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Ultrasound-Guided Nerve Block for Chronic Pain

Sonographic anatomy and real-time visualization in interventional pain management

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Radyoloji department. Book Appointment →

What is Ultrasound-Guided Nerve Block for Chronic Pain?

Ultrasound (US) is the preferred modality for nerve blocks because it provides real-time visualization of the target nerve, surrounding vascular structures, pleura, peritoneum, and the needle tip. High-frequency (linear, 7-15 MHz) probes are used; nerve fascicular structure (honeycomb appearance) is detected. Compared to fluoroscopy and 'blind' techniques, sonographic guidance reduces complication rates by 60-70% and shortens the procedure duration.

Common indications include: trigeminal/sphenopalatine block (atypical facial pain), cervical-thoracic-lumbar facet/medial branch block, suprascapular block (shoulder pain), genicular block (knee osteoarthritis), pudendal block (chronic pelvic pain), and ilioinguinal/iliohypogastric block (postsurgical pain).

Diagnostic blocks require local anesthetic (1-2 mL bupivacaine 0.5%) only, while therapeutic blocks add steroid (depo-methylprednisolone 40-80 mg or triamcinolone 20 mg). Pulsed/conventional radiofrequency or chemical neurolysis (alcohol/phenol) are options in resistant cases.

Symptoms

Chronic pain over 3 months
Pain not responsive to medical treatment
Localized neuropathic pain
Failed back surgery syndrome
Cancer pain (palliative)
Allodynia and hyperalgesia

Risk Factors

Coagulopathy or anticoagulant use
Local infection (block site)
Anatomic variations (post-surgical)
Difficult access in obese patients
Allergy (local anesthetic)
Severe psychiatric comorbidity

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent localized pain over 3 months
  • Failure of NSAIDs and physical therapy
  • Insufficient response to high-dose opioids
  • Severe quality-of-life impairment
  • Suspected nerve entrapment syndrome

Treatment Methods

01
Ultrasound-guided diagnostic nerve block (local anesthetic only)
02
Therapeutic block (local anesthetic + steroid)
03
Pulsed radiofrequency (in continued response)
04
Chemical neurolysis (cancer pain)
05
Multidisciplinary pain management approach
06
Physical therapy and cognitive behavioral therapy combination

Which Department to Visit?

You can visit our Radyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.