Ultrasound in pain and musculoskeletal interventions: A nation-wide survey of practicing pain physicians

Abstract

Background: Conventionally, fluoroscopy has been used by Pain Physicians to perform minimally invasive pain and spine interventions. In recent times, the use of ultrasound (US) in interventional pain management (IPM) has increased significantly. However, there is no Indian data with regard to US use for IPM. Hence, the musculoskeletal (MSK) pain special interest group (SIG) of the Indian Society for Study of Pain (ISSP) decided to conduct a survey among Indian Pain Physicians to get an insight into various aspects of US in IPM. Materials and Methods: The MSK Pain SIG of ISSP developed the questionnaire, and the same was sent to ISSP members with an active E-mail ID. The questionnaire was mainly about US availability at the workplace, training received for US-guided IPM, barriers to US use, and suggestions to improve widespread US use. Results: The response rate was only 15% (176 out of 1160 physicians responded). The majority (69.3%) of the respondents used both US and fluoroscopy and the US machine was available in 76.1% pain clinics. Over three-fourth reported that they have received training for US-guided IPM. Only half of the participants expressed that they received US training during pain fellowships. Barriers for US use included lack of formal teaching/training of US, availability of US machine, and preconception and prenatal diagnostic techniques (PCPNDT) act. The future strategy includes taking measures for US availability for pain physicians, mandatory US training during fellowships and regular workshops. Conclusion: This first-of-its-kind survey provides many valuable insights on US availability, barriers, and future suggestions. ISSP can consider joint collaboration with other organizations on dilution of existing law and take measures to improve US training and its widespread use.