Imaging procedures such as ultrasound and X-ray are important and indispensable medical standards 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-rays and ultrasound.
Precision and safety, as well as their differentiated delivery, have been greatly improved by these imaging techniques. Some interventional pain therapy procedures could only be introduced and carried out in this way.
Due to the history of medical technology development, the focus was initially on X-rays with C-arm or CT-guided pain therapy procedures.
With the increasing development of powerful ultrasound devices with high resolution, ultrasound-guided interventional pain therapy procedures have become an indispensable part of today’s pain therapy.
It is important to note that X-ray, CT and ultrasound complement but do not replace each other, just as they do in diagnostics.
Each of these imaging procedures has its advantages and disadvantages in the respective pain therapy application.
X-ray C-arm and CT are predominantly used for interventional pain therapy procedures on the spine and joints to allow viewing through the natural bone barrier,
especially with the use of a contrast medium, and to avoid false positions during injection.
Ultrasound is the procedure of choice for interventional pain therapy in soft tissues such as perineural injections of nerves, among others, and increasingly in joints and the spine.
The possibility of controlling the flow of the injection in real time, analogous to the C-arm or CT (both with contrast medium), makes it possible to avoid false positions in blood vessels.
The use of ultrasound for interventional pain therapy in the spine and joints is an important alternative depending on the anatomical region and medical problem.
The main advantages are the avoidance of radiation exposure and the use of contrast media, as well as the dynamic image control and the flexible application at any time and any place.
Ultrasound-guided interventional pain therapy procedures can also be classified as reliable and safe in terms of hygiene.
Prerequisites for the application are the safe and competent handling of ultrasound as well as regular training and continuing education with experienced and skilled instructors.For me, the use of ultrasound in diagnostics and therapy is not only an interesting challenge, but also a fundamental enrichment of my medical skills.
Although ultrasound does not cause any radiation exposure, the radiation exposure of a C-arm-guided interventional pain therapy can be classified as low if the indication exists and it is carried out professionally.
After a thorough and medically necessary clinical, imaging and, if necessary, laboratory diagnosis, I discuss the medically possible and sensible procedure in my practice.
The preparation and implementation of an interventional pain therapy procedure is only carried out in consultation with my patients if there is an indication and if other therapies have already been carried out before without the desired therapeutic success.