Ultrasound-Guided Erector Spinae Plane Block in the Emergency Department: A Treatment for Intractable Sciatica

Sciatica, often characterized by low back pain (LBP) radiating to the leg, is a challenging condition to manage, especially when conventional therapies fail. We present the case of a 27-year-old man who suffered from persistent low back pain with left-sided radicular symptoms. Despite treatment with numerous oral medications, including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, and muscle relaxants, his symptoms persisted and intensified. Upon presenting to the emergency department (ED) for pain control, he underwent an ultrasound-guided erector spinae plane block (ESPB). The patient reported significant pain relief and functional improvement following the procedure. This case underscores the potential utility of the erector spinae plane (ESP) block as a safe and effective interventional approach for managing acute or chronic low back pain with radiculopathy in the emergency setting, particularly for patients unresponsive to conventional therapies.