Short Term Effects of Medial Branch Block vs Para-spinal Injection in Muscle Patients With Non-specific Chronic Low Back Pain
Short Term Effects of Medial Branch Block vs Para-spinal Injection in Muscle Patients With Non-specific Chronic Low Back Pain
This study compares the efficacy of medial branch block (MBB) vs. paravertebral deep intramuscular (PDI) injection for pain relief in chronic low back pain. Based on randomization in first intervention session, one side receives MBB and the other side takes PDI and in second session the pattern reverses.
Pain relief following medial branch block (MBB) might be due to facet joints desensitization and/or myofascial trigger points' desensitization. Patients will be randomized to two groups. The first group receives MBB in one side and paravertebral deep intramuscular (PDI) injection in the other side of the back. Next week the pattern of injection will be reversed so the side which had received MBB will take PDI injection and PDI side will take MBB. Second group takes the intervention in reverse order.
Inclusion Criteria:
CLBP of non-malignant origin fulfilling the following criteria:
Lumbar spine CT scan or MRI done in the last 2 years
Average visual analogue scale (VAS) for pain ≥4/10 on each side for the 3 days
Cognitive and physical ability to provide informed consent in English or French
Exclusion Criteria:
Neurologic signs or symptoms suggesting nerve root involvement
Strictly unilateral Low Back Pain (LBP)
CT scan or MRI findings suggestive of pain etiology beyond degenerative spine disease
Patients who have received injections of any type or acupuncture therapy to the low back in the last 3 months
Prior spine surgery
Local or systemic infection
Bleeding disorder or the use of anticoagulation medications but for low-dose aspirin
Known allergy to amid local anesthetics
Active insurance claim (CSST, SAAQ)
Uncontrolled psychiatric condition
yoram.shir@muhc.mcgill.ca