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Diagnosis of chronic radiating lower back pain without overt focal neurologic deficits: what is the value of segmental nerve blocks?

Andre P Wolff, Gerbrand J Groen and Oliver HG Wilder-Smith

The purpose of this paper is to discuss the value of spinal segmental nerve blocks in establishing diagnosis in chronic lower back pain patients with pain radiating to the leg without overt focal neurologic deficits. These patients represent a large population. Establishing diagnosis is often problematic and the effectiveness of presently available therapies is low. Indication, character of radiating pain, pain diagnosis, factors influencing segmental nerve blocks, reliability of segmental nerve blocks in diagnosing pain, recently performed studies on the reproducibility of segmental nerve block effects and considerations with respect to ‘segmental pain’ will be discussed herein.