Ultrasound in Acute and Chronic Pain Medicine

Ultrasound is becoming popular in anaesthetic practice because of numerous advantages. Its introduction in pain medicine is recent and its use is growing. It allows the identification of soft tissues, vessels and nerves, without the risk of radiation. The additional advantages in pain medicine are avoidance of repeated radiations and ease of use in outpatient clinics, thus saving time and decreasing work load on interventional theatres. Ultrasound has multiple applications in pain medicine. It finds use in providing acute pain relief in the form of peripheral nerve blocks. In chronic pain, possible applications include blocks of cervical and lumbar facet joints, stellate ganglion block, intercostal nerve blocks, blocks of painful stump neuromas, caudal epidural injections and injections of trigger or tender points. The nerves can be visualised directly, thus helping in destructive processes like cryoanalgesia, radiofrequency lesioning and chemical neurolysis. The disadvantages are loss of resolution for deep-seated structures and lack of controlled trials. The article presents a review of ultrasound usage in acute and chronic pain interventional procedures.