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Neurolysis for pain management: Nerve destruction using chemicals to promote analgesia had been extensively used in the early part of the 20th century for management of pain. With the advent of newer analgesics and the development of safer techniques for pain management, its use has markedly diminished. However, recent neurodestructive techniques for pain management such as cryoablation and the use of radiofrequency lesioning resulted in a surge of interest in this method of pain relief. Unfortunately, there are no clear cut guidelines for indications, report of long term outcome, and uniformity in techniques for this type of therapeutic modality. Presently, these procedures are available as part of the management option for chronic pain and its use is usually based on the expertise of the pain specialist and the felt need of a selected group of patients. There are four methods of neurolysis:

  1. Chemical Neurolytic Blocks
  2. Cryoablative Techniques
  3. Radiofrequency Lesioning
  4. Neurosurgical Procedures

Neurolysis, or destruction of nerves either by the application of chemicals, heat, cold, or surgical disruption has gained renewed interest and is now commonly used as a tool in the management of previously recalcitrant chronic pain conditions.

However, these techniques require specialized training, in-depth knowledge of neural anatomy, and understanding of chronic pain physiology. Application of any of these techniques should be reserved for use in painful conditions where conventional conservative management has failed.

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