NCT07632820PHASE4Recruiting

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

Mayo Clinic

Start Date

8/1/2026

Completion Date

8/30/2029

Summary

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.

Eligibility Criteria

Age Range: 18 years to 80 years

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

Interventions

DRUG

Erector Spinae Plane (ESP) Block with 0.5% Plain Bupivacaine

DRUG

Trigger Point Injection (TPI) with 0.5% Plain Bupivacaine

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Conditions

Back Pain

Locations

Mayo Clinic

Jacksonville, Florida 32224

United States

University of Maryland

Baltimore, Maryland 21201

United States

Mayo Clinic

Rochester, Minnesota 55905

United States

The Ohio State University Wexner Medical Center

Columbus, Ohio 43210

United States

MD Anderson Cancer Center

Houston, Texas 77030

United States