Treatment of Myofascial Pain Syndrome With Lidocaine Injection and Physical Therapy.
Condition: Myofascial Pain Syndrome; Pain; Myofascial Trigger Point Pain; Musculoskeletal Pain
MeSH terms: Musculoskeletal Pain; Myofascial Pain Syndromes; Fibromyalgia; Syndrome; Somatoform Disorders
Study type: Interventional
Phase: Phase 4

Summary: 
      Background: Myofascial pain syndrome (MPS) of the shoulder girdle and cervical region is a
      common musculoskeletal problem that is often chronic or recurrent. It has demonstrated the
      effectiveness of different treatments such as exercise, injection but not comparing them with
      each other. The objective of this research was to demonstrate whether lidocaine injection
      into trigger points combined with a physical therapy program was more effective than each
      separatetreatment in improving pain, function and quality of life in a group of patients with
      myofascial pain syndrome (MPS) of the shoulder girdle and cervical region.

      Design: Single-blind, randomized, controlled clinical trial with three parallel groups in the
      departments of physical medicine and rehabilitation of two urban hospitals. There were 127
      patients with myofascial pain in the shoulder girdle for more than six weeks in length and
      pain greater than 40 mm on the visual analog scale (VAS). There were three intervention
      groups: physical therapy (PT), lidocaine injection (LI), or the combination of both (PT +
      LI). The primary outcome at one month was the VAS, and the secondary outcomes were measured
      using the SF36 pain scaleat one and three months.

      Keywords: Myofascial pain, trigger points, lidocaine injection, physical therapy.
    

Detailed description: 
      We propose a double blind randomized controlled clinical trial, in different health centers
      in Medellin. The subjects are patients with myofascial trigger points (MTP) in muscles of the
      shoulder girdle (levator scapulae, trapezius, infraspinatus) diagnosed by neck ans shoulder
      pain lasting langer than 6 weeks, and that have not received rehabilitation treatment and are
      not currently taking analgesic medications. We have calculated a sample of 45 patients in
      each group.

      The physical and rehabilitation doctors who evaluated the patients and the nurse who assessed
      the patients were blinded to treatment allocation. Physicians who performed the MTP injection
      did not participate in the evaluation of primary and secondary outcomes. Physical therapists
      who conducted the therapeutic exercise program did not participate in the evaluation of
      primary and secondary outcomes.
    

Intervention name(s): Physical therapy; Lidocaine injection; Lidocaine injection + physical therapy
Intervention type(s): Other; Drug; Other
Intervention description(s): Twelve sessions (3 per week); blocking the Myofascial trigger point (MTP) with lidocaine injection, unique dose.; blocking the Myofascial trigger point (MTP) with lidocaine injection plus a standarized therapeutic exercise program (twelve sessions, 3 per week)
Other intervention name(s): standardized therapeutic exercise program; blocking the Myofascial trigger point; blocking plus a standarized therapeutic exercise program
Intervention MeSH terms: Lidocaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Myofascial pain; Trigger points.; Lidocaine injection.; Physical therapy