Table of ContentsView AllTable of ContentsBenefitsDrawbacksWhat to ExpectSide EffectsAlternatives
Table of ContentsView All
View All
Table of Contents
Benefits
Drawbacks
What to Expect
Side Effects
Alternatives
Ultrasound-guided injections allow healthcare providers to see the needle in real-time as it enters the body and is injected into a precise spot.Orthopedic surgeonsoften use injections to treat a variety of conditions. Commonly injected medications includecortisone,local anesthetics, and joint lubricants such as hyaluronic acid.
In some cases, delivering an injection is not as easy as it sounds. Some require you to hit the target just right, often with the slimmest margin of error. Ultrasound-guided injections reduce the risk of errors or complications during such injections.
This article explains the pros and cons of ultrasound-guided injections. It touches on how the procedure is done, why it is controversial, and alternative methods available.
Slobodan Vasic / Getty Images
What Are the Benefits of Ultrasound-Guided Injections?
Ultrasound-guided injections are valuable for healthcare providers for several reasons. The use of ultrasound imaging allows providers to:
Ultrasound is beneficial both for healthcare providers and their patients because it:
There is clear evidence that ultrasound-guided injections provide superior pain relief and a faster recovery compared to injections made without image guidance. The treatment’s success is largely due to its accuracy.
Are Ultrasound-Guided Injections Painful?Ultrasound-guided injections can be painful since they involve placing a needle through the skin and into a joint, muscle, bursa, or other structure. The injection is not any more painful than a non-ultrasound-guided injection, though. In some cases, it may even be less painful than a traditional injection because the needle can be placed more accurately.
Are Ultrasound-Guided Injections Painful?
Ultrasound-guided injections can be painful since they involve placing a needle through the skin and into a joint, muscle, bursa, or other structure. The injection is not any more painful than a non-ultrasound-guided injection, though. In some cases, it may even be less painful than a traditional injection because the needle can be placed more accurately.
What Conditions Do Ultrasound-Guided Injections Treat?
Ultrasound-guided injections are used to treat a variety of conditions related to themusculoskeletal system, including joints, muscles, tendons, nerves, and the fluid-filled sacs that cushion joints (bursae).
The technique is commonly used to treat:
Injections ofbotulinum toxin(botox) are sometimes done using ultrasound guidance, as well as aspirations (retrievals) of various tissues, including breast and liver tissues, forneedle biopsy.
What Are the Drawbacks of Ultrasound-Guided Injections?
There has been an ongoing debate as to whether ultrasound-guided injections are worth all the fuss. Much of the dissent comes from insurers and private payers who cite two main objections:
While there is some validity to these points, the fact remains that certain types of injection procedures are more challenging than others. Not to mention, differences in human anatomy can further complicate procedures, particularly in people with certain musculoskeletal conditions.
For example, delivering a lumbar puncture is especially challenging in people with conditions likeankylosing spondylitis, which causes spinal vertebrae to fuse. Ultrasound guidance allows providers to find a safe path for the needle through complex and abnormal spinal anatomy. This, in turn, dramatically reduces the risk of puncturing unintended tissues or structures.
What to Expect From Ultrasound-Guided Injections
Ultrasound-guided injections are performed much in the same way as traditional injections. To ensure the images come in clear, an ultrasound gel will be applied directly to the skin. The gel acts as a conductive medium that creates a tight bond between the skin and the ultrasound probe. This ensures the reflected sound waves have minimal interference.
The probe, also known as a transducer, is then placed near or adjacent to the targeted tendon or joint. Once the healthcare provider has identified the anatomic landmarks on the monitor, the injection will be delivered using a standard needle and syringe.
The ultrasound also allows you to visualize fluids so that you can see if the medication is being distributed exactly where you need it to be.
How Long Does an Ultrasound-Guided Injection Take?
Ultrasound-guided injections should not take much longer than traditional injections. In many cases, ultrasound-guided injections take less time and eliminate the need for multiple attempts (in people with more complicated anatomy).
Generally, ultrasound-guided injections should not take longer than one hour to complete. This includes the time it takes to:
Keep in mind that certain procedures may take longer than others, particularly if you have unique anatomical features due to an underlying musculoskeletal condition.
Recovery
Recovery can vary somewhat depending on the procedure, so you will need to follow your healthcare provider’s instructions closely. Your provider may instruct you to:
Your pain may take a couple of weeks to improve, and your joint pain may feel worse the day after the injection (steroid injections only). You can takeTylenolto help with the pain.
As with a kind of injection or open wound, it’s important to monitor the injection site forsigns of infection. Call your healthcare provider if you develop:
What are the Side Effects of Ultrasound-Guided Injections?
Although uncommon, side effects and risks associated with injections include:
Different procedures also come with their own, distinct risks. Be sure to ask your healthcare provider about the risks associated with any procedure they prescribe.
Alternative Procedures
Computed tomography (CT) scanners are commonly used for some guided injections like nerve blocks and typically involve the use of contrast dye to monitor needle insertion. However, research shows that ultrasound may be just as effective as CT scanners for certain injections, minus the risk of radiation.
