Interest of ultrasounds in chronic pain syndrome management

Recently, there has been significant interest in the utilization of ultrasound for chronic pain management procedures. Traditional visualization techniques for these procedures include fluoroscopy and computed tomography, and even MRI. With fluoroscopic guided procedures, the initial extrapolation of the position of soft tissues (i.e. muscles, blood vessels, and nerves) is based on their anatomic relationship to viewed bony structures. The interest in the use of ultrasound for chronic pain management procedures has grown from certain visualization advantages including the ability to see muscle layers, nerves and blood vessels. Ultrasound allows for the elimination or reduction of radiation exposure for both the patient and physician. Additionally, real time needle advancement can be visualized with ultrasound, as well as the diffusion of the injected solution. Limitations to current ultrasound technology exist, - i.e acoustic shadow artefact, narrow image windows - which result in the inability to view structures deep to bony obstruction, but techniques are rapidly progressing, allowing to extend and increase the indications in the field of pain medicine.