Intramuscular and nerve root stimulation vs lidocaine injection to trigger points in myofascial pain syndrome

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[Note: myofascial pain syndrome is chronic pain that involves a single muscle or a muscle group. It is believed to stem from a tender or hyper-irritable “trigger point” that may be remote from the location of the pain. Intramuscular stimulation employs acupuncture-thin needles delivering electrical stimulation to relieve tightness in “shortened” muscle bands.]

Journal: Journal of Rehabilitation Medicine. 2007 May;39(5):374-8.

Authors and affiliation: Ga H, Koh HJ, Choi JH, Kim CH. Department of Family Medicine, Inha University College of Medicine, Incheon, Korea.

PMID: 17549328

Objectives: To compare the efficacies of an intramuscular stimulation technique and 0.5% lidocaine injection to trigger points in myofascial pain syndrome.

Participants: Forty-three people with myofascial pain syndrome of the upper trapezius muscle.

Interventions: Twenty-two subjects were treated with intramuscular stimulation and another 21 with 0.5% lidocaine injection at all the trigger points on days 0, 7 and 14.

Results: Intramuscular stimulation resulted in a significant reduction in Wong-Baker FACES pain scale scores at all visits and was more effective than trigger point injection. Intramuscular stimulation also resulted in significant improvement on the Geriatric Depression Scale – Short Form. Local twitch responses occurred in 97.7% (42/43) of patients. All the passive cervical ranges of motion were significantly increased. Post-treatment soreness was noted in 54.6% of patients in the intramuscular stimulation group and 38.1% in the trigger point injection group, respectively, and gross subcutaneous haemorrhage (> 4 cm2) was seen in only one patient in the trigger point injection group.

Conclusion: In managing myofascial pain syndrome, after one month intramuscular stimulation resulted in more significant improvements in pain intensity, cervical range of motion and depression scales than did 0.5% lidocaine injection of trigger points.

Intramuscular stimulation is therefore recommended for myofascial pain syndrome.

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