The Superiority of Water-Diluted 0.25% to Neat 1% Lidocaine for Trigger-Point Injections in Myofascial Pain Syndrome: A Prospective, Randomized, Double-Blinded Trial

Iwama, Hiroshi; Akama, Yoichi

doi:10.1213/00000539-200008000-00033

Cited by 20 publications

(28 citation statements)

References 7 publications

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“…For the TPI, 0.25% lidocaine [5] was administered by multiple needling with continuous pressure on the plunger of the syringe, which resulted in a very small amount of lidocaine (0.1-0.2 ml) being administered at each injection site [6]. Dry needling [7] were performed with the needle used for acupuncture with the same motion as TPI.…”

Section: Casementioning

confidence: 99%

Complex Regional Pain Syndrome is a Manifestation of the Worsened Myofascial Pain Syndrome: Case Review

Chang¹

2017

J Pain Relief

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Complex regional pain syndrome is a severe chronic pain condition. Its diagnosis to date is controversial. Effects of various treatment methods also remain controversial with unpredictable outcomes. The author experienced a case of complex regional pain syndrome type 2 which was cured by sympathetic blockade and myofascial trigger point injection. Afterwards, the author focused on myofascial trigger points for the management of CRPS and the results were successful in almost all the cases. Through the review of complex regional pain syndrome cases those were successfully treated, the author tried to figure out pathologic mechanism, methods of treatment, and diagnostic criteria of complex regional pain syndrome.

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Section: Casementioning

confidence: 99%

Complex Regional Pain Syndrome is a Manifestation of the Worsened Myofascial Pain Syndrome: Case Review

Chang¹

2017

J Pain Relief

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“…24) Other studies have reported that the most effective concentration for local anesthetics ranged between 0.2% and 0.25% rather than 1%. 34,35) Regarding additive use with local anesthetics, any additives including vasoconstrictors and bisulfite should not be included because they cause post-injection sensitivity and pain. 24) Regarding the additional effects of injectates, many studies have shown no significant differences among groups of dry needling and wet needling using steroid, procaine or lidocaine, and botulinum toxin.…”

Section: Clinical Proceduresmentioning

confidence: 99%

Clinical Consideration of Trigger Point Injection/Dry Needling Therapy: A Narrative Review

Jung¹,

Byun²,

Choi³

2017

Journal of Oral Medicine and Pain

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Myogenous temporomandibular disorder is a collective term for pathologic conditions of the masticatory muscles, mainly characterized by pain and dysfunction associated with various pathophysiological processes. Among the subtypes of myogenous temporomandibular disorder, myofascial pain is one of the most common muscle disorders, characterized by the presence of trigger points (TrPs). Various modalities, such as ultrasound, manipulative therapy, sprayand-stretch technique, transcutaneous electrical nerve stimulation, injection/dry needling, and low-level laser therapy are used to inactivate TrPs. Needling/injection on the TrPs is one of the most common treatments for myofascial pain. Despite the evidence, there is continued controversy over defining the biological and clinical characteristics of TrPs and the efficacy of injection/dry needling. This review discusses the current concept of injection/needling to relieve TrPs.

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“…The 21-and 25-gauge needles were chosen because they are generally recommended or used in research studies for trigger point injections. 6,[8][9][10][11][12] In addition, a needle size (23 gauge) in between the 2 sizes was selected for this study for comparison. The 23-and 25-gauge needles were 1in long and the 21-gauge needles c 1.25in long; injections were made with a 3mL syringe filled with 0.5% lidocaine.…”

Section: Interventionmentioning

confidence: 99%

“…7 Nevertheless, many studies on trigger point injection in patients with myofascial pain syndrome of neck and shoulder have used a smaller diameter 25-gauge needle. [8][9][10][11][12] In the present study, we selected 3 differently sized needles to determine whether different needle thicknesses affect treatment efficacy and pain intensity. Accordingly, the purpose of this study was to determine the best needle size in terms of treatment efficacy and pain intensity during trigger point injection in myofascial pain syndrome of upper-and middletrapezius muscle.…”

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confidence: 99%

Comparison of 3 Needle Sizes for Trigger Point Injection in Myofascial Pain Syndrome of Upper- and Middle-Trapezius Muscle: A Randomized Controlled Trial

Rah

Sheen

et al. 2009

Archives of Physical Medicine and Rehabilitation

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Objectives: To investigate (1) the relation between needle diameter and treatment efficacy of myofascial pain syndrome and (2) the relation between needle diameter and pain intensity during injection.Design: Randomized controlled trial. Setting: University-affiliated tertiary-care hospital. Participants: Volunteers (Nϭ77) with myofascial pain syndrome affecting upper-and middle-trapezius muscles with at least 3 months' duration of pain.Intervention: Participants were randomly assigned to receive trigger point injections on 1 side of the trapezius with a 21-, 23-, or 25-gauge needle. After a 1-time injection, participants were followed up for 14 days. Participants and the assessor were blinded for group assignment.Main Outcome Measures: Treatment efficacy was measured with the visual analog scale (VAS; at pretreatment, and posttreatment on days 1, 4, 7, 14) for neck and upper-back pain, the Neck Disability Index (NDI; at pretreatment, and posttreatment on days 7, 14), and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36, at pretreatment and posttreatment on days 7, 14) for health-related quality of life. Pain intensity during injection was evaluated immediately after injection with VAS.Results: VAS scores for posttreatment on days 4, 7, and 14 decreased significantly compared with pretreatment scores in all groups; NDI scores on days 7 and 14 decreased significantly compared with pretreatment scores in all groups; SF-36 scores on days 7 and 14 decreased significantly compared with pretreatment scores in the 21-and 23-gauge needle groups; and SF-36 score on day 14 showed significant difference between the 21-and 25-gauge needle groups. For pain intensity during injection, VAS scores indicated no significant difference between the 3 groups. Conclusions:No difference between the needle types was observed in terms of VAS or NDI, or in terms of pain intensity felt by patients during injection. In terms of SF-36 scores, injections with 21-or 23-gauge needles were found to be more effective. However, a well-controlled investigation is needed to explore the effect of needle thickness on health-related quality of life.

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The Superiority of Water-Diluted 0.25% to Neat 1% Lidocaine for Trigger-Point Injections in Myofascial Pain Syndrome: A Prospective, Randomized, Double-Blinded Trial

Cited by 20 publications

References 7 publications

Complex Regional Pain Syndrome is a Manifestation of the Worsened Myofascial Pain Syndrome: Case Review

Complex Regional Pain Syndrome is a Manifestation of the Worsened Myofascial Pain Syndrome: Case Review

Clinical Consideration of Trigger Point Injection/Dry Needling Therapy: A Narrative Review

Comparison of 3 Needle Sizes for Trigger Point Injection in Myofascial Pain Syndrome of Upper- and Middle-Trapezius Muscle: A Randomized Controlled Trial

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