Nerve Block for Sciatica

(TGSNB vs SoC Trial)

Overseen By Felipe Ocampo, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Francisco

Must not be taking: Anticoagulants

Disqualifiers: Allergy to anesthetics, Coagulopathy, Spinal infection, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

Duration: 1 day

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether an ultrasound-guided transgluteal nerve block can relieve sciatic back pain more effectively than standard pain management methods. It focuses on individuals with acute or ongoing sciatic pain radiating from the lower back or buttock down one leg. Participants will be randomly assigned to receive either the nerve block or typical emergency department pain treatments. Ideal candidates are those with severe pain (rated 5 out of 10 or higher) who recently visited the emergency room for this condition. As an unphased trial, this study offers participants the chance to explore a potentially more effective pain relief option.

Do I need to stop my current medications for the trial?

The trial information does not specify if you need to stop taking your current medications. However, if you are on anticoagulation therapy (blood thinners), you cannot participate in the trial.

What prior data suggests that this nerve block is safe for treating sciatic back pain?

Research has shown that using ultrasound to guide a needle for a sciatic nerve block through the buttock is generally safe for treating sciatic pain. In a study of 2,742 procedures, only 0.4% resulted in complications. Most patients experienced significant pain relief without major issues. Another study found that with proper training, these nerve blocks safely reduced pain.

While no treatment is completely risk-free, data suggests this method is well-tolerated, and complications are rare. Current evidence should reassure participants about the safety of this approach. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using an ultrasound-guided transgluteal nerve block for treating sciatica because it offers a targeted approach that directly numbs the affected sciatic nerve. Unlike standard treatments, which often rely on oral or IV medications like NSAIDs, acetaminophen, or opioids, this technique uses ropivacaine, a local anesthetic, to provide pain relief precisely where it’s needed. This method could potentially offer faster and more localized pain control with fewer systemic side effects than traditional pain management options.

What evidence suggests that the transgluteal sciatic nerve block is effective for treating sciatic back pain?

In this trial, participants will receive either an ultrasound-guided transgluteal sciatic nerve block or standard emergency department analgesic management. Previous studies have shown that patients with sudden sciatica pain who received the ultrasound-guided transgluteal sciatic nerve block experienced significant pain relief and improved movement. Research shows that this injection can quickly ease pain along the sciatic nerve. Another study found that these injections, when administered in the emergency room, were safe and effectively reduced pain. These findings suggest that this nerve block could be a good option for treating sciatic back pain in ER patients. ^{1 2 3 5 6}

Who Is on the Research Team?

Jeanne Noble, MD

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

This trial is for adults with sciatic back pain who come to the emergency department. Participants should be able to answer questions about their pain and walk a short distance. Specific inclusion or exclusion criteria are not provided.

Inclusion Criteria

I am 18 years old or older.

My pain level is 5 or higher on a scale of 0 to 10.

I have severe leg pain extending from my lower back or buttock down to my leg, possibly beyond the knee.

Exclusion Criteria

Known allergy to study medications (e.g., local anesthetics)

I have a bleeding disorder or am on blood thinners.

I have issues with leg weakness or controlling my bladder or bowels.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 day

1 visit (in-person)

Treatment

Participants receive either a transgluteal sciatic nerve block or standard ED analgesic management

1 day

1 visit (in-person)

Follow-up

Participants are monitored for pain scores and ambulatory status after treatment

48 hours

2 follow-up contacts (virtual)

Extended Follow-up

A chart review will be performed to assess bounce-back rate

30 days

What Are the Treatments Tested in This Trial?

Interventions

• Ultrasound-Guided Transgluteal Nerve Block

Trial Overview

The study compares two treatments: an ultrasound-guided transgluteal sciatic nerve block using ropivacaine versus standard medical treatment. Patients will be randomly assigned to one of these groups and monitored for changes in pain levels.

How Is the Trial Designed?

Group I: Transgluteal sciatic nerve block Experimental Treatment 1 Intervention

Patients will receive an 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.

Group II: Standard of care Active Control 1 Intervention

Standard ED analgesic management per departmental protocols (oral/IV NSAIDs, acetaminophen, opioids, muscle relaxants).

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12008639/

The Efficacy of Ultrasound-Guided Transgluteal Sciatic Nerve ...

Patients with acute sciatica who elected to have an ultrasound-guided TGSNB in the ED showed significant improvements in pain scores and function.

2.

clinicaltrials.gov

clinicaltrials.gov/study/NCT07397117

Comparing Ultrasound-Guided Transgluteal Nerve Block to ...

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 ...

3.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S0735675725008253

Manuscript title: Utilizing an ultrasound-guided nerve block ...

Ultrasound-guided transgluteal sciatic nerve block (TGSNB) can rapidly relieve radicular pain; ED adoption is limited. 2. What question this ...

4.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/40256350/

The Efficacy of Ultrasound-Guided Transgluteal Sciatic ...

Patients with acute sciatica who elected to have an ultrasound-guided TGSNB in the ED showed significant improvements in pain scores and function.

5.

annemergmed.com

annemergmed.com/article/S0196-0644(22)00857-5/fulltext

248 Ultrasound-Guided Transgluteal Sciatic Nerve Block in ...

This prospective study demonstrated that with appropriate training, ED-performed TGSNBs were safe, associated with clinically significant reductions in pain.

6.

jamanetwork.com

jamanetwork.com/journals/jamanetworkopen/fullarticle/2826105

Complication Rates After Ultrasonography-Guided Nerve ...

In this cohort study of 2742 UGNBs performed across 11 emergency departments, patients experienced a complication rate of 0.4%. One major complication was ...