Ask The Experts: Managing Pain With Neurodesctructive Therapy


Dr. Sunil Panchal, M.D. explains what Neurodestructive Therapy is, and how it nullifies pain signals.

Q: I’ve read that neurodestructive techniques can manage pain. What are the pros and cons?

The term neurodestructive sounds pretty scary. But it’s just a method of interrupting the nerve pathways responsible for your pain by cutting, freezing or burning the nerves, or by injecting chemicals like alcohol into them. The benefits are long-term relief, less need for medication and fewer medication-related side effects. These techniques have been around for decades and they’re quite safe; a simple outpatient procedure is usually done using very thin needles inserted with the help of X-rays, so there is very low risk of bleeding, infection, allergic reaction or accidental nerve damage.

Each method of interruption has advantages based on the nerves being targeted. For example, if you have abdominal pain, the best method is to inject alcohol into the celiac plexus, a network of nerves in your belly; that allows the alcohol to spread to all the nerves in that area. But if a physician needs to interrupt the nerves in a precise area, like a joint in your spine, a better choice is radiofrequency, which allows the physician to control the size of the treatment area.

Sensory nerves that carry pain signal– but aren’t close to other nerves responsible for critical functions like mobility make the best candidates for neurodestruction. Keep in mind that nerves do tend to grow back over time, usually after a year or so. If your pain returns it’s perfectly safe to repeat the treatment.


Sunil Panchal, M.D., president of the National Institute of Pain, in Lutz, Florida and of the Coalition for Pain Education (COPE) Foundation

Pain Solutions Magazine, Spring 2010
Photo credit: Vladacanon at

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