Summary
Ultrasound-guided injections provide pain relief in a number of conditions, including arthritis, pinched nerves, and bursitis. Compared to traditional injections, ultrasound-guided injections tend to take less time and are more effective, as the procedure allows for more precision. Most ultrasound-guided injections take less than an hour to complete. The risk of side effects varies somewhat depending on the procedure, but overall, it’s low.
While ultrasounds are a great alternative to other imaging modalities, they may not be right in every case. If you have questions about ultrasound-guided injections, talk to your healthcare provider.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sahu AK, Rath P, Aggarwal B.Ultrasound-guided injections in musculo-skeletal system - an overview.J Clin Orthop Trauma. 2019 May;10(4):669-673. doi:10.1016/j.jcot.2019.05.013Daniels E, Cole D, Jacobs B, Phillips S.Existing evidence on ultrasound-guided injections in sports medicine.Orthop J Sports Med. 2018 Feb;6(2):2325967118756576. doi:10.1177/2325967118756576Aetna.Ultrasound guidance - selected indications.Huang C, Li J, Guo Y, et al.Ultrasound-assisted lumbar puncture with a horizontal and perpendicular paramedian approach based on positioning in patients with abnormal spinal anatomy: A case report and technical description.BMC Anesthesiol. 2023 Dec;23(1):410. doi:10.1186/s12871-023-02368-7UCSF.Ultrasound guided musculoskeletal/neuro injections.Ye L, Wen C, Liu H.Ultrasound-guided versus low dose computed tomography scanning guidance for lumbar facet joint injections: same accuracy and efficiency.BMC Anesthesiol. 2018 Nov;18(1):160. doi:10.1186/s12871-018-0620-7
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sahu AK, Rath P, Aggarwal B.Ultrasound-guided injections in musculo-skeletal system - an overview.J Clin Orthop Trauma. 2019 May;10(4):669-673. doi:10.1016/j.jcot.2019.05.013Daniels E, Cole D, Jacobs B, Phillips S.Existing evidence on ultrasound-guided injections in sports medicine.Orthop J Sports Med. 2018 Feb;6(2):2325967118756576. doi:10.1177/2325967118756576Aetna.Ultrasound guidance - selected indications.Huang C, Li J, Guo Y, et al.Ultrasound-assisted lumbar puncture with a horizontal and perpendicular paramedian approach based on positioning in patients with abnormal spinal anatomy: A case report and technical description.BMC Anesthesiol. 2023 Dec;23(1):410. doi:10.1186/s12871-023-02368-7UCSF.Ultrasound guided musculoskeletal/neuro injections.Ye L, Wen C, Liu H.Ultrasound-guided versus low dose computed tomography scanning guidance for lumbar facet joint injections: same accuracy and efficiency.BMC Anesthesiol. 2018 Nov;18(1):160. doi:10.1186/s12871-018-0620-7
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sahu AK, Rath P, Aggarwal B.Ultrasound-guided injections in musculo-skeletal system - an overview.J Clin Orthop Trauma. 2019 May;10(4):669-673. doi:10.1016/j.jcot.2019.05.013Daniels E, Cole D, Jacobs B, Phillips S.Existing evidence on ultrasound-guided injections in sports medicine.Orthop J Sports Med. 2018 Feb;6(2):2325967118756576. doi:10.1177/2325967118756576Aetna.Ultrasound guidance - selected indications.Huang C, Li J, Guo Y, et al.Ultrasound-assisted lumbar puncture with a horizontal and perpendicular paramedian approach based on positioning in patients with abnormal spinal anatomy: A case report and technical description.BMC Anesthesiol. 2023 Dec;23(1):410. doi:10.1186/s12871-023-02368-7UCSF.Ultrasound guided musculoskeletal/neuro injections.Ye L, Wen C, Liu H.Ultrasound-guided versus low dose computed tomography scanning guidance for lumbar facet joint injections: same accuracy and efficiency.BMC Anesthesiol. 2018 Nov;18(1):160. doi:10.1186/s12871-018-0620-7
Sahu AK, Rath P, Aggarwal B.Ultrasound-guided injections in musculo-skeletal system - an overview.J Clin Orthop Trauma. 2019 May;10(4):669-673. doi:10.1016/j.jcot.2019.05.013
Daniels E, Cole D, Jacobs B, Phillips S.Existing evidence on ultrasound-guided injections in sports medicine.Orthop J Sports Med. 2018 Feb;6(2):2325967118756576. doi:10.1177/2325967118756576
Aetna.Ultrasound guidance - selected indications.
Huang C, Li J, Guo Y, et al.Ultrasound-assisted lumbar puncture with a horizontal and perpendicular paramedian approach based on positioning in patients with abnormal spinal anatomy: A case report and technical description.BMC Anesthesiol. 2023 Dec;23(1):410. doi:10.1186/s12871-023-02368-7
UCSF.Ultrasound guided musculoskeletal/neuro injections.
Ye L, Wen C, Liu H.Ultrasound-guided versus low dose computed tomography scanning guidance for lumbar facet joint injections: same accuracy and efficiency.BMC Anesthesiol. 2018 Nov;18(1):160. doi:10.1186/s12871-018-0620-7
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