Back Pain? Nerve Block May Not Help: Study
By Kathleen Doheny
Originally published by Reuters Health, August 20, 2002
SAN DIEGO (Reuters Health) — Nerve blocks, commonly given to patients with low back pain, don't seem to reduce pain, improve mood or cut the use of analgesic medications, a researcher reported here Monday at the 10th World Congress on Pain.
Nerve blocks are often recommended for both acute and chronic low back pain, but long-term studies of the blocks are scarce, according to Steven H. Sanders, program director in the psychology department at the Siskin Hospital for Physical Rehabilitation in Chattanooga, Tennessee.
"We wanted to see whether (the blocks) made any difference," he said. So he evaluated two groups: 30 patients with low back pain who received the blocks and 30 with low back pain who did not.
The blocks, called lumbar sympathetic nerve blocks, are so called because they are injected into the area surrounding sympathetic nerves in the lower back. Most contain either local anesthetic or local anesthetic with corticosteroid drugs. Sanders used blocks with anesthetic alone.
Both study groups had the same treatment plan except for the blocks. The plan included physical therapy three times a week, medical visits twice a week and psychological visits for 6 weeks, with three follow-up visits over 6 months. The block group had three to six blocks. The subjects in the block and nonblock groups were matched as far as age, gender, duration of pain (which ranged from 2 to 4 years) and previous back surgery. The patients ranged in age from 43 to 56 years.
At the end of 6 months, the patients who received blocks did no better than those who did not get blocks in terms of pain, reduced use of pain medication, mood and other parameters.
The blocks did drive up treatment costs—from an average of $4,500 per patient in the group without blocks to $5,900 for the patients who got blocks.
What it boiled down to, Sanders explained, is "a lot of expense, but no clinical benefits. You have to wonder why you do these (blocks).
"The rationale has been, give (back pain) patients blocks and help them get through physical therapy and it might have a cumulative effect," Sanders said. "That's what you hear all the time. But it is not true, not for this group."
