A randomized, controlled study comparing a lidocaine patch, a placebo patch, and anesthetic injection for treatment of trigger points in patients with myofascial pain syndrome: Evaluation of pain and somatic pain thresholds

Affaitati, Giannapia; Fabrizio, Alessandra; Savini, Antonella; Lerza, Rosanna; Tafuri, Emmanuele; Costantini, Raffaele; Lapenna, Domenico; Giamberardino, Maria Adele

doi:10.1016/j.clinthera.2009.04.006

Cited by 93 publications

(70 citation statements)

References 31 publications

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“…An insufficient response to these classic therapies is unfortunately found in a substantial percentage of patients. In addition, safety is frequently a problem, due to side effects and contraindications, but also drug-drug interactions in the case of comorbidities, very frequent in migraine, such as psychiatric and cardiovascular diseases, various forms of visceral pain, fibromyalgia or myofascial pain syndromes [33][34][35][36][37][38][39][40][41][42][43][44]. Alternative treatments are, therefore, necessary, particularly in the field of prophylaxis of high-frequency episodic and chronic migraine.…”

Section: Migraine: a Therapeutic Challengementioning

confidence: 98%

Anti-CGRP monoclonal antibodies in migraine: current perspectives

et al. 2016

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Migraine is a highly disabling neurological pain disorder in which management is frequently problematic. Most abortive and preventative treatments employed are classically non-specific, and their efficacy and safety and tolerability are often unsatisfactory. Mechanism-based therapies are, therefore, needed. Calcitonin gene-related peptide (CGRP) is recognized as crucial in the pathophysiology of migraine, and new compounds that target the peptide have been increasingly explored in recent years. First tested were CGRP receptor antagonists; they proved effective in acute migraine treatment in several trials, but were discontinued due to liver toxicity in long-term administration. Monoclonal antibodies against CGRP (LY2951742, ALD-403, and LBR-101/TEV-48125) or its receptor (AMG334) were subsequently developed. As reviewed in this study, numerous phase 1 and 2 trials and preliminary results of phase 3 trials have shown a good safety/tolerability profile and efficacy in migraine prevention, especially in high frequent episodic and chronic forms. Being macromolecules, these mAbs are not suitable for oral administration; however, their intravenous or subcutaneous delivery can be performed at relatively low frequency-every month or even quarterly-which enhances patients' compliance. Although not all migraineurs respond to this treatment, and longer administration periods will be needed to assess long-term effects, the results so far obtained are extraordinarily promising. The future introduction of mAbs on the market will probably represent a turning point for prevention similar to that represented by triptans for abortive treatment in migraine.

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Section: Migraine: a Therapeutic Challengementioning

confidence: 98%

Anti-CGRP monoclonal antibodies in migraine: current perspectives

et al. 2016

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“…[6][7][8][26][27][28] Apart from Hong et al, [6] who reported on the effect of needling treatments rather than injected substances, the other studies have suggested that local anesthetics are more efficient than DN. For instance, in the study by Affaitati et al, [29] the efficiency of bupivacaine injections, lidocaine patches, and placebo patches were compared in 60 patients with MPS, and the patients' pain during rest and activities along with any changes in pain during daily living activities and work as well as any changes in pain in accordance with mood were questioned. Treatments with lidocaine patches and bupivacaine injections were revealed to be significantly beneficial when compared with a placebo.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Efficacy of Dry Needling, Lidocaine Injection, and Oral Flurbiprofen Treatments in Patients with Myofascial Pain Syndrome: A Double-Blind (For Injection, Groups Only), Randomized Clinical Trial

et al. 2013

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Amaç: Bu çalışmada boyun ve sırt bölgesinde miyofasiyal ağrı sendromu (MAS) bulunan hastalarda kuru iğneleme, lidokain enjeksiyonu ve oral flurbiprofen tedavilerinin etkinliği karşılaştırıldı. Hastalar ve yöntemler:Bu prospektif çalışmaya toplam 60 hasta (7 erkek, 53 kadın; ort yaş 33.7 yıl; dağılım 18-50 yıl) dahil edildi. Hastalar blok randomizasyon ile üç gruba ayrıldı. Bir gruba tetik noktalara kuru iğneleme, bir gruba lidokain enjeksiyonu (çift kör) ve diğer gruba yedi gün süresince 200 mg/gün oral flurbiprofen tedavisi verildi. Ayrıca hastaların tümüne tutulan kasın gerilmesini temel alan standart bir ev egzersiz programı da verildi. Tedavi öncesi ve tedaviden sonraki üçüncü ve 14. günlerde ağrı şiddeti, görsel analog ölçeği (GAÖ) ile tetik noktaların duyarlılık derecesi algometre ile boyun ve omuz aktif eklem hareket açıklıkları gonyometre ile ve yaşam kalitesi Nottingham Sağlık Profili ile değerlendirildi. Bulgular: Üç grupta da tedaviden sonraki üçüncü ve 14. günlerde tedavi öncesine göre ağrı şiddeti, tetik nokta hassasiyeti, eklem hareket açıklıkları ve yaşam kalitesi açısından iyileşme saptandı. Tedavilerin etkinlikleri açısından gruplar arasında anlamlı fark bulunmadı.Sonuç: Miyofasiyal ağrı sendromunun tedavisinde, ev egzersizleri ile birlikte kuru iğneleme, lidokain enjeksiyonu ve oral flurbiprofen tedavilerinin tümü etkindir.Anahtar sözcükler: Kuru iğneleme; flurbiprofen; lidokain; miyofasiyal ağrı sendromu. Objectives:The aim of this study was to assess and compare the efficiency of dry needling, lidocaine injection and oral flurbiprofen treatments in patients with myofascial pain syndrome (MPS) involving the neck and back region. Patients and methods:A total of 60 patients (7 males, 53 females; mean age 33.7 years; range 18 to 50 years) were included in this prospective study. The patients were divided into three groups by block randomization. Each group was assigned to dry needling for trigger points, lidocaine injection (double blind) or oral flurbiprofen 200 mg/day over seven days. All patients were also prescribed a standardized home exercise program based on stretching of the affected muscles. Before treatment and on the third and 14 days after treatment, pain severity was assessed by visual analog scale (VAS), degree of tenderness at the trigger points by algometry, active joint range of motion of the neck and shoulders by goniometry, and the quality of life by Nottingham Health Profile.Results: There was a significant improvement in pain severity, trigger point tenderness, joint range of motion, and quality of life in all three groups on the third and 14 th days of treatment. No significant difference was found in treatment efficiency among the groups. Conclusion:Treatments with dry needling, lidocain injection and oral flurbiprofen along with home exercises are all effective in the management of MPS.

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“…Another study suggested that diclofenac injections at myofascial trigger points reduced the pain score more than lidocaine injections (43). Although steroid injections at trigger points are still controversial, triamcinolone plus lidocaine were found to cause a relatively higher rate of pain relief, compared to lidocaine monotherapy (44). In a comparison study between saline and mepivacaine injections on myofascial trigger points, Frost et al (45) reported that the saline injection was more effective.…”

Section: Trigger Point Injectionsmentioning

confidence: 99%

“…Furthermore, tropisetron at trigger points produced rapid and long-term improvements in pain scores in MPS patients (49,50). Saline or local anesthetic injections with or without steroids were reported to have several side effects including worsened healing, tissue weakness, local atrophy of the adipose tissue, skin depigmentation, crystal deposit-induced inflammation, hypothalamo-pituitary axis suppression, local bleeding, pneumothorax, and joint damage presenting with avascular necrosis (44)(45)(46)(47)(48).…”

Section: Trigger Point Injectionsmentioning

confidence: 99%

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A new insight into the management of myofascial pain syndrome

Koca¹,

Boyacı²

2014

Gaziantep Med J

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Myofascial pain syndrome (MPS) is a musculoskeletal disorder which is characterized by pain, muscle spasms, and muscle tenderness, as well as a limited range of motion, weakness, and rarely, autonomous dysfunction. Management includes exercise programs in particular, and many other invasive and non-invasive therapies, depending on the clinical status of the patient. The main options include medical therapies with analgesics, myorelaxants and antidepressants, hot pack therapy, exercise, stretch and spray therapy, ischemic compression, therapeutic massage, biofeedback, transcutaneous electrical nerve stimulation (TENS), ultrasound (US), interferential (IFA) current, low-energy light amplification by stimulated emission of radiation (LASER), extracorporeal shock wave therapy (ESWT), trigger point injections, dry needling, and acupuncture. There is growing evidence that trigger point injections and dry needling, as well as stretching exercises, are effective alternatives in the management of MPS. Management success is primarily based on the cooperation of the patient and the treating physician and the elimination of predisposing factors.

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A randomized, controlled study comparing a lidocaine patch, a placebo patch, and anesthetic injection for treatment of trigger points in patients with myofascial pain syndrome: Evaluation of pain and somatic pain thresholds

Cited by 93 publications

References 31 publications

Anti-CGRP monoclonal antibodies in migraine: current perspectives

Anti-CGRP monoclonal antibodies in migraine: current perspectives

A Comparison of the Efficacy of Dry Needling, Lidocaine Injection, and Oral Flurbiprofen Treatments in Patients with Myofascial Pain Syndrome: A Double-Blind (For Injection, Groups Only), Randomized Clinical Trial

A new insight into the management of myofascial pain syndrome

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