Correct Sciatic Nerve Management to Apply Ultrasound-Guided Percutaneous Neuromodulation in Patients With Chronic Low Back Pain: A Pilot Study

San-Emeterio-Iglesias, Roberto; Minaya-Muñoz, Francisco; Romero‐Morales, Carlos; De-la-Cruz-Torres, Blanca

doi:10.1111/ner.13396

Cited by 7 publications

(13 citation statements)

References 39 publications

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“…In the case of functional electrical stimulation, this is applied transcutaneously to restore function and prevent muscle atrophy (e.g stimulation of the common peroneal nerve in patients with foot drop). Although the use of transcutaneous electrical stimulation has been widely used in MS patients, the effects of this stimulation performed percutaneously has been only researched in musculoskeletal conditions, 6 showing to be effective to treat chronic lateral epicondylalgia, 7 chronic low back pain 8 and to decrease postoperative pain following ambulatory rotator cuff repair. 9…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report

Javier-Ormazábal¹,

Herrero²,

González-Platas³

2023

DNND

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Multiple sclerosis is a degenerative inflammatory disease that causes different musculoskeletal problems. Its impact has led to the study of treatment alternatives such as the use of invasive physiotherapy. In this study, we analyze the effects of ultrasound-guided percutaneous neuromodulation to a 51-year-old man suffering from multiple sclerosis and an associated hemiparesis in the left upper limb. A dry needling needle was placed in contact with the median nerve under ultrasound guidance and 10 trains of 10 seconds of electrostimulation with a frequency of 10 Hz and an impulse width of 240 µs were applied, with 10 seconds of pause between them. There was a significant improvement in the grip strength immediately after the treatment which increased progressively at 24 hours and at 4 days follow-up. There was also an improvement in the hand function, with a decrease in the time necessary to perform the 9 Hole Peg Test immediately after the treatment, which was maintained at 24 hours and at 4 days follow-up. Future studies with larger samples are needed to further test the effects of this invasive physiotherapy technique as well as its possible applications to other neurological conditions.

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Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report

Javier-Ormazábal¹,

Herrero²,

González-Platas³

2023

DNND

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“…Anatomical variations of the SN in relation to the PM have been described for many years and the possible implications these variations might play in certain pathologies. The correct identification of the anatomical variations in the population are important to identify patients for correct medical care, as the SN block is routinely used for anesthesia and analgesia during foot and ankle surgery, as also for minimally invasive techniques to provide neurostimulation therapies for chronic pain [ 2 , 3 , 4 , 5 ]. Ultrasound can be utilized to localize a specific nerve, view neighboring soft tissue anatomy, and plan a needle trajectory.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Variations of the Sciatic Nerve Exit from the Pelvis and Its Relationship with the Piriformis Muscle: A Cadaveric Study

Reynoso

Ramirez

Nurmukhametov

et al. 2022

Neurology International

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Background: The sciatic nerve (SN) is the widest nerve of the human body that exits the pelvis through the greater sciatic foramen, usually below the piriformis muscle (PM), and descends between the greater trochanter of the femur and ischial tuberosity of the pelvis to the knee. The aim of this paper is to examine and identify the SN variations in relation to the PM, its prevalence, pattern, and course. Methods: A prospective-descriptive cross-sectional study was carried out to determine the frequency of anatomical variations in the exit of the SN in relation with the PM in 20 anatomical bodies (corpses) of both genders, in equal numbers. Results: The dissection of 40 SNs in corpses of both sexes in equal numbers showed that the SN exited inferior to the PM in 37 lower limbs (92.5%); between the fascicles of the PM and inferior to the PM in two lower limbs (5%); and in one thigh, between the fascicles of the PM and superior to the PM (2.5%). Our study reported that the SN divides in its terminal branches more commonly in the proximal part of the popliteal fossa in 55% of cases, in the gluteal region in 35% of cases, and in the middle third of the thigh in 10% of cases. Conclusions: Anatomical variations of the SN in relation to the PM are challenging for the diagnostic and therapeutic procedure in many clinical and surgical cases. Rapid recognition of the SN changes makes surgical approaches more accurate and effective. Our study confirmed that the SN exits the pelvis most commonly below the PM, although some anatomical variations may occur.

