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.
How do nerve blocks work?
Lumbar sympathetic nerve blocks contain either local anesthetic or local anesthetic with corticosteroids. They are injected into the area surrounding the sympathetic nerves in the lower back. This study used blocks with only anesthetic.
When are nerve blocks prescribed?
Nerve blocks are often prescribed for both acute and chronic low back pain, but there are doubts as to its effectiveness, even when paired with complementary treatments such as physical therapy.
How was the study conducted?
The study evaluated 60 patients with low back pain. Half received the treatment and half did not. Both study groups had the same complementary treatment plan. The plan included:
The test group that received the blocks received from three to six blocks. The subjects in the block and non-block 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.
What were the conclusions of the study?
At the end of 6 months the study concluded that 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. Another negative effect of the blocks was the cost; treatment cost went up from an average of $4500 for non-block patients to $5900 for the patients who received the blocks.
The 10th World Congress on Pain San Diego August 19, 2002
As far as I know, there’s never any need to have a steroid nerve block done for back pain, at least in all the patients I have treated over the last twenty years. There are so many better options. My suggestions:
In my own practice I have come to value the gentle massage technique from Australia called NST. It’s a complex neurological reflex structural balancing that dramatically improves many of our patients. You can use the NST referral page to find an NST practitioner near you. Dr. Sarno is a psychiatrist who works with patients who have documented "structural problems" verified with an MRI. Their pain was so bad these patients had their backs operated on for the pain. By the time the patients get to Dr. Sarno, they are still in pain and have failed surgical interventions. The amazing part of this story is that over 90 percent of these patients get better. His book, Healing Back Pain, describes his wonderful success treating patients with chronic low back pain.
I have been using the psychological acupressure technique EFT for pain and frequently see similar results. EFT seems to be far more effective when one is working on the emotional reasons that led up to the pain. The incredibly amazing element of EFT though, is that it’s usually instant and typically permanent if the correct stressor is found and treated.
I have been using EFT since June of 2001 and have seen this demonstrated successfully in my office many dozens of times, so I know it works. It certainly is not 100 percent effective for pain, but it’s my experience that at least 50 percent of pain problems respond really well.
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