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Nerve Blocks Help Back Pain Patients Avoid Surgery

Injection of a numbing agent in the lumbar spine is one way to treat chronic pain from lumbar radiculopathy. Radiculopathy refers to low back pain that travels to the buttocks and/or down the leg. It may be accompanied by other symptoms such as numbness and weakness. The symptoms are caused by irritation of the spinal nerve root.

Nerve root blocks in the lumbar spine can even be used to help patients avoid surgery for this problem. This report is the second part of a previous study. In the first study, a group of patients were given injections of either a local anesthetic (bupivacaine) or bupivacaine combined with a steroid (betamethasone). All patients included in this study had symptoms of lumbar radiculopathy caused by a herniated disc or spinal stenosis.

Five years later, 21 of the 55 patients in the original study had successfully avoided surgery. They all had reduced symptoms of back and leg pain, numbness, and weakness.

The authors report no difference in results between those who had a nerve block with bupivacaine alone and those who had the combined bupivacaine and betamethasone injection. Patients with a herniated disc had greater relief of their back pain compared to the spinal stenosis group.

The results of this study show that for many people, nerve root blocks provide more than just temporary relief from back pain and other symptoms. Injections of a local anesthetic may be all that's needed for a permanent effect. Lumbar nerve root blocks are therefore advised as a first step before surgery. Patients with lumbar radiculopathy due to a herniated disc or spinal stenosis may be able to avoid surgery with a lumbar nerve block.


Daniel Riew, MD, et al. Nerve Root Blocks in the Treatment of Lumbar Radicular Pain. In The Journal of Bone and Joint Surgery. August 2006. Vol. 88-A. No. 8. Pp. 1722-1725.

08/31/2006

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