Efficacy of nerve block treatment combined with trigger-point injection for the relief of low back and leg pain in the elderly

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  • ITO Hiroshi
    医療法人社団 高山整形外科病院〔〒125-0042 東京都葛飾区金町3-4-5〕
  • 高山 瑩
    医療法人社団 高山整形外科病院〔〒125-0042 東京都葛飾区金町3-4-5〕
  • 岩間 徹
    医療法人社団 高山整形外科病院〔〒125-0042 東京都葛飾区金町3-4-5〕
  • 木下 朋雄
    医療法人社団 高山整形外科病院〔〒125-0042 東京都葛飾区金町3-4-5〕

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  • 腰痛と下肢痛に対する神経ブロック療法とトリガーポイント注射の効果
  • ヨウツウ ト カシツウ ニ タイスル シンケイ ブロック リョウホウ ト トリガーポイント チュウシャ ノ コウカ

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We report on the efficacy of the concomitant use of nerve blocks and trigger-point injections for pain reduction in the low back and legs. A total of 63 subjects, 32 males and 31 females, with a mean age of 65.6 years were included in this study. We measured the duration of time that patients felt no pain and reduced pain and were able to calculate pain remission rates. The severity of pain was evaluated using a 5 point Numerical Rating Scale (NRS), with remission rates obtained through the analysis of the scores of pain pre-post nerve block treatment. Subjects were treated primarily with 1% mepivacaine hydrochloride. For 90% of subjects with NRS above 2 degree, co-administration of 1.9mg to 3.8mg of dexamethasone phosphate is performed to 90% of subjects with NRS at 2 degree based on the subjects age. Results: The mean NRS score before and after blocks performed was 2.4, and 0.7 respectively. The remission rate was 73% and the mean duration of pain relief or reduction was 8.1 days. 53 subjects 83% obtained remission rates of 60% or better. No aggravation / side effects were observed in any subjects. Conclusions: We concluded that local anesthetics are safe and can be expected to cause little or no adverse reactions when compared to analgesics. The concomitant use of several nerve blocks or trigger point injections is effective in addressing low back and leg pain. This treatment could meet patients’ satisfaction enough, even given the transient nature of relief. We believe that this would be the first applicable treatment for both occasional and chronic pain in the lower back or legs in our growing geriatric population.

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