Rehabilitation Practice and Science


A 65-year-old man reported severe low back pain in Guillain–Barré syndrome. Although adequate doses of oral medications (75 mg of pregabalin three times a day, 300 mg of oxcarbazepine before sleep, and 300 mg of oxcarbazepine twice a day) and physical modalities (electrical nerve stimulation and a hot pack) were administered, his low back pain improved slightly, with his Numerical Rating Scale score decreasing from 10 to 8. In response, an ultrasound-guided caudal epidural block with 40 mg of methylprednisolone, 2 mL of 1% xylocaine, and 18 mL of normal saline was performed on day 78 after onset, resulting in a considerable improvement in the low back pain, with his score of Numerical Rating Scale decreasing from 8 to 3. No adverse effects were noted after the intervention, and his pain was controlled successfully without the requirement of further injection. This study presented the first documented case of caudal epidural block considerably relieving low back pain in Guillain–Barré syndrome. Ultrasound-guided caudal epidural block was noted to be an excellent choice for treating low back pain in Guillain–Barré syndrome if oral medications fail to relieve the symptom.