title: Ultrasound indications for chronic pain management: an update on the most recent evidence.
abstract: OBJECTIVE
  The ability of ultrasound to provide detailed anatomic visualization while avoiding radiation exposure continues to make it an appealing tool for many practitioners of chronic pain management. This review will present the most recent evidence regarding the use of ultrasound-guidance for the performance of interventional procedures in the treatment of chronic pain.
  
  
  RESULTS
  For a variety of different procedures, studies continue to compare ultrasound-guided techniques to commonly used fluoroscopic or landmark-based techniques. Small, randomized controlled trials are beginning to demonstrate that ultrasound-guided approaches to interventional pain procedures can be as well tolerated and effective as the traditionally used techniques, while providing some potential advantages in terms of decreased radiation exposure, avoidance of vascular structures, and in some cases, improved efficiency and decreased rates of adverse effects.
  
  
  CONCLUSIONS
  Despite continued interest in ultrasound-guided techniques for chronic pain management procedures, the evidence is still limited mainly to small, randomized trials and case series. For some procedures, such as stellate ganglion block and peripheral joint injections, recent evidence appears to be tilting in favor of ultrasound-guidance as the preferred technique, though fluoroscopy continues to be a much more reliable method for detection of intravascular uptake of injectate.
authors.affiliation: aDepartment of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois, USA bDepartment of Anesthesiology, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Perrine
authors.forename: Gina
authors.initials: G
authors.lastname: Votta-Velis
authors.forename: Alain
authors.initials: A
authors.lastname: Borgeat
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000294:innervation; D059350:Chronic Pain / Q000188:drug therapy*; D005471:Fluoroscopy; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000294:innervation; D009407:Nerve Block / Q000379:methods* / Q000639:trends; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging / Q000294:innervation; D013126:Spinal Nerve Roots / Q000187:drug effects; D013233:Stellate Ganglion / Q000187:drug effects; D018084:Ultrasonography, Interventional / Q000706:statistics & numerical data* / Q000639:trends
chemical_list: D000779:Anesthetics, Local