Review article: is ultrasound guidance advantageous for interventional pain management? A systematic review of chronic pain outcomes.

BACKGROUND Modern ultrasound (US) is an attractive alternative to anatomical landmark-, nerve stimulation-, and fluoroscopic-guided techniques for interventional procedures performed to treat chronic pain syndromes. METHODS In this review, we evaluated the effects of US guidance compared with traditional guidance techniques on performance, efficacy, and safety outcomes for interventional chronic pain procedures. We identified 46 studies, including 41 case series and 5 randomized trials of intermediate-to-good quality that investigated the use of US guidance for a diverse variety of chronic pain procedures. RESULTS Our results suggest that US guidance can match or improve performance- and safety-related outcomes compared with many anatomic landmark-, nerve stimulation-, and fluoroscopic-guided techniques for treating chronic pain. CONCLUSIONS There are presently insufficient data to support improved efficacy with procedures performed with US guidance for relieving both short- and long-term chronic pain.