The selection of candidates for interventions may be daunting. The desire to apply advanced methods to cure or manage chronic pain often outweigh clinical reasoning and sometimes contradicts the fundamental principle “do no harm”.

When the patient side of the story is critically dissected, the best way to keep with medically sound recommended approach of matching the subjective, objective and imaging to construct the diagnosis. When one of these components does not make sense, invasive methods are better to be avoided. Social problems and mental disorders respond to other strategies lying outside the operating theatre and procedure room.

Once a patient is deemed to be a candidate for intervention, the physician's expertise and qualifications became the next crucial question. No one deserves a surgeon who performed just a few operations. Hands-on training is an essential part of medical education, but it should not be done on patients. At the very least, a physician must disclose his limited experience to the patient.

Finally, when an experienced physician administers an invasive procedure, other vital elements of care must be thought out, such as education with building self-management tools, functional rehabilitation, nutrition, etc.

Interventional pain procedures are rarely successful in isolation. Physicians must avoid using invasive methods as a placebo. They should be adequately educated and train to select the best methods and apply them to patients who may benefit. Support care and ancillary services should be available to achieve better and long-lasting results.