RECRUITING Phase 4 ClinicalTrials.gov

Erector Spinae Plane Block Versus Trigger Point Injection for Chronic Thoracic Myofascial Pain

Sponsor: Mayo Clinic • ClinicalTrials.gov ID: NCT07632820

Registry updated: 2026-09-09

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Description

Chronic thoracic (mid-back) pain can be difficult to treat, and there is limited evidence to guide the use of injection therapies for pain arising from muscles and surrounding soft tissues. Two commonly used treatments are trigger point injections (TPI) and erector spinae plane (ESP) blocks, but no studies have directly compared their effectiveness for chronic thoracic myofascial pain. The purpose of this study is to compare pain relief, physical function, emotional well-being, patient satisfaction, and safety following treatment with either an ESP block or TPI. Participants will be randomly assigned to receive one of the two treatments. Researchers will follow participants for up to 12 weeks after the procedure and collect information through questionnaires and pain assessments.

Interventions

Erector Spinae Plane (ESP) Block with 0.5% Plain Bupivacaine (Drug)
Participants will receive an ultrasound-guided thoracic erector spinae plane (ESP) block at the thoracic level corresponding to the location of maximal pain. Under ultrasound guidance, a 22-gauge needle will be advanced into the fascial plane deep to the erector spinae muscle and superficial to the transverse process. Participants will receive 5 mL of 0.5% plain bupivacaine per side, with bilateral injections performed when clinically indicated for bilateral thoracic pain.
Trigger Point Injection (TPI) with 0.5% Plain Bupivacaine (Drug)
Participants will receive ultrasound-guided trigger point injection(s) into the thoracic paraspinal musculature at the site(s) of maximal tenderness. Under ultrasound guidance, 0.5% plain bupivacaine will be injected in volumes of 1-2 mL per injection site, with a maximum total volume of 5 mL per side and up to five injection sites per laterality.

Eligibility criteria

Inclusion Criteria: * Adults aged 18-80 years * Chronic thoracic myofascial pain lasting at least three months * Pain intensity of ≥4 on 11-point NRS * At least two of three following conditions: Focal thoracic paraspinal pain, palpable taut band, referred pain pattern with palpation Exclusion Criteria: * Thoracic radiculopathy * Cervical myelopathy with neurological deficit * Prior cervicothoracic spine surgery * Pregnancy or lactation * Contraindication to local anesthetic * Active malignancy * Fibromyalgia * BMI \>40 kg/m2 * Workers' compensation or active litigation related to thoracic pain * Acute herpes zoster or history of postherpetic neuralgia involving thoracic dermatomes * Current opioid use \>50 morphine milligram equivalents daily * Severe psychiatric or cognitive disorders, specifically history of schizophrenia, chronic psychotic disorders, dementia * History of substance use disorder * Inability to provide informed consent

Conditions

Back Pain

Locations

Mayo Clinic — Jacksonville, Florida, United States
University of Maryland — Baltimore, Maryland, United States
Mayo Clinic — Rochester, Minnesota, United States
The Ohio State University Wexner Medical Center — Columbus, Ohio, United States
MD Anderson Cancer Center — Houston, Texas, United States

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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