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Randomized Controlled Trial
. 2016 May;17(5):569-76.
doi: 10.1016/j.jpain.2016.01.469. Epub 2016 Jan 30.

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

Marta Imamura  1 , Satiko Tomikawa Imamura  2 , Rosa Alves Targino  3 , León Morales-Quezada  4 , Luis C Onoda Tomikawa  5 , Luis G Onoda Tomikawa  3 , Fabio M Alfieri  3 , Thais R Filippo  3 , Ivan D da Rocha  6 , Raul Bolliger Neto  7 , Felipe Fregni  8 , Linamara Rizzo Battistella  5
Affiliations
Randomized Controlled Trial

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

Marta Imamura et al. J Pain. 2016 May.

Abstract

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.

Clinical trial registration: NCT02387567.

Perspective: There are few data to support paraspinous lidocaine injection use in patients with nonspecific chronic low back pain. Our results show that this therapy when combined with standard therapy significantly increases the number of responders versus standard treatment alone. Its effects on hyperalgesia might correlate with a change in central sensitization.

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

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials 2010 patient flow diagram. Abbreviation: STD, standard treatment.
Figure 2
Figure 2
Differences between baseline and after treatment and between baseline and follow-up according to treatment group.
See this image and copyright information in PMC

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References

    1. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–S300. - PMC - PubMed
    1. Andrade DC, Borges I, Bravo GL, Bolognini N, Fregni F. Therapeutic time window of noninvasive brain stimulation for pain treatment: inhibition of maladaptive plasticity with early intervention. Expert Rev Med Devices. 2013;10:339–352. - PubMed
    1. Balague F, Ochoa Amaya G, Genevay S. Conservative treatment of chronic low back pain: What is new in 2008? [in French] Rev Med Suisse. 2009;5:560–562. 564. - PubMed
    1. Benedetti F. Placebo and the new physiology of the doctor-patient relationship. Physiol Rev. 2013;93:1207–1246. - PMC - PubMed
    1. Borghi B, Aurini L, White PF, Mordenti A, Lolli F, Borghi R, Martignani M, Greggi T. Long-lasting beneficial effects of periradicular injection of meloxicam for treating chronic low back pain and sciatica. Minerva Anestesiol. 2013;79:370–738. - PubMed

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