Ultrasound in Pain Medicine: When Is It Used?
Ultrasound technology has a wide range of applications in medicine, from assessing the condition of internal organs to enabling targeted pain treatment, particularly for pain localized at trigger points. Ultrasound is a safe, non-invasive technology that helps identify the precise location of painful areas.
Trigger Point Injections
The term “trigger point” is often mentioned, but many patients don’t fully understand what it entails or the recommended treatment path and the type of specialist they should consult.
A deep, dull, aching pain that worsens with muscle tension or even psychological stress is often associated with myofascial pain. It typically arises from muscle trauma or prolonged tension, leading to the formation of myofascial trigger points (painful muscle knots). These trigger points cause discomfort in areas like the head, neck, arms, and hands.
Trigger points occur when specific muscles contract and cannot relax, which can hinder blood circulation, making the area painful. The main factors that contribute to trigger points include poor posture, recurrent stress, joint dysfunction, lack of sleep, vitamin deficiencies, muscle overuse, trauma, or untreated minor injuries. Trigger points are frequently associated with chronic pain and musculoskeletal disorders.
Although a single trigger point can cause discomfort, multiple points are often involved, affecting a larger area. To treat them, doctors may administer injections—commonly called blocks—where a mix of anesthetics and anti-inflammatory medications is injected directly into the painful areas of the muscles.
In some cases, painful muscle knots can sensitize nearby nerves, creating a sensation of pain in another part of the body. For this reason, pain specialists often use ultrasound to locate the exact source of pain before administering an injection. This method ensures that the medication is delivered precisely to the trigger point, often resulting in immediate relief.
What to Expect During the Procedure
Trigger point injections typically take just a few minutes. If several muscle points are affected, multiple injections can be administered in one visit. The injection helps restore blood flow to balance oxygen levels in the painful muscle.
Ultrasound in pain medicine is commonly used for invasive procedures in areas like the head, cervical spine, back (thoracic and lumbar regions), and the upper and lower extremities, such as the shoulder. Ultrasound aids in guiding the needle precisely to avoid nerves, arteries, or muscles, increasing the injection’s effectiveness and reducing complications. The ultrasound also shortens the procedure’s duration, allowing more time for the specialist to assess the patient’s condition and discuss potential further treatments.
However, ultrasound isn’t always necessary for trigger point injections. In some cases, a skilled pain specialist can perform the procedure accurately and comfortably without ultrasound.
Possible Complications
Trigger point injections are generally safe, but like any invasive procedure, they can come with certain risks, such as bruising, bleeding, hematoma formation, infection, and nerve injury.
The risk of pneumothorax (collapsed lung) depends on the injection site, but ultrasound guidance can help minimize this risk.
The success of the procedure largely depends on the experience of the specialist performing it, as working with ultrasound requires both experience and skill.
Post-Procedure Recommendations
Patients can resume normal activities immediately following the procedure, though they should avoid heavy lifting for at least one to two days. Within the following week, patients are advised to consult a physical therapist, who will assess their condition and suggest appropriate exercises or physical therapy to maintain proper muscle mobility and prevent the formation of new trigger points.
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