Pain is the common denominator of many medical conditions, and it can adversely affect a person’s quality of life. Apart from physical discomfort and disruption to daily activities such as sleeping and eating, pain often leads to emotional distress. Above all, pain that is not well controlled can develop into chronic pain.
Compared to conventional landmark or palpation techniques for injection medications, ultrasound greatly improves the accuracy of these injections to target areas such as nerve, muscle, tendon and ligament. As these structures are radiolucent and not seen under fluoroscopy (X-rays), the use of traditional fluoroscopic-guided techniques to guide these injections has its limitations.
Ultrasound guidance of infiltrations in the management of chronic pain allows the physician to make visual the advance of the needle and the diffusion of the analgesic agent in and around the pain-generating region. Besides precision, ultrasound guided injections are also safer since important structures such as blood vessels can be identified and avoided to prevent intravascular puncture and other complications. In recent years, there has been an increased use of ultrasound-guided injection techniques – such as stellate ganglion block, piriformis muscle injection, pudendal nerve block, intercostal nerve block, facet joint injections and deep trigger point injections – to relieve chronic pain.
The portability of the ultrasound machine also means that some of these procedures can be done at an outpatient clinic instead of a hospital, which brings cost savings without compromising the quality of treatment. However, ultrasound is not suitable for certain chronic pain interventions such as intradiscal procedures. With the numerous research journals that acknowledge the efficacy of ultrasound-guided procedures as well as strong recommendations from both doctors and treated patients, the use of ultrasound to guide chronic pain injections could become a common practice in the near future.