Lumbar spine
Blocks and injections of the paraspinal muscles and quadratus lumborum
Painful muscle points and fascial planes are well visualised and lend themselves to a targeted treatment.
How it is performed
An important component of back pain originates from the muscles and fascia surrounding the spine. Using ultrasound, the fascial planes between the erector spinae muscle and the quadratus lumborum can be identified, and local anaesthetic can be deposited there, with or without corticosteroid (erector spinae plane block, quadratus lumborum block), or the painful trigger points can be treated selectively. The result is a reduction in pain and muscle tightness that facilitates rehabilitation.
Who it is for
- Myofascial low back pain and chronic muscle tightness
- Persistent non-specific low back pain
- Need to reduce pain to allow active physiotherapy
Recovery
Ultrasound-guided procedure under local anaesthesia, through an access point of a few millimetres: you return home immediately and resume movement the same day.
Conditions treated in this area: chronic low back pain, disc herniation and sciatica, sacroiliac joint pain, muscle tension and pain (paraspinal, piriformis).
Scientific evidence
Systematic reviews on lumbar fascial plane blocks in non-specific low back pain report a reduction in short-term pain and a good safety profile; a recent randomised study compares their effectiveness with transforaminal epidural injection in low back pain with radiating symptoms.
References on PubMed
- Efficacy and safety of erector spinae plane block in non-specific low back pain: an exploratory systematic review
Slouma M, Zarati S, et al. — Pain Manag, 2026 · PMID 41549965
- Transforaminal epidural steroid injection versus high-volume lumbar erector spinae block in patients with low backache and radicular pain — a randomized clinical trial
Singhrol RA, Reena D, et al. — Agri, 2025 · PMID 40856394
Published data describe average results in groups of patients and are not a prediction of an individual outcome. The indication for treatment must always be assessed during a consultation.
Risks, costs and opinions
The three questions patients ask most often before deciding, with clear answers.
What are the risks of blocks and injections of the paraspinal muscles and quadratus lumborum?
It is an outpatient procedure performed with a thin needle under local anaesthesia and continuous ultrasound guidance, which makes it possible to see the needle, the target and the structures to avoid in real time. The most common issues are transient: pain or swelling for 24-48 hours, a small bruise. Joint infection is a rare event, prevented by sterile technique. In treatments with cortisone, facial flushing or a temporary rise in blood sugar may occur in diabetic patients. Personal risks and contraindications are assessed during the consultation.
How much does the blocks and injections of the paraspinal muscles and quadratus lumborum cost?
The cost depends on the setting in which the procedure is performed: some treatments are available through the National Health Service or under agreement, others privately or through insurance. The quote is given clearly before scheduling the treatment, and includes the assessment, the procedure and the planned follow-up. During the consultation I tell you which pathway is available in your case: you do not have to decide before knowing the cost.
Does it really work? What patients and the literature say
The most frequent questions are "how long does the benefit last?" and "can I repeat it?". The answer depends on the diagnosis and the stage: some injections resolve the painful episode, others serve to open a window in which rehabilitation becomes effective. Experiences read in forums concern cases different from yours. During the consultation we review your imaging and I tell you frankly what to expect, how many sessions may be needed and when another approach is better.
Want to know if it is right for you?
At the first consultation we review your clinical history and previous imaging together.