Pain is the most common reason for the emergency department visit.

Usually, acute pain managed by using drugs: narcotics, steroidal and non steroidal anti-inflammatory drugs.

In the last few years the use of interfascial blocks for acute pain management has been spreading, nowadays particularly the use of ESPB looks promising.

 ESP block, initially born as a chest wall block for the treatment of thoracic neuropathic pain,  is now also used as an anesthetic block in different contexts and  now also performed at the lumbar level. The applicability of the technique covers many clinical scenarios.

The use of ESPB in anesthesia / analgesia in Thoracic¹and Breast²surgery and in chronic thoracic neuropatic pain³treatment is consolidated whereas in spinal surgery⁴and in abdominal surgery⁵it is spreading.

Furthermore ESP Block is used in non postsurgical pain management : many case reports have been illustrated, describing the use of ESPB in pain management at the cervico-thoraco-dosral level both in the case of neuropathic⁶pain and in the case of myofascial⁷pain and in case of oncological pain too.

There are few studies regarding the use of ESP block in the treatment of low back pain and there is almost total absence of studies regarding the use of ESP block in acute low back pain.

In our experience ESPB  can be useful in the treatment of acute nonspecific low back pain.  In fact, this treatment provides a first response to acute low back pain, is easy to perform and safe, and can be a temporary treatment to be performed during a period of in-depth study of the patient.

The aim of this study is to describe the role of lumbar ESP block in treating acute non-specific lumbar pain.

References

1)        Forero M, Rajarathinam M, Adhikary S, Chin KJ. Erector spinae plane (ESP) block in the management of post thoracotomy pain syndrome: a case series. Scand J Pain

2)        Gürkan Y, Aksu C, Kuş A, Yörükoğlu UH, Kılıç CT. Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: a randomized controlled study. J Clin Anesth. 2018;50:65–8

3)        Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):621–627

4)        Ueshima H, Inagaki M, Toyone T, Otake H. Efficacy of the erector spinae plane block for lumbar spinal surgery: a retrospective study. Asian Spine J. 2019;13:254–7

5)        Tulgar S, Kapakli MS, Senturk O, Selvi O, Serifsoy TE, Ozer Z. Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: a prospective, randomized, controlled clinical trial. J Clin Anesth. 2018;49:101–6.

6)        Fusco P, Carlo DI, Scimia S, et al. Could the new ultrasound-guided erector spinae plane block be a valid alternative to paravertebral block in chronic chest pain syndromes? Minerva Anestesiol 2017; 83:1112–1113      

7)        Piraccini E, Corso RM, Maitan S. Ultrasound guided erector spinae plane block for myofascial pain syndrome. J Clin Anesth. 2019;57:121.