Paraspinous Lidocaine Injection for Chronic Nonspecific Low Back Pain: A Randomized Controlled Clinical Trial

JOURNAL OF PAIN

卷:17

Article

Imamura, Marta^1,5  Imamura, Satiko Tomikawa³  Targino, Rosa Alves⁵  Morales-Quezada, Leon^7,8  Onoda Tomikawa, Luis C.⁶  Onoda Tomikawa, Luis G.⁵  Alfieri, Fabio M.⁵  Filippo, Thais R.⁵  da Rocha, Ivan D.²  Neto, Raul Bolliger⁴  Fregni, Felipe⁷  Battistella, Linamara Rizzo⁶ 

[1] Univ Sao Paulo, Sch Med, Clin Hosp, Phys & Rehabil Med Div, Sao Paulo, Brazil

[2] Univ Sao Paulo, Sch Med, Clin Hosp, Spine Grp, Sao Paulo, Brazil

[3] Univ Sao Paulo, Sch Med, Clin Hosp, Ctr Pain, Sao Paulo, Brazil

[4] Univ Sao Paulo, Sch Med, Clin Hosp,Orthoped & Traumatol Inst, Musculoskeletal Syst Med Res Lab LIM 41, Sao Paulo, Brazil

[5] Univ Sao Paulo, Sch Med, Clin Hosp, Clin Res Ctr, Sao Paulo, Brazil

[6] Univ Sao Paulo, Sch Med, Clin Hosp, Phys & Rehabil Med Inst IMREA, Sao Paulo, Brazil

[7] Spaulding Rehabil Hosp, Spaulding Neuromodulat Ctr, 96 13th St, Charlestown, MA 02129 USA

[8] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Placebo Studies Lab, Boston, MA 02215 USA

关键词: Randomized clinical trial;    paraspinous lidocaine injection;    nonspecific chronic low back pain;    evidence-based medicine;    central sensitization;   

DOI  :  10.1016/j.jpain.2016.01.469

来源: Elsevier

【 摘 要 】

In this large, sham-controlled, randomized trial, we examined the efficacy of the combination of standard treatment and paraspinous lidocaine injection compared with standard therapy alone in subjects with chronic low back pain. There is little research-based evidence for the routine clinical use of paraspinous lidocaine injection for low back pain. A total of 378 subjects with nonspecific chronic low back pain were randomized to 3 groups: paraspinous lidocaine injection, analgesics, and exercises (group 1, LID-INJ); sham paraspinous lidocaine injection, analgesics, and exercises (group 2, SH-INJ); and analgesics and exercises (group 3, STD-TTR). A blinded rater assessed the study outcomes at 3 time points: baseline, after treatment, and after 3 months of follow-up. There were increased frequency of pain responses and better low back functional scores in the LID-INJ group compared with the SH-INJ and STD-TTR groups. These effects remained at the 3-month follow-up but differed between all 3 groups. There were significant changes in pain threshold immediately after treatment, supporting the effects of this intervention in reducing central sensitization. Paraspinous lidocaine injection therapy is not associated with a higher risk of adverse effects compared with conventional treatment and sham injection. Its effects on hyperalgesia might correlate with changes in central sensitization. (C) 2016 Published by Elsevier Inc. on behalf of the American Pain Society

【 授权许可】

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