Sciatica Acute
Conditions
Keywords
sciatica, sciatic back pain, lumbar radiculopathy, sciatic radiculopathy
Brief summary
The goal of this clinical trial is to compare transgluteal sciatic nerve block to standard of care to treat sciatic back pain in adult patients who present to the emergency department. The main question it aims to answer is: Is a transgluteal sciatic nerve block better than standard of care in improving pain in ER patients with sciatic back pain? If there is a comparison group: Researchers will compare patients who receive transgluteal sciatic nerve blocks to patients who receive standard of care to see if pain scores improve in ER patients with sciatic back pain. Participants will be randomized into the transgluteal sciatic nerve block group or the control group (standard of care). Participants will be asked to answer questions about their pain and will be asked to walk a timed short distance.
Interventions
PROCEDUREnerve block with ropivacaine
Ultrasound-guided transgluteal sciatic nerve block with 10-20 mL of 0.2% ropivacaine injected around the affected sciatic nerve at the level of the greater trochanter
OTHERStandard medical treatment
Standard ED analgesic management per departmental protocols (oral/IV NSAIDs, acetaminophen, opioids, muscle relaxants).
Sponsors
University of California, San Francisco
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years and older * Presentation to ED with: * Acute or acute-on-chronic pain consistent with sciatica, defined as unilateral lumbosacral radicular pain radiating from the lower back or gluteal region to the posterior leg, may extend distal to the knee. * Pain score ≥ 5/10 on Numeric Rating Scale (NRS)
Exclusion criteria
* Known allergy to study medications (e.g., local anesthetics) * Coagulopathy or current anticoagulation therapy * Suspected or confirmed spinal infection, or tumor * Neurological deficits (bowel or bladder dysfunction, leg weakness) * Inability to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain scores | 30 minutes after intervention, time of ED disposition (at decision point of admission to the hospital or discharge which can be up to 6 hours), 24 hours after ED visit, 48 hours after ED visit | Patients in each group will be asked their pain score 30 minutes after their received intervention and at time of ED disposition (at decision point of admission to the hospital or discharge which can be up to 6 hours). Patients will then be contacted 24 and 48 hours after intervention to ask their pain score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ambulatory status | Before ED disposition, 24 and 48 hours after ED visit | Before ED disposition, patients will be asked to perform another timed up and go (TUG) test. A patient rises from a chair, walks at a normal pace to a line (3 meters total), turns, walks back, and sits down. Patients will then be contacted 24 and 48 hours after intervention to ask about how their ambulatory status is. |
| ED Bouncback | 30 days after ED visit | A chart review will be performed after 30 days to assess bounce-back rate |
Countries
United States
Contacts
CONTACTTianyu Tang, MD
CONTACTFelipe Ocampo, MD
PRINCIPAL_INVESTIGATORJeanne Noble, MD
University of California, San Francisco
Outcome results
None listed