Why We Need Fluoroscopy and Ultrasound for Chronic Pain Management.

Although they have different functionalities, ultrasound and Fluoroscopy are both effective pain management methods for people with chronic pain. Ultrasounds focus on soft tissue like cartilage and ligaments, and fluoroscopy images the bones, and they help to treat the source of the chronic pain correctly. Fluoroscopy uses injections of hyaluronic acid containing synthetic synovial fluid to replace the naturally occurring fluid, which deteriorates over time and improves the patient’s quality of life. It is a non-evasive and nonsurgical treatment and is often practiced alongside physical therapy, an offloading brace, and a home exercise machine. Ultrasounds allow for direct visualization of nerves and blood vessels.

What is chronic pain, and what causes it? 

Unfortunately, chronic pain is more common than not and can be caused by various things, from an old injury that never healed correctly or from diseases like arthritis or cancer. However, interventive methods like spinal injections and nerve blocks can help reduce pain, and they are more readily available and accessible in recent years. The improvement of image guidance technologies has also helped get to more direct sources of the pain and see more areas of various tissue, not just bones, to help improve the patient’s quality of life. It is worth noting that facet joint injections can be done under ultrasound guidance with equivalent efficacy to fluoroscopic guidance. This is a circumstance where they act alongside each other.

What is Fluoroscopy, and what is ultrasound?

Fluoroscopy is an imaging procedure that uses several pulses of an X-ray beam to take real-time footage of bones, specifically joints, inside various parts of your body where you are experiencing pain and injury. It is helpful for chronic pain management with conditions like arthritis. The benefits include its immediacy that it is nonsurgical and not invasive.

Our joints are covered in synovial fluid, a clear, gel-like substance that provides lubrication for movement. As an example, when you have Osteoarthritis, your synovial fluid (which consists of hyaluronic acid) deteriorates. During the procedure, synthetic hyaluronic acid is injected into the patient’s joints to reduce pain, and an estimated 85% percent of patients get 80+ percent better. This simple procedure improves pain management (up to 5+ years), and side effects are rare.

Ultrasound is a physical therapy that uses heat; ultrasound waves can penetrate deep tissue reaching internal structures that other external heat sources (like a heating pad) can’t touch. For the greatest effectiveness, the tissue has to be between 104°F to 113°F for at least 5 minutes. Ultrasounds can improve cellular function by making microscopic gas bubbles near your injury and making it expand and contract rapidly, a process called cavitation.

Why choose fluoroscopy and ultrasound as your form of therapy? 

These procedures are nonsurgical, non-invasive, and low-risk, with no recovery time and long-lasting, positive effects. Both of these procedures can dramatically help with pain relief, and they are also fairly common and can be relatively inexpensive. A perk of an ultrasound machine is that it is generally portable and affordable when compared to a CT scanner and fluoroscopic machine. However, this depends on the nature of the pain that the patient is experiencing, as Fluoroscopy may still be more suitable to their specific chronic pain management needs. As pain specialists continue to improve their patient care, ultrasound will undoubtedly be incorporated more into the pain management practice. Fluoroscopy and ultrasound are a must in providing proper guided injections, and they should always be used correctly, which at TruWell, Dr. Brown does, being double board-certified and trained at Cleveland clinic.


Finding ways to manage chronic pain in a nonsurgical and not invasive manner is beneficial in preventing it from worsening over an extended period. TruWell Health offers state-of-the-art technology on-site, which includes guidance for delivering injectable treatments and a fully equipped physical therapy suite. We are fully equipped to take care of any of your pain management needs by calling our office at 727-440-5410 or alternatively using the online booking form to schedule a consultation.




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