The paraspinal muscles of the cervical, thoracic, and lumbar spine are important pain generators because muscle strains or myofascial pain syndrome caused by trigger points are common during clinical practice. Ultrasonography is the most convenient imaging tool for evaluating these muscles due to its advantages, such as providing good delineation of soft tissues, easy accessibility, and zero radiation. Additionally, ultrasound can serve as a useful guiding tool for paraspinal muscle intervention to prevent inadvertent injuries to vital axial neurovascular structures. This pictorial essay presents ultrasound scanning protocols for the paraspinal and other associated muscles as well as a discussion of their clinical relevance. Axial magnetic resonance imaging has also been used to elucidate reciprocal anatomy. In conclusion, ultrasound imaging proves to be a valuable tool that facilitates the differentiation of individual paraspinal muscles. This capability significantly enhances the precision of interventions designed to address myofascial pain syndrome.

Center for Regional Anesthesia and Pain Medicine Wang Fang Hospital Taipei Medical University Taipei 11600 Taiwan

Department of Medical Imaging National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan 704302 Taiwan

Department of Physical and Rehabilitation Medicine Hacettepe University Medical School Ankara 06100 Turkey

Department of Physical Medicine and Rehabilitation Chi Mei Medical Center Tainan 71004 Taiwan

Department of Physical Medicine and Rehabilitation College of Medicine National Taiwan University Taipei 10048 Taiwan

Department of Physical Medicine and Rehabilitation National Taiwan University Hospital Bei Hu Branch Taipei 10845 Taiwan

Department of Physical Medicine and Rehabilitation Taipei Hospital Ministry of Health and Welfare Taipei 24213 Taiwan

Department of Rehabilitation Medicine 1st Faculty of Medicine and General University Hospital Prague Charles University 12800 Prague Czech Republic

Institute of Public Health National Yang Ming Chiao Tung University Taipei 11221 Taiwan

Jolly Clinics Kaohsiung 80232 Taiwan

Physical and Rehabilitation Medicine Unit Department of Biomedical and Neuromotor Science Istituto di Ricovero e Cura a Carattere Scientifico Rizzoli Orthopedic Institute 40136 Bologna Italy

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Integrating Ultrasound-Guided Injections and Peripheral Magnetic Stimulation in Chronic Myofascial/Lumbar Pain