Erector spinae plane block

What is an erector spinae plane block (ESPB)?

Erector spinae muscles are attached to either side of the spine. Erector spinae plane block (ESPB) involves depositing the medication in between the muscle and the spine. ESPB is a minimally invasive procedure and the injection will contain a local anaesthetic (numbing medicine) with or without an anti-inflammatory cortisone (steroid). ESPB is done for different musculoskeletal pain and nerve pain conditions. This includes pain originating from the spine, muscles around the spine, or other body parts from where the pain signals reach the spinal cord.

Are there any risks?

ESPB is a relatively safe procedure. However, any medical intervention does carry some risks. This includes infection, bruising, injection soreness and failure of the injection to help reduce symptoms. There is a small risk of worsening of symptoms.

Other specific risks depend on the level of spine where the injections are performed. For example, dizziness following neck injections; risk of lung collapse in chest injections; difficulty in walking following lower-back injections etc. Plenty of precautions (such as use of ultrasound) will be taken to keep the risks as minimum as possible.

Before the procedure

• You will receive the treatment as an outpatient

• You will be given a 30-minute appointment.

• You may eat and drink as normal and continue your routine medications unless advised otherwise by your doctor.

• Please bring a list of your current medications with you.

• Please inform the doctor of any known allergies.

• If there is any possibility that you may be pregnant please inform the doctor.

• Your doctor will discuss the procedure with you and take your consent.

The procedure

• The procedure is carried out in one of the clinic treatment rooms.

• Depending on the site of the injection you may either wear your own clothes or a hospital gown.

• You will be asked to sit or lie on your front on a hospital couch.

• The doctor will clean your skin with an antiseptic solution which may feel cold

• Using a fine needle, the medicine will be injected into the correct location with the aid of an ultrasound.

• If a small dressing has been placed over the needle insertion site, this can be removed later when you have a shower.

Following the procedure

• After the procedure, please be careful when you first get off the couch – ensure you are steady on your feet.

• Following injections in certain areas of the body it may be unsafe to drive. It would be more advisable to arrange safe transport take you back home. If in doubt, discuss with your doctor.

• Take your regular medication and pain killers as normal.

• No need for bed rest. You can resume your normal activity from the next day onwards.

• A letter will be sent to your GP describing the procedure you underwent.

The main purpose of these injections is to facilitate a pain-free period which should provide a window period of opportunity to engage with stretching exercises and increase activity level. The need for repeating the injection in the future depends on how you respond to the ESPB injections, amount of pain relief, reduction in the need for pain medications, improvement in physical activity etc.