The Application of Erector Spinae Plane Block in Chronic Pain Management: From Anatomical Mechanisms to Clinical Innovations

Erector Spinae Plane Block (ESPB) is a fascial plane-based regional analgesia technique that involves injecting local anesthetics between the deep aspect of the erector spinae muscle and the transverse processes of the vertebrae. This blocks the dorsal rami of spinal nerves, thereby achieving multi-segmental analgesia. With the widespread adoption of ultrasound guidance, ESPB has gained extensive application in acute and chronic pain management due to its relative simplicity and high safety profile. However, its systematic evaluation and value positioning in chronic pain management remain to be clarified. This article aims to provide a comprehensive overview of ESPB, spanning from its anatomical basis to clinical innovations. It focuses on reviewing its mechanisms of action, clinical efficacy, technical advantages, and limitations in managing chronic pain (including cancer-related pain and neuropathic pain). Future research directions are also discussed to inform clinical practice and related studies.