Evaluation of dry needling and 0.5% lidocaine injection therapies in myofascial pain trigger points in masticatory muscles

Abstract

OBJECTIVE: The purpose of this study was to compare the effectiveness of trigger points injections using lidocaine 0.5% and dry needling without any kind of home-based rehabilitation program. METHODS: Sixteen patients with myofascial pain and trigger points in masticatory muscles were randomly assigned to two groups and received only one application session. The pressure pain threshold (PPT) was recorded before and after the injection: Ten minutes, 24 hours later, 7, 15, 21 and 30 days after the treatment. Visual analogue scale (VAS) was used to in all evaluation periods. RESULTS: There were no difference between groups for PPT, but for all groups the PPT during the time significantly increased when compared the before treatment. VAS showed differences between groups and during the time. The 0.5% lidocaine had the lowest VAS values when compared to dry needling, but at 30 days there were no differences among them. CONCLUSIONS: Despite the differences in VAS and considering there were no differences in PPT increases, we concluded that, in this study, both groups were able to disrupt the mechanisms of trigger point and relieve the myofascial pain symptoms

Eficácia da técnica de agulhamento seco no controle da síndrome da dor miofascial

“…Justificou-se, em uma pesquisa, que o agulhamento seco é tão eficaz como a injeção de uma solução anestésica, como a lidocaína, visto que ambos foram capazes de interromper os mecanismos do PGM e aliviar os sintomas de dor miofascial 27 . Em concordância com outro estudo randomizado, comparou-se o uso de agulhamento seco versus injeção de lidocaína na intervenção de PGM, que mostrou que ambos são eficazes na inativação deles, porém sugeriu-se que o agulhamento seco pode ser preferido aos anestésicos locais, devido a menos efeitos colaterais 25 .…”

“…Foram avaliados os níveis de dor pela EAV, limiar de dor p. 111 à pressão e palpação de PGM. Concluiu-se que ambos os grupos tiveram redução estatisticamente significativa, de acordo com a EAV, e foram capazes de interromper os mecanismo dos PGM e aliviar os sintomas da dor miofascial 27 .…”

Is acupuncture an effective treatment for temporomandibular disorder?: A systematic review and meta-analysis of randomized controlled trials

“…Study designs for RCTs included in the analysis were as follows: comparisons of acupuncture with an inactive control (n = 16), [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] comparison of acupuncture with a conventionally used active control (n = 19), [50,[52][53][54][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] and comparison of effects of an active control with the same treatment plus acupuncture use as an add-on treatment (n = 4). [65,66,71,72] Among these, 5 articles contained both inactive and active controls, [50,[52][53][54]56] and 2 articles used both active controls and add-on treatments with active controls [65,66] (Supplementary Tables 2-4, http://links.lww.com/ MD/J...…”

“…Inactive controls used included the following: sham acupuncture, [41][42][43][45][46][47]49,50,55] sham laser acupuncture, [44,48,56] sham DN, [51,53] and no treatment (wait-list) [52,54] (Supplementary Table 2, http://links.lww.com/MD/J688). Traditional active controls identified were as follows: physical therapy including ultrasound and ultrashort-wave therapy, [50,[58][59][60][61][62] laser therapy, [56] drug therapy, [57,64,65,67] injection therapy, [53,63,[66][67][68] and the use of a splint [52,54,69,70] (Supplementary Table 3, http://links.lww. com/MD/J689).…”

“…Acupuncture interventions used included various forms of traditional and contemporary acupuncture, including acupuncture point stimulation; [42,[44][45][46][47][48][49]52,[54][55][56]58,59,61,62,64,[68][69][70][71][72] electroacupuncture; [60,68,72] warm needling; [58,61,64] and stimulation of trigger points [41,43,50,51,53,56,57,63,[65][66][67] or A-shi points. [58,60,64,68] Various proximal (GB2, GB20, GB21, ST6, ST6, SI18, SI19, EX-HN5, etc) and distal (GB34, LI4, ST36, SI2, SI3, etc) acupuncture points were used as sites of acupuncture stimulation.…”