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:10.1097/00000539-200008000-00033

Cited by 29 publications

(15 citation statements)

References 5 publications

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“…The scores in the MP group, however, returned to baseline at 1 month. We suggest that these temporary improvements are similar to what is seen in the literature where transient, partial relief of pain from suspected TrPs identified by MP is the expected outcome [14][15][16][17][18]. We believe that this is a result of the lack of specificity inherent to MP in identifying the source of muscle pain.…”

Section: Discussionsupporting

confidence: 82%

“…Muscles and the TrPs they presumably contain can be a treatable pain source; however, the observed pain relief is often transient and/or partial when using MP as the method of detection [15,16,19], as noted in our study. We suggest that improper identification with MP of the actual muscle(s) causing regional pain leads to inconsistent and suboptimal treatment outcomes [10,[13][14][15][19][20][21].…”

Section: Resultsmentioning

confidence: 47%

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A New Muscle Pain Detection Device to Diagnose Muscles as a Source of Back and/or Neck Pain

et al. 2010

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Section: Discussionsupporting

confidence: 82%

Section: Resultsmentioning

confidence: 47%

A New Muscle Pain Detection Device to Diagnose Muscles as a Source of Back and/or Neck Pain

et al. 2010

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“…Invasive treatments include injections with local anaesthetics, corticosteroids, or botulinum toxin, or dry needling [13–18]. …”

Section: Mechanisms Of Action Of Trigger Point Injectionsmentioning

confidence: 99%

A New Look at Trigger Point Injections

Wong

2012

Anesthesiology Research and Practice

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Trigger point injections are commonly practised pain interventional techniques. However, there is still lack of objective diagnostic criteria for trigger points. The mechanisms of action of trigger point injection remain obscure and its efficacy remains heterogeneous. The advent of ultrasound technology in the noninvasive real-time imaging of soft tissues sheds new light on visualization of trigger points, explaining the effect of trigger point injection by blockade of peripheral nerves, and minimizing the complications of blind injection.

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“…Because an LTR was induced even in PTs where TrPs were not present, an LTR was not a specific reaction for MPS to have TrPs, and most tend to match the acupuncture points (GB-21, BL-10, SI-14). In light of this clinical response, it is possible that neck and shoulder pain syndrome (so-called katakori ) may be closely related to the broad definition of MPS in the shoulder girdle, and MAPI for idiopathic katakori patients may be an effective means of treatment similar to the TrP injections by Graboski et al [ 32 ], Iwama et al [ 33 ], Esenyel et al [ 34 ], and Kiralp et al [ 35 ]. It is possible that injections that deviate from TrPs exacerbate pain [ 36 ], but among the subjects in this study, none had an exacerbation of pain after MAPI.…”

Section: Discussionmentioning

confidence: 99%

Multi-Acupuncture Point Injections and Their Anatomical Study in Relation to Neck and Shoulder Pain Syndrome (So-Called Katakori) in Japan

et al. 2015

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Katakori is a symptom name that is unique to Japan, and refers to myofascial pain syndrome-like clinical signs in the shoulder girdle. Various methods of pain relief for katakori have been reported, but in the present study, we examined the clinical effects of multi-acupuncture point injections (MAPI) in the acupuncture points with which we empirically achieved an effect, as well as the anatomical sites affected by liquid medicine. The subjects were idiopathic katakori patients (n = 9), and three cadavers for anatomical investigation. BL-10, GB-21, LI-16, SI-14, and BL-38 as the WHO notation were selected as the acupuncture point. Injections of 1 mL of 1% w/v mepivacaine were introduced at the same time into each of these points in the patients. Assessment items were the Pain Relief Score and the therapeutic effect period. Dissections were centered at the puncture sites of cadavers. India ink was similarly injected into each point, and each site that was darkly-stained with India ink was evaluated. Katakori pain in the present study was significantly reduced by MAPI. Regardless of the presence or absence of trigger points, pain was significantly reduced in these cases. Dark staining with India ink at each of the points in the anatomical analysis was as follows: BL-10: over the rectus capitis posterior minor muscle and rectus capitis posterior major muscle fascia; GB-21: over the supraspinatus muscle fascia; LI-16: over the supraspinatus muscle fascia; SI-14: over the rhomboid muscle fascia; and BL-38: over the rhomboid muscle fascia. The anatomical study suggested that the drug effect was exerted on the muscles above and below the muscle fascia, as well as the peripheral nerves because the points of action in acupuncture were darkly-stained in the spaces between the muscle and the muscle fascia.

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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 29 publications

References 5 publications

A New Muscle Pain Detection Device to Diagnose Muscles as a Source of Back and/or Neck Pain

A New Muscle Pain Detection Device to Diagnose Muscles as a Source of Back and/or Neck Pain

A New Look at Trigger Point Injections

Multi-Acupuncture Point Injections and Their Anatomical Study in Relation to Neck and Shoulder Pain Syndrome (So-Called Katakori) in Japan

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