Medically reviewed by Dr. David L. Greenwald, MD, FAANS, FACS — dual board-certified spine surgeon & neurosurgeon. Last reviewed October 2026.

Interventional pain management uses precise, image-guided procedures — not long-term medication — to relieve back, neck, and nerve pain at its source. At Desert Spine and Pain, these procedures are performed under live imaging by a surgeon, so they're both accurate and, often, diagnostic: they can confirm exactly which structure is causing your pain.

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How an Image-Guided Spinal Injection Works

What Is Interventional Pain Management?

Interventional pain management is a branch of medicine that treats chronic back, neck, and nerve pain with targeted, minimally invasive procedures aimed directly at the source of the pain — rather than masking it with ongoing medication. Instead of managing symptoms indefinitely, the goal is to find the specific structure that is generating your pain — a facet joint, an irritated nerve root, a compressed nerve, a damaged disc — and treat it precisely.

What sets interventional care apart is precision. These procedures are delivered under live imaging, so medication or treatment is placed exactly at the painful structure and nowhere else. Many of the same techniques are also diagnostic: when a targeted injection or nerve block relieves your pain, it confirms where the pain is actually coming from, which sharpens every decision that follows.

At Desert Spine and Pain, interventional pain care sits between conservative, non-invasive treatment and spine surgery. For a great many patients, a well-placed procedure is all that's needed — it relieves the pain and makes an operation unnecessary. And because Dr. Greenwald is a spine surgeon and a neurosurgeon, the rare patient who does need more has a clear, seamless path to it.

Our Interventional Pain Procedures

Interventional pain management isn't one procedure but a toolkit — and the right choice depends entirely on your diagnosis. These are the main categories of image-guided care we provide, each matched to a specific pain source:

Not sure which applies to you? That's exactly what your consultation determines. Dr. Greenwald identifies the true source of your pain first, then recommends the single most effective procedure — never a one-size-fits-all protocol.

When Is Interventional Pain Care Appropriate?

Interventional procedures aren't usually the first thing we try, and they're not for everyone. They tend to be the right step when pain is persistent, when it has a clear anatomical source, or when you want relief without jumping straight to surgery. You're likely a good candidate when:

• Conservative care hasn't been enough. Pain that lingers after a reasonable course of rest, activity modification, physical therapy, or medication.
• Your pain has a specific source. A facet joint, sacroiliac joint, irritated nerve root, or inflamed nerve that imaging and your exam point to — something a targeted procedure can reach.
• You have nerve-related symptoms. Radiating leg or arm pain, numbness, or tingling from an irritated or pinched nerve — the pattern seen in sciatica and radiculopathy.
• You want to confirm the diagnosis. A diagnostic block can pinpoint the exact pain generator before you commit to a longer-term treatment or an operation.

Interventional care is also a natural fit when you'd prefer to exhaust precise, non-surgical options first — and when you want those options delivered by a specialist who could perform the surgery too, if it ever came to that.

Procedures, Not Just Prescriptions

Desert Spine and Pain is a surgical spine practice — our interventional pain care is about targeted procedures that treat the source of pain, not ongoing medication management. Because Dr. Greenwald is both a spine surgeon and a neurosurgeon, he performs these procedures with a deep understanding of the anatomy and the nerves, and can seamlessly escalate to a surgical solution in the rare case one is needed.

The Precision Advantage — Image-Guided and Surgeon-Performed

The difference between a procedure that works and one that disappoints often comes down to a few millimeters. At Desert Spine and Pain, every injection, block, and ablation is performed under live fluoroscopic (X-ray) guidance, so the needle is placed exactly at the target structure — the specific facet joint, nerve root, or nerve branch causing your symptoms — and the treatment goes precisely where it will help. Placement you can see on a screen is far more reliable than placement by feel alone.

That same precision makes many of these procedures diagnostic as well as therapeutic. If a carefully targeted block relieves your pain, it tells us the pain is coming from that exact structure. If it doesn't, that's valuable information too — it rules a source out and redirects the plan. Either way, you aren't guessing, and neither are we.

Just as important is who holds the needle. Your procedures are performed by a dual board-certified spine surgeon and neurosurgeon who understands the full three-dimensional anatomy of the spine and the nerves that travel through it. That depth of training informs where he treats, how he interprets your response, and — if a procedure points toward a structural problem — what the next step should be. Interventional care at a surgical practice means the person treating your pain also understands exactly what's causing it.

What to Expect — From Consultation to Procedure

Good pain care starts with an accurate diagnosis, not a prescription pad. Here's how the process works at Desert Spine and Pain:

• Consultation & imaging review. Dr. Greenwald listens to your history, examines you, and reviews your MRI, CT, or X-rays to identify the most likely source of your pain.
• A targeted recommendation. You'll hear which specific procedure fits your diagnosis and why — and whether a diagnostic block should come first to confirm the source.
• The procedure. Most are quick, outpatient procedures performed in-office or at our accredited affiliated facility, using local anesthesia and live imaging. Many take only about 15 to 30 minutes.
• Review & next steps. We track how you respond, because your response guides the plan — whether that means repeating a procedure that worked, trying a longer-lasting option, or, rarely, discussing a surgical solution.

Recovery & Aftercare

One of the biggest advantages of interventional pain procedures is how little they interrupt your life. Most are performed on an outpatient basis, and the large majority of patients go home the same day and return to normal activity the same or next day. You may be asked to take it easy for the rest of the day and to arrange a ride home if you received sedation, but there's no long hospital stay and no extended downtime.

How quickly you feel relief — and how long it lasts — depends on the procedure and your condition. Some injections bring relief within a few days as inflammation settles; a treatment like radiofrequency ablation can take a couple of weeks to reach its full effect but often lasts many months and can be repeated. You'll leave with clear aftercare instructions and a plan for follow-up, and we'll adjust course based on how you respond rather than guessing. For some patients, a procedure pairs well with physical therapy to extend and build on the relief.

Insurance, Out-of-Network & Cost

We welcome out-of-network patients of every kind, and you don't need a referral to be seen. Our team verifies your benefits and explains any out-of-pocket costs up front — before anything is scheduled — so there are no surprises. Because many of our patients come to us after a car accident or work injury, we also coordinate closely with personal-injury attorneys and offer 24/7 concierge support for accident-related pain care, so documentation and billing don't become one more thing you have to manage while you're hurting.

Proudly Serving the Greater Phoenix, Arizona Area

Why Choose Our Pain Management Specialists in Phoenix

Your procedures are performed by a specialist who is both a board-certified spine surgeon and a neurosurgeon — rare among pain practices, and a real advantage when precision and the option to escalate matter. We welcome out-of-network patients, require no referral, and partner closely with personal-injury attorneys for accident-related pain.

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Interventional Pain Management: Frequently Asked Questions