Imaging techniques in interventional pain therapy

Imaging techniques such as X-ray and ultrasound are an important and indispensable medical standard in both pain diagnostics and interventional pain therapy.
The anatomical reference points, also called landmarks, were the only way to perform interventional pain therapy procedures until the introduction of X-ray and ultrasound. Precision and safety, as well as their differentiated delivery, have been greatly enhanced by these imaging modalities. Some interventional pain therapy procedures could only be introduced and performed in this way.
Due to the development of medical technology, the initial focus was on X-rays with C-arm or CT-guided pain therapy procedures.
With the increasing development of powerful ultrasound devices, ultrasound probe-guided pain therapy procedures were also possible due to their high resolution.
It should be noted that, as in diagnostics, X-ray and ultrasound complement but do not replace each other.
Each of these imaging methods has its advantages and disadvantages in the respective pain therapy application.
X-ray C-arm and CT are predominantly used for interventional pain management procedures of the spine and joints to allow viewing through the natural bone barrier, especially with the use of a contrast agent, and to avoid misplacement during injection.
Ultrasound is the procedure of choice for interventional pain management in soft tissues such as perineural nerve injections, among others. The ability to monitor the flow of the injection in real time, analogous to the C-arm (with contrast agent), allows the avoidance of false locations in blood vessels. The use of ultrasound for interventional pain therapy in the spine and joints is limited because of bone-related sound extinction.
Although ultrasound does not cause radiation exposure, the radiation exposure of C-arm-guided interventional pain therapy can be classified as low if the indication exists and the procedure is performed professionally.
After a thorough and medically necessary clinical, imaging and, if necessary, laboratory diagnosis, I discuss the medically possible and reasonable procedure in my practice. The preparation and implementation of an interventional pain therapy procedure is only carried out in consultation with my patients if other therapies have already been carried out without success or are not promising from my point of view.