Comparing Ultrasound-Guided Transgluteal Nerve Block to Standard Care (TGSNB vs SoC)

Comparing Ultrasound-Guided Transgluteal Nerve Block to Standard Care for Emergency Department Patients With Low Back Pain and Sciatic Radiculopathy: A Randomized Controlled Trial

The goal of this clinical trial is to compare transgluteal sciatic nerve block to standard of care to treat sciatic back pain in adult patients who present to the emergency department.

The main question it aims to answer is: Is a transgluteal sciatic nerve block better than standard of care in improving pain in ER patients with sciatic back pain?

If there is a comparison group: Researchers will compare patients who receive transgluteal sciatic nerve blocks to patients who receive standard of care to see if pain scores improve in ER patients with sciatic back pain.

Participants will be randomized into the transgluteal sciatic nerve block group or the control group (standard of care). Participants will be asked to answer questions about their pain and will be asked to walk a timed short distance.

Study Overview

• Status: Recruiting
• Conditions: Sciatica Acute
• Intervention / Treatment: Procedure: nerve block with ropivacaine; Other: Standard medical treatment

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Tianyu Tang, MD; Phone Number: 628-247-7578; Email: tianyu.tang@ucsf.edu
• Study Contact Backup: Name: Felipe Ocampo, MD; Email: felipe.ocampo@ucsf.edu

Study Locations

• United States
  • California
    • San Francisco, California, United States, 94107
      • Recruiting
      • University of California, San Francisco
      • Contact: Tianyu Tang, MD; Phone Number: 628-247-7578; Email: tianyu.tang@ucsf.edu
      • Sub-Investigator: Kavita Gandhi, MD
      • Sub-Investigator: Nancy Anaya, MD
      • Sub-Investigator: Jeffrey Merz-Herrala, MD
      • Sub-Investigator: Tianyu Tang, MD
      • Sub-Investigator: Felipe Ocampo, MD
      • Principal Investigator: Jeanne Noble, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adults aged 18 years and older
• Presentation to ED with:
• Acute or acute-on-chronic pain consistent with sciatica, defined as unilateral lumbosacral radicular pain radiating from the lower back or gluteal region to the posterior leg, may extend distal to the knee.
• Pain score ≥ 5/10 on Numeric Rating Scale (NRS)

Exclusion Criteria:

• Known allergy to study medications (e.g., local anesthetics)
• Coagulopathy or current anticoagulation therapy
• Suspected or confirmed spinal infection, or tumor
• Neurological deficits (bowel or bladder dysfunction, leg weakness)
• Inability to provide informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Transgluteal sciatic nerve block; Patients will receive an ultrasound-guided transgluteal sciatic nerve block with 10-20 mL of 0.2% ropivacaine injected around the affected sciatic nerve at the level of the greater trochanter.	Procedure: nerve block with ropivacaine; Ultrasound-guided transgluteal sciatic nerve block with 10-20 mL of 0.2% ropivacaine injected around the affected sciatic nerve at the level of the greater trochanter
Active Comparator: Standard of care; Standard ED analgesic management per departmental protocols (oral/IV NSAIDs, acetaminophen, opioids, muscle relaxants).	Other: Standard medical treatment; Standard ED analgesic management per departmental protocols (oral/IV NSAIDs, acetaminophen, opioids, muscle relaxants).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain scores	Patients in each group will be asked their pain score 30 minutes after their received intervention and at time of ED disposition (at decision point of admission to the hospital or discharge which can be up to 6 hours). Patients will then be contacted 24 and 48 hours after intervention to ask their pain score	30 minutes after intervention, time of ED disposition (at decision point of admission to the hospital or discharge which can be up to 6 hours), 24 hours after ED visit, 48 hours after ED visit

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ambulatory status	Before ED disposition, patients will be asked to perform another timed up and go (TUG) test. A patient rises from a chair, walks at a normal pace to a line (3 meters total), turns, walks back, and sits down. Patients will then be contacted 24 and 48 hours after intervention to ask about how their ambulatory status is.	Before ED disposition, 24 and 48 hours after ED visit
ED Bouncback	A chart review will be performed after 30 days to assess bounce-back rate	30 days after ED visit

Collaborators and Investigators

• Sponsor: University of California, San Francisco
• Investigators: Principal Investigator: Jeanne Noble, MD, University of California, San Francisco

Publications and helpful links

General Publications

• Goldsmith AJ, Merz-Herrala J, Gullikson J, Selame LA, Cash RE, Martin D, Schwimmer H, Shokoohi H, Duggan NM, Nagdev A. The Efficacy of Ultrasound-Guided Transgluteal Sciatic Nerve Blocks for Sciatic Radiculopathy Pain in the Emergency Department: A Multicenter Prospective Study. J Am Coll Emerg Physicians Open. 2025 Apr 10;6(3):100137. doi: 10.1016/j.acepjo.2025.100137. eCollection 2025 Jun.

Study record dates

Study Major Dates

• Study Start (Actual): May 26, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): January 31, 2027

Study Registration Dates

• First Submitted: January 25, 2026
• First Submitted That Met QC Criteria: February 5, 2026
• First Posted (Actual): February 9, 2026

Study Record Updates

• Last Update Posted (Actual): June 2, 2026
• Last Update Submitted That Met QC Criteria: May 29, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: lumbar radiculopathy; sciatica; sciatic back pain; sciatic radiculopathy
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Nervous System Diseases; Neuromuscular Diseases; Peripheral Nervous System Diseases; Neuralgia; Mononeuropathies; Sciatic Neuropathy; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Radiculopathy; Sciatica; Organic Chemicals; Surgical Procedures, Operative; Anilides; Amides; Aniline Compounds; Amines; Anesthesia and Analgesia; Neurosurgical Procedures; Anesthesia, Conduction; Anesthesia; Denervation; Ropivacaine; Nerve Block
• Other Study ID Numbers: 25-44506

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No