Integrating Ultrasound-Guided Multifidus Injections with Repeated Peripheral Magnetic Stimulation for Low Back Pain: A Feasibility Study

Wei-Ting Wu,1– 3 Ke-Vin Chang,1– 4 Levent Özçakar5 1Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; 2Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan; 3Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; 4Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan; 5Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, TurkeyCorrespondence: Ke-Vin Chang, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, No. 87, Nei-Jiang Road, Wan-Hwa District, Taipei, 10845, Taiwan, Tel +886223717101-5309, Email [email protected]: Low back pain is a globally prevalent musculoskeletal issue. Repetitive peripheral magnetic stimulation (rPMS) is emerging as a promising modality for managing musculoskeletal pain, while ultrasound-guided lumbar facet/multifidus injections are a potential therapeutic option for low back pain. This study explores the feasibility of combining these two treatments for managing low back pain.Materials and Methods: Ultrasound-guided injections were administered using 5 mL of 50% dextrose and 5 mL of 1% lidocaine. Bilateral injections targeted the L4/L5 and L5/S1 facet joints with 1 mL at each site, and the remaining 8 mL was distributed over the multifidus muscles using peppering techniques. Following injections, rPMS therapy was conducted with the TESLA Stym® device, targeting the bilateral lumbosacral region over 12 sessions. Pain intensity was measured using the visual analog scale (VAS), and disability was assessed with the Oswestry disability index (ODI) at baseline, after six sessions, and after 12 sessions of rPMS.Results: Three participants were enrolled. Baseline VAS and ODI scores were 8.33 ± 0.29 cm and 49.63 ± 1.28%, respectively. After six rPMS sessions, VAS and ODI scores changed to 4.33 ± 3.75 cm and 21.48 ± 19.42%, respectively. After 12 sessions, VAS decreased to 0.83 ± 1.44 cm and ODI to 5.19 ± 8.98%. Significant differences were observed between baseline and final assessments.Conclusion: Combining ultrasound-guided lumbar facet/multifidus injections with rPMS shows promise for treating low back pain. However, long-term efficacy and comparison with conventional treatments require further investigation through prospective randomized controlled trials.Keywords: Magnetic field therapy, lumbar vertebrae, paraspinal muscles, ultrasonography, interventional procedures