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“…The US-guided PNM technique is based on the use of a low frequency current through an acupuncture needle that is situated next to the nerve or motor point of the muscle with ultrasound guidance [11]. According to the authors' best knowledge, there is emerging scientific knowledge on the application of this procedure for a variety of clinical conditions, such as elbow pain [12], anterior knee pain [13], cubital tunnel syndrome [14], and lower back pain [15]. Prior research has reported positive results from the US-guided PNM technique on radial, cubital, femoral, and sciatic nerves [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…According to the authors' best knowledge, there is emerging scientific knowledge on the application of this procedure for a variety of clinical conditions, such as elbow pain [12], anterior knee pain [13], cubital tunnel syndrome [14], and lower back pain [15]. Prior research has reported positive results from the US-guided PNM technique on radial, cubital, femoral, and sciatic nerves [12][13][14][15]. Despite this, although most investigations have aimed attention on pain control, specific evidence also supports the application of this technique on the nerve, with the improvement of muscle performance, ROM, balance, or function [16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

“…Regarding chronic LBP, there are a limited number of investigations studying the application of this technique in such pathology. In a previous study, San-Emeterio-Iglesias et al [15] evaluated the best anatomical point of the sciatic nerve pathway to apply the US-guided PNM technique to achieve clinical benefits in LBP patients. They showed that all intervention point caused improvement of pain level, hip passive ROM, and balance in such patients.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Ultrasound-Guided Percutaneous Neuromodulation of Sciatic Nerve on Hip Muscle Strength in Chronic Low Back Pain Sufferers: A Pilot Study

San-Emeterio-Iglesias

De-la-Cruz-Torres

Romero‐Morales

et al. 2022

JCM

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Background: Limited hip internal rotation range of motion (IR-ROM) and hip abductor weakness are recognized in low back pain (LBP) sufferers. The main aim was to investigate the effect of a ultrasound (US)-guided percutaneous neuromodulation (PNM) technique on hip strength in people with LBP. A second purpose was to discover whether the location along the sciatic nerve, where percutaneous neuromodulation was applied, could influence the change of strength response in these patients. Methods: Sixty LBP sufferers were recruited and divided randomly into three groups. All participants received an isolated percutaneous electrical stimulation at one of three different locations of the sciatic nerve pathway (proximal, middle, and distal), depending on the assigned group. Pain intensity, hip passive IR-ROM, hip muscle strength, and the Oswestry disability index (ODI) were analyzed. All variables were calculated before the intervention and one week after the intervention. Results: All interventions significantly decreased pain intensity and improved the IR-ROMs, strength, and functionality after one week (p = 0.001). However, between-group (treatment x time) differences were reported for flexion strength in the non-intervention limb (p = 0.029) and ODI (p = 0.021), although the effect size was small (Eta2 = 0.1) in both cases. Conclusions: The application of an isolated intervention of the US-guided PNM technique may be a useful therapeutic tool to increase the hip muscle strength in patients with chronic LBP.

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Correct Sciatic Nerve Management to Apply Ultrasound-Guided Percutaneous Neuromodulation in Patients With Chronic Low Back Pain: A Pilot Study

Cited by 7 publications

References 39 publications

Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report

Ultrasound-Guided Percutaneous Neuromodulation in Multiple Sclerosis: A Case Report

Anatomical Variations of the Sciatic Nerve Exit from the Pelvis and Its Relationship with the Piriformis Muscle: A Cadaveric Study

Effect of Ultrasound-Guided Percutaneous Neuromodulation of Sciatic Nerve on Hip Muscle Strength in Chronic Low Back Pain Sufferers: A Pilot Study

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