Fluoroscopic guided injections: how technology delivers safer pain relief treatment

Written by: Dr Yasser Mehrez
Published: | Updated: 02/10/2023
Edited by: Cameron Gibson-Watt

Pain medicine is one of the fastest-growing medical specialties. This is due to the fact that pain is now recognised as a condition in its own right that requires treatment. The advancement in technology has helped in the development of new techniques and equipment to deliver pain relief interventions, such as fluoroscopic guided injections.

Dr Yasser Mehrez, a leading consultant in pain medicine, explains how the use of fluoroscopy has considerably helped to deliver safer injections to alleviate pain.

What is a fluoroscopic guided injection?

Injection treatments have been widely used to relieve long-term chronic pain. This includes spinal injections to relieve spinalvisceral and various body pains. There are also injections and interventions to help with joint pain and soft tissue conditions.

Fluoroscopy is a type of medical imaging that produces images similar to an X-ray. The idea of using fluoroscopy started years ago to help the practitioner to safely confirm the intended location of their injections. These images can be dynamic to allow live monitoring of a procedure or still images to confirm that the target area has been successfully treated.

Using fluoroscopy has significantly helped to deliver safer treatments and reduce the overall risks involved. Because of this, interventions in pain medicine have significantly increased with more successful results. Most interventional pain procedures are currently done under fluoroscopy.


What type of treatments can I receive?

A fluoroscopic guided injection involves injecting medicine directly into an area of the body, such as joints, muscles and around major nerves. So, it’s possible to perform many types of interventions and injection treatments. Some of the procedures include:

  • Radiofrequency denervation of the lumbar, thoracic or cervical facet and sacroiliac joints
  • All forms of epidural injections
  • Sympathetic nerve ablation
  • Pulsed radiofrequency of the spinal nerves and knee, hip, wrist and shoulder joints.

Such treatments can significantly help with spinal, arm, leg, joints and nerve type pains.


How are the injections performed?

The patient would be positioned on a special X-ray compatible table in an operating theatre. The area of the body to be treated would be examined and then imaged using the C-shaped fluoroscopy device.

To make the procedure more comfortable for patients, we use local anaesthesia to numb the skin and intravenous sedation to provide a more comfortable experience for the patient.

We use X-ray guidance (fluoroscopy) to direct a very small needle into the targeted area. Once the correct position is confirmed, the medicine is injected, other nerve treatments can be applied and the needle is then removed.

Following injection treatments, the patient is observed in the recovery area for a short period to make sure that they have adequately recovered following the injection. After that, they can go home accompanied by a family member or friend.


How long do I have to rest afterward?

Most patients can resume usual activities on the following day. However, some patients can resume activities immediately following injection treatment as per the practitioner’s advice.



Dr Yasser Mehrez is a leading consultant in pain medicine, anaesthesia and intensive care based in Milton Keynes. To make an appointment with him, visit his Top Doctors profile today.

By Dr Yasser Mehrez
Pain medicine

Dr Yasser Mehrez is a leading consultant in pain medicine, anaesthesia and intensive care. He currently practices at his NHS and private clinic in Milton Keynes where he treats all types of chronic pain using advanced techniques such as fluoroscopic and ultrasound guided interventional pain management procedures. Dr Mehrez leads a team of clinicians, psychologists, physiotherapists and nurses to deliver a high standard multidisciplinary pain service to his patients.

He has a special interest in treating back, neck, joint and facial pain, post-surgical scar pain, neuropathic pain and cancer pain using minimally invasive procedures. These include epidural injections, pulsed radiofrequency treatments, neuromodulation, removal of epidural adhesions and many more. Dr Mehrez ensures his patients receive the best long-term pain relief using a range of sophisticated medicines and techniques.

Dr Mehrez spent most of training in major institutions. He has gained extensive experience in pain medicine including multidisciplinary planning through working closely with other specialties. For example he has started joint clinics with the spinal surgical team,  joint efforts with urology teamed also primary care teams to allow the patient to clear understanding of their treatment options and to access the agreed line of treatment in timely manner. Dr Mehrez uses up to date treatments and technology to help his patients to benefit from advances in the growing specialty of pain medicine.

Dr Mehrez was trained at South Thames School in London; he spent a year at Guy’s and St Thomas' Hospital Pain Management Centre practicing the most advanced techniques in neuromodulation and pain management. He now works as a Lead Clinician at Milton Keynes University Hospital NHS trust, at his private clinic and teaches as an honorary clinical lecturer at the University of Buckingham Medical School. He is also a professional member of the Neuromodulation Society of the United Kingdom and Ireland, The British Pain Society and the International Association for the Study of Pain.

He is actively involved in the day-to-day running and strategic planning for the pain services in Milton Keynes. He is continuously involved in planning and redesigning the pain service in the area by advising, communicating and educating the services in the community. He is also in charge of monitoring pilot community pain services and introduced patient information booklets and various leaflets currently used at the clinic. He's actively involved in the education of his junior colleagues, general practitioners, nursing staff and most importantly, his patients.

For information leaflets on individual treatments, please use the search function on the Royal College of Anaesthetists website (link in websites below).

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