Effectiveness of Ultrasound-guided Spinal Accessory and Dorsal Scapular Nerve Fascial Plane Intervention in Chronic Upper Back Myofascial Pain: A Prospective Observational Study

Abstract Background: Chronic upper back myofascial pain usually does not respond well to conventional treatments. This study evaluates the effectiveness of fascial plane interventions targeting spinal accessory and dorsal scapular (SADS) nerves using ultrasound (US) in alleviating pain and reducing analgesic usage. Materials and Methods: Twenty participants who were suffering from chronic upper thoracic myofascial pain were included in this prospective observational study. Participants underwent a US-guided SADS nerve fascial plane intervention. This procedure was categorized as a minimally invasive pain and spine intervention. Pain levels (numerical rating scale [NRS]), functional recovery (Global Perceived Effect [GPE]), and the level of prescribed drugs (Medication Quantification Scale [MQS]) were evaluated before the procedure, immediately after, and at 1 and 3 months postoperatively. Results: Mean NRS values demonstrated a statistically significant decrease from 6.9 ± 0.91 preoperative value to 2.2 ± 1.15 postoperative, 2.3 ± 2.51 at 1 month, and 2.55 ± 2.52 at 3 months ( P < 0.001). The greater part of the patients (70%) reported “very much” or “much improved” at 3 months according to GPE scores. Moreover, MQS showed a decline from 22.6 ± 2.01 to 6.95 ± 9.60 at the 3-month follow-up. There were no serious complications noted. Conclusion: Fascial plane interventions targeting SADS nerves under US guidance appear to provide significant reduction of pain, improvement of functional outcome, and reduction of analgesic consumption in chronic upper back myofascial pain patients. Further randomized controlled trials are needed to validate these findings.