A new lightning treatment for lumbago tested at the Saint-Jean polyclinic in Cagnes-sur-Mer

It affects thousands of people every year and is one of the leading causes of sick leave in France: lumbago, or "back pain," often occurs after a simple gesture—carrying a cardboard box, bending over to pick up an object—and causes pain so intense that it becomes almost impossible to move.

"Usually, treatment is based on a cocktail of medications (anti-inflammatories, analgesics, sometimes morphine) and the recommendation to remain active to avoid chronic pain. But when the pain reaches 8, 9 or 10 out of 10 on the intensity scale, continuing to move is a feat. As a result, many patients end up in the emergency room, with time off work, and considerable medical and economic costs," explains Dr. Vincent Bruckert, an anesthesiologist-resuscitator at the Saint-Jean polyclinic.

From back surgery… to lumbago

A new solution is emerging, which this establishment is experimenting with: ultrasound-guided lumbar infiltration.

In reality, the technique is already well known, but for completely different indications. "We have been using it for a long time in addition to general anesthesia to relieve the postoperative effects of spinal surgery; it involves injecting a local anesthetic, sometimes combined with cortisone, into the erector spinae muscles of the back."

A few months ago, two Montpellier anesthesiologists, Professor Xavier Capdevila and Dr. Olivier Choquet, had the idea of ​​transposing this infiltration to patients suffering from acute lumbago, without general anesthesia.

“Magical” results

"The first time they tested this technique on a patient, they found it hard to believe: the patient arrived curled up on his side, unable to get up; a few minutes after the infiltration, he was up and walking. Patients go from unbearable pain to mild discomfort in ten to fifteen minutes," reports Dr. Bruckert.

"And the effect does not stop at the product's duration of action, which is 24 hours; in the majority of cases, the pain does not recur."

Almost 100% effective

Convinced by the results achieved by their colleagues in Montpellier, the team of anesthesiologists at the Saint-Jean Polyclinic decided to share the benefits with the local population. "We've already treated around fifty patients from the Côte d'Azur since the launch, and it's almost 100% effective when the diagnosis is correct."

One last important point: the treatment is in fact reserved for "typical" lumbago, which mainly affects people aged 20-65. "Older people or those with atypical pain may be hiding other pathologies: vertebral fractures, herniated discs, etc., and are therefore ruled out."

The technique is already proving popular internally: nursing assistants, surgeons, and administrative staff at the clinic have themselves used it after a blockage. "Seeing someone arrive doubled over and leave straight, smiling, is very gratifying," says Dr. Bruckert, who compares this moment to when an epidural relieves a woman in labor.

Management remains cautious, however: "We want to avoid an unmanageable influx," admits the doctor. This is why communication is, for the moment, targeted at local health professionals.

"If the patient is referred by a doctor, physiotherapist or osteopath, they can be treated directly by the anesthesia practice and receive the injection within the hour. Otherwise, the patient can go to the emergency room themselves, but keep in mind that the average treatment time is three to four hours for lumbago."

A national study is underway to clarify the benefits and protocol (read more below). But if the effectiveness is confirmed, this infiltration could quickly become a major weapon against a public health problem that, sooner or later, affects a large part of the working population.