{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:05:13Z","timestamp":1787497513048,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Evidence supporting repeated intravenous lidocaine infusions for probable nociplastic chronic non-specific low back pain remains limited despite its use as a centrally acting analgesic in several chronic pain conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether repeated intravenous lidocaine infusions provide clinically meaningful benefit beyond placebo for pain reduction in probable nociplastic chronic non-specific low back pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Department of Physical Medicine and Rehabilitation, NRS Medical College and Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Eighty-four adults with chronic non-specific low back pain and probable nociplastic pain features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Participants were randomized equally to receive either intravenous lidocaine (1 mg\/kg bolus followed by 4 mg\/kg infusion weekly for 4 weeks) or placebo saline infusion. All participants received background multimodal pain management consisting of amitriptyline and aerobic exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes<\/jats:title>\n                    <jats:p>The primary endpoint was the between-group difference in Visual Analogue Scale (VAS) pain intensity at 3 months. Therapeutic equivalence was assessed using a prespecified equivalence margin of \u00b11.5 VAS units and the two one-sided tests (TOST) framework. Secondary outcomes included sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and functional disability (Quebec Back Pain Disability Scale [QBPDS]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 3 months, the between-group difference in VAS was 0.24 (90% CI, \u22120.33 to 0.81), entirely within the predefined equivalence bounds, confirming therapeutic equivalence (TOST P &amp;lt; .001). Both groups improved significantly over time without a significant group \u00d7 time interaction. Improvement in sleep quality was greater in the lidocaine group (mean difference in change score, 1.81; 95% CI, 0.49-3.14; P = .027). Functional improvement numerically favored lidocaine, although continuous disability outcomes were not significantly different. Adverse events were more common in the lidocaine group but were mild, transient, and self-limiting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Repeated intravenous lidocaine infusions did not provide additional analgesic benefit over saline infusions administered alongside multimodal pain management in patients with probable nociplastic chronic non-specific low back pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance<\/jats:title>\n                    <jats:p>These findings support prioritizing evidence-based multimodal pain management, including exercise and centrally acting pharmacological therapy, over routine adjunctive intravenous lidocaine for probable nociplastic chronic non-specific low back pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration number<\/jats:title>\n                    <jats:p>CTRI\/2024\/07\/070888.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trials Registry-India (CTRI)<\/jats:title>\n                    <jats:p>https:\/\/ctri.nic.in\/Clinicaltrials\/pmaindet2.php?EncHid=MTA4ODk1&amp;Enc=&amp;userName=.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnag093","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:28:38Z","timestamp":1784633318000},"source":"Crossref","is-referenced-by-count":1,"title":["Intravenous lidocaine does not provide additional pain reduction beyond placebo in probable nociplastic chronic low back pain: a randomized controlled equivalence 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