered requisite. Knowledge of the anatomy and pharmacology of injected substances coupled with adequate experience and technical skill for performing prospective procedures are also requisite. The practitioner should be licensed with privileges to perform therapeutic procedures in the appropriate medical care settings.


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