Ultrasound-Guided MSK Injections: Precision Pain Management in Resource-Limited Settings

Introduction

Musculoskeletal pain (MSP) is a multifaceted clinical challenge encompassing nociceptive, neuropathic, and nociplastic pain. As a leading cause of global disability, MSP particularly burdens low and middle-income countries where access to advanced surgical care may be limited. A recent study published in Cureus highlights a transformative implementation of ultrasound-guided musculoskeletal (MSK) injections in South Trinidad, offering a scalable model for precision medicine in resource-constrained environments.

Study Overview

The research, conducted by Rampersad and Morris, details a two-year observational experience (2023–2025) in a general medical and surgical clinical setting. The project focused on the translational feasibility of ultrasound-guided interventions for 115 adult patients suffering from chronic MSP. These patients had previously experienced an unsatisfactory response to traditional oral analgesics, highlighting the need for more effective, localized treatments.

Clinical Findings and Procedural Success

The implementation focused on delivering high-precision treatments for degenerative conditions like osteoarthritis and tendinous injuries. The clinicians utilized a variety of injectable agents tailored to patient needs:

• Hyaluronic Acid (HA): Aimed at restoring joint lubrication and reducing friction.
• Platelet-Rich Plasma (PRP): Utilized for its potential in tissue regeneration and healing.
• Diluted Corticosteroids: Employed to manage acute inflammatory flares within chronic conditions.

The outcomes were clinically significant. Patients reported marked qualitative improvements in pain levels and a visible increase in physical functionality post-intervention. Remarkably, the study reported no major procedural complications, affirming that ultrasound-guided techniques can be safely integrated into standard clinical workflows outside of major hospital hubs.

Advantages in Resource-Limited Settings

In regions where advanced imaging or surgical services are scarce, ultrasound-guided MSK injections provide a vital intermediate treatment tier. The study emphasizes several key advantages:

• Radiation-Free Visualization: Unlike fluoroscopy, ultrasound offers real-time imaging without exposing patients to ionizing radiation.
• Workflow Efficiency: The portability of ultrasound allows for bedside procedures, streamlining the patient journey from diagnosis to treatment.
• Accessibility: By providing a minimally invasive alternative to surgery, it bridges the gap for patients who face financial or systemic barriers to operative care.

Conclusion

The implementation in South Trinidad serves as a proof-of-concept for the global health community. It demonstrates that with the right technical training, ultrasound-guided MSK injections are a feasible, safe, and highly effective tool for managing chronic pain. This approach not only improves individual patient quality of life but also reduces the socioeconomic burden of musculoskeletal disability in developing healthcare systems.

Source: PubMed Central