Challenges in establishing the epidemiology of adverse events associated with interventional therapies for chronic pain

Abstract

Objectives. This paper aims to examine the current state of knowledge about adverse events associated with interventional pain techniques. Methods. This paper reviews the available databases on risk from sources such as closed claim analysis, peer review, and published literature; and also examines risk stratification for pain practitioners, the current state of malpractice insurance, and the procedures that are considered to have elevated risk. Conclusions. Substantial neurological sequelae can occur from interventional pain techniques. Considering the growing number of physicians who perform these procedures the actual occurrence of these problems appears to be low. The incidences of complications are difficult to correctly identify based on limitations of reporting and data analysis. The author recommends a national data bank be created to allow better monitoring and self assessment of the specialty of pain medicine. This information could be used to improve outcomes, reduce risk, and change clinical practice. © 2008 by American Academy of Pain Medicine.