#EMconf: Do Trigger Point Injections Improve Musculoskeletal Pain?

Clinical Question: Does Trigger Point Injection Improve a Patient's Musculoskeletal Pain?

Take Home Message: Trigger point injections provide better analgesia compared to standard therapy alone for patients suffering from chronic musculoskeletal back pain.  Pain improvement may be independent of the use of lidocaine during injection.   

Study 1: 

  • Prospective, RCT, single-blinded study in Brazil, homogenous demographics in adult population 
  • 71% of people receiving Lidocaine trigger point injection, tylenol and exercise achieved at least a 30% pain response on pain scale at 3 week follow up 
  • NNT = 6 to achieve a pain response of 30% 
  • 54.4% of people receiving dry needling, Tylenol and exercise group achieved at least a 30% pain response at 3 week follow up 
  • 53.5% of people receiving standard therapy (tylenol and exercise) achieved at least a 30% pain response at 3 week follow up  

Study 2: 

  • Prospective, RCT, single blinded study on adults with cervical musculoskeletal pain in Turkey, female predominant patient population 
  •  A statistically significant improvement in pain response in the lidocaine group and the dry needling group compared to standard therapy 
  •  No statistically significant difference in pain response between the lidocaine and the dry needling group 
    -In the lidocaine group: baseline pain score: 5.82+/-1.25, 4 week pain score 2.27=/-0.98
    -In the dry needline group: baseline pain score: 5.55+/-1.33, 4 weekpain score 3.82+/- 0.47


Articles Reviewed: 

Study 1: Imamura M, et al. Paraspinous Lidocaine Injection for Chronic Nonspecific Low Back Pain: A Randomized Controlled Clinical Trial. The Journal of Pain 2016; Vol 17, No 5 (May): pp 569-576

Study 2: Saime Ay, et al. Comparison of injection methods in myofascial pain syndrome: a randomized controlled trial. Clinical Rheumatology 2010; 29: 19-23