[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-406125-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-406125-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","the-application-of-erector-spinae-plane-block-in-chronic-pain-management-from-anatomical-mechanisms-to-clinical-innovations","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 regional analgesia technique using local anesthetics injected between the erector spinae muscle and vertebral transverse processes. It blocks the dorsal rami of spinal nerves to deliver multi-segmental analgesia. Although ultrasound guidance has expanded ESPB use in acute and chronic pain, systematic evaluation and clear value positioning in chronic pain remain unresolved. This review links anatomical basis with clinical innovations, summarizing mechanisms, efficacy, advantages, limitations, and research priorities across cancer and neuropathic pain.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/the-application-of-erector-spinae-plane-block-in-chronic-pain-management-from-anatomical-mechanisms-to-clinical-innovations/406125/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/the-application-of-erector-spinae-plane-block-in-chronic-pain-management-from-anatomical-mechanisms-to-clinical-innovations/406125.png","ImageObject",300,407,{"name":42,"@type":43},"Aria Callaghan","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the Erector Spinae Plane Block (ESPB) and how does it provide analgesia?","Question",{"text":63,"@type":64},"ESPB involves injecting local anesthetics into the fascial plane between the deep aspect of the erector spinae muscle and the transverse processes. This blocks the dorsal rami of spinal nerves, producing multi-segmental analgesia.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why is ESPB used for chronic pain, and what limits its broader adoption?",{"text":68,"@type":64},"Ultrasound guidance and the technique’s relative simplicity and safety have driven growing use for acute and chronic pain, including cancer-related and neuropathic pain. Broader adoption is limited by insufficient systematic evidence synthesis and robust efficacy assessments.",{"name":70,"@type":61,"acceptedAnswer":71},"What chronic pain mechanisms does the review emphasize as relevant to ESPB?",{"text":72,"@type":64},"The review highlights the transition from acute to chronic pain as a multifactorial process involving peripheral and central sensitization. It describes how mediator release lowers neuronal firing thresholds and activates glial cells, driving progression from peripheral to central sensitization.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},406125,1790758304,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":124,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},962084926284,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Journal of Pain Research  \n Open Access Full Text Article  \nREVIEW  \nThe Application of Erector Spinae Plane Block in Chronic Pain Management: From Anatomical Mechanisms to Clinical Innovations  \nShengfang Du, Qianqian Xie, Tingting Liang, YinHua Feng  \nDepartment of Anesthesiology, The Second Hospital of Lan Zhou University, Lanzhou, People’s Republic of China Correspondence: Shengfang Du, Email [793065701@qq.com](793065701@qq.com)  \n\n| Abstract: 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.\u003Cbr>Keywords: erector spinae plane block, chronic pain, anatomical mechanism, clinical application, technological innovation |\n| --- |\n| Introduction\u003Cbr>Global Burden of Disease (GBD) studies have established pain-related disorders as the predominant cause of years lived with disability (YLDs) worldwide.1 In North America alone, chronic pain affects over 20% of the adult population,2 significantly impairing quality of life and imposing substantial personal and socioeconomic burdens.3,4 While pharmacotherapy remains a mainstay of treatment, its efficacy is often limited by suboptimal outcomes and significant adverse effects, which constrain its clinical utility. Consequently, the development of effective and minimally invasive interventional analgesic techniques has become a critical objective in pain medicine.\u003Cbr>Regional nerve block techniques have gained increasing prominence in managing both acute and chronic pain due to their procedural simplicity and favorable safety profiles. Among these, the ESPB—a relatively novel truncal nerve block first described in 2016—has rapidly emerged as a focus of research and clinical interest. Its appeal stems from its unique anatomical targets and potential for broad analgesic coverage.5 The clinical applications of ESPB have expanded considerably from initial use in thoracic neuropathic pain to include various chronic pain conditions, such as chronic post-surgical pain syndromes and cancer-related pain.6 However, the widespread adoption of this technique is hindered by the lack of a systematic evidence synthesis and robust efficacy assessments. The current literature primarily consists of case reports and small-scale observational studies, which exhibit considerable heterogeneity in quality.7–9 Furthermore, key questions regarding its mechanism of action, patterns of drug diffusion, and comparative effectiveness against established techniques like epidural or paravertebral blocks remain unresolved, resulting in a fragmented knowledge base.\u003Cbr>This review aims to synthesize the current evidence on the mechanisms and clinical applications of ESPB in chronic pain management. We will analyze its anatomical and pharmacodynamic foundations and summarize its advancements in treating cancer pain, neuropathic pain, and other chronic disorders. The performance of ESPB will be compared with conventional techniques, such as epidural and paravertebral blocks. Finally, we will explore the potential of ESPB in |\n\nReceived: 22 June 2025  \nAccepted: 14 December 202","cbCaim2rxC4MprPd","https://ap.wps.com/l/cbCaim2rxC4MprPd","pdf",467686,"English","# Introduction\n## Pathophysiological mechanisms of chronic pain\n# Pathophysiological mechanisms of chronic pain\n## Central sensitization itself","[{\"question\":\"What is the Erector Spinae Plane Block (ESPB) and how does it provide analgesia?\",\"answer\":\"ESPB involves injecting local anesthetics into the fascial plane between the deep aspect of the erector spinae muscle and the transverse processes. This blocks the dorsal rami of spinal nerves, producing multi-segmental analgesia.\"},{\"question\":\"Why is ESPB used for chronic pain, and what limits its broader adoption?\",\"answer\":\"Ultrasound guidance and the technique’s relative simplicity and safety have driven growing use for acute and chronic pain, including cancer-related and neuropathic pain. Broader adoption is limited by insufficient systematic evidence synthesis and robust efficacy assessments.\"},{\"question\":\"What chronic pain mechanisms does the review emphasize as relevant to ESPB?\",\"answer\":\"The review highlights the transition from acute to chronic pain as a multifactorial process involving peripheral and central sensitization. It describes how mediator release lowers neuronal firing thresholds and activates glial cells, driving progression from peripheral to central sensitization.\"}]","The Application of Erector Spinae Plane Block in Chronic Pain Management - From Anatomical Mechanisms to Clinical Innovations | PDF",1790563656,25]