Wu Wei-Ting, Chang Ke-Vin, Özçakar Levent
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan.
J Pain Res. 2024 Sep 4;17:2873-2880. doi: 10.2147/JPR.S473079. eCollection 2024.
Low back pain is a globally prevalent musculoskeletal issue. Repetitive peripheral magnetic stimulation (rPMS) is emerging as a promising modality for managing musculoskeletal pain, while ultrasound-guided lumbar facet/multifidus injections are a potential therapeutic option for low back pain. This study explores the feasibility of combining these two treatments for managing low back pain.
Ultrasound-guided injections were administered using 5 mL of 50% dextrose and 5 mL of 1% lidocaine. Bilateral injections targeted the L4/L5 and L5/S1 facet joints with 1 mL at each site, and the remaining 8 mL was distributed over the multifidus muscles using peppering techniques. Following injections, rPMS therapy was conducted with the TESLA Stym device, targeting the bilateral lumbosacral region over 12 sessions. Pain intensity was measured using the visual analog scale (VAS), and disability was assessed with the Oswestry disability index (ODI) at baseline, after six sessions, and after 12 sessions of rPMS.
Three participants were enrolled. Baseline VAS and ODI scores were 8.33 ± 0.29 cm and 49.63 ± 1.28%, respectively. After six rPMS sessions, VAS and ODI scores changed to 4.33 ± 3.75 cm and 21.48 ± 19.42%, respectively. After 12 sessions, VAS decreased to 0.83 ± 1.44 cm and ODI to 5.19 ± 8.98%. Significant differences were observed between baseline and final assessments.
Combining ultrasound-guided lumbar facet/multifidus injections with rPMS shows promise for treating low back pain. However, long-term efficacy and comparison with conventional treatments require further investigation through prospective randomized controlled trials.
腰痛是一种全球普遍存在的肌肉骨骼问题。重复外周磁刺激（rPMS）正在成为一种有前景的管理肌肉骨骼疼痛的方法，而超声引导下腰椎小关节/多裂肌注射是腰痛的一种潜在治疗选择。本研究探讨将这两种治疗方法联合用于管理腰痛的可行性。
使用5毫升50%葡萄糖和5毫升1%利多卡因进行超声引导下注射。双侧注射针对L4/L5和L5/S1小关节，每个部位注射1毫升，其余8毫升采用点状注射技术分布于多裂肌。注射后，使用特斯拉Stym设备进行rPMS治疗，针对双侧腰骶部区域进行12次治疗。使用视觉模拟量表（VAS）测量疼痛强度，并在基线、rPMS治疗6次后和12次后使用Oswestry功能障碍指数（ODI）评估功能障碍情况。
招募了三名参与者。基线VAS和ODI评分分别为8.33±0.29厘米和49.63±1.28%。rPMS治疗6次后，VAS和ODI评分分别变为4.33±3.75厘米和21.48±19.42%。治疗12次后，VAS降至0.83±1.44厘米，ODI降至5.19±8.98%。在基线和最终评估之间观察到显著差异。
超声引导下腰椎小关节/多裂肌注射与rPMS联合应用显示出治疗腰痛的前景。然而，长期疗效以及与传统治疗方法的比较需要通过前瞻性随机对照试验进一步研究。
