Ultrasound-guided Fascial Release Injection for Myofascial Pain Syndrome in the Upper Trapezius Muscle

Study Overview
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Brief Summary
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Patients with myofascial pain syndrome at upper trapezius will be randomized into 2 groups, fascial injection group and subcutaneous control injection group. Pain condition pain, range of motion and function will be evaluated in 1 week, 4 weeks and 12 weeks after injection.

Detailed Description
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Myofascial pain