Ultrasound-guided multifidus injection with 5 % dextrose for lumbar facet syndrome in the emergency department.

INTRODUCTION

Lumbar facet syndrome is an under-recognized cause of chronic lower back pain. Treatment typically occurs in outpatient settings, with few procedural options available in the emergency department (ED).

CASE PRESENTATION: We present the case of a 92-year-old female with refractory lower back pain and severe functional limitation due to lumbar facet syndrome, successfully treated with ultrasound-guided multifidus injections using 5 % dextrose (D5W) in the ED.

DISCUSSION: This approach is novel in emergency medicine and offers a simple and effective treatment alternative. It is easier to perform and more accessible than medial branch or facet joint blocks and avoids the risks associated with local anesthetics.

CONCLUSION

Ultrasound-guided multifidus injection with D5W may represent a practical, opioid-sparing option for older adults presenting to the ED with severe back pain.