Effect of Skin Stretching on Pain Reduction During Local Anesthetic Injections: A Randomized Clinical Study

Inclusion Criteria: * Adults aged 19 years or older with chronic low back pain lasting for more than 3 months, accompanied by bilateral lower extremity radiculopathy, who require Selective Transforaminal Epidural Block (STEB). * Patients with a Numerical Rating Scale (NRS) score of 5/10 or higher, with pain that affects daily life activities. Exclusion Criteria: * Patients whose pain is influenced by mechanisms other than radiculopathy, such as peripheral neuropathy or myelopathy. * Patients with a history of lumbar surgery within the last 6 months, or spinal injection treatment within the last 3 months. * Patients with a history of allergy to local anesthetics, steroids, or contrast agents, or those at increased bleeding risk due to anticoagulant use (INR \> 1.2). * Patients with localized infections, sepsis, uncontrolled diabetes, or hypertension. * Patients who are unable to consent or cooperate with the study procedures (e.g., cognitive impairment, severe mental illness).