Ultrasound-guided fascial plane blocks in chronic pain: a narrative review

Recent studies have unveiled the intricate and distinctive nature of fascia, no longer regarding it solely as a muscle container. Recent research highlights its complex innervation and structure, signifying its significance in chronic pain pathways. We conducted a systematic literature search (updated on February 2024) to evaluate the role of fascial plane blocks in chronic pain treatment. All article types (randomized clinical trials, prospective and retrospective observational studies along with case reports and case series) were deemed eligible for inclusion if they referenced "fascial plane blocks" for the control of chronic pain conditions (persistent post-surgical, neuropathic, musculoskeletal-myofascial and cancer-related) and were published between 2010 and February 2024. The search revealed an increasing evidence in the literature for the implementation of fascial blocks in chronic pain management, although still heavily limited to case reports or series. With the integration of ultrasound technology and a deeper understanding of their mechanisms of action, the fascial plane blocks continue to broaden their application also in chronic pain management, as a part of a multimodal strategy or as an alternative to conventional drugs or opioids.