Caudal block for low back pain with symptoms of neuropathic pain

Abstract

Introduction: Patients with low back pain underwent caudal block (CB) and were classified into two groups based on their Pain Detect (PD) scores, with the aim of clarifying the effectiveness of CB.

Methods: From May 2019 to July 2024, 532 sessions were conducted for 300 patients with low back pain who underwent CB and had their properties evaluated using PD. They were then grouped by their PD scores: non-neuropathic pain group (No group), with PD score < 19 points; and neuropathic pain group (Ne group), with PD score ≥19 points. The items examined were the visual analog scale (VAS) scores before and 1 hour (1 h), 1 day (1 d), and 1 week (1 w) after CB, and the VAS improvement rate at 1 h, 1 d, and 1 w after CB.

Results: There were 273 cases (91.0%) in the No group and 27 cases (9.0%) in the Ne group. The VAS was significantly lower in the No group than in the Ne group throughout the entire course, and the VAS improvement rate was significantly greater in the No group than in the Ne group throughout the entire course. Within the groups, the VAS at 1 h, 1 d, and 1 w was significantly lower than before.

Conclusions: In treating low back pain, though CB is more effective for non-neuropathic pain than for neuropathic pain, it is considered worthwhile to perform it as a treatment.