Erector Spinae Plane Block vs. Usual Care for ED Patients With Mechanical Back Pain

Erector Spinae Plane Block vs. Usual Care for ED Patients With Mechanical Back Pain: A Randomized Controlled Trial

The goal of this clinical trial is to compare the Erector Spinae plane (ESP) block, a nerve block, to usual care in emergency department patients with back pain. The main question it aims to answer:

Is the ESP block superior to usual care in the treatment of back pain in the emergency department? Participants will be randomly assigned to the ESP or the usual care group. Pain improvement at the time of emergency department discharge will be compared.

Inclusion Criteria: Patients deemed to have mechanical back pain with a component of paravertebral tenderness or paravertebral spasm reported by the patient or noted on examination by treating physician.

Exclusion Criteria:

• previous recipient of erector spinae plane block
• exam concerning for cauda equina syndrome
• current IV drug use
• organ transplant recipient
• history of or suspected bleeding diathesis
• current use of anticoagulants
• sepsis or soft tissue infection at site of the block within last three months
• pregnancy
• overt malignancy involving skin or underlying soft tissue at the site of block
• allergy to any of the research medications
• inability to participate in telephone follow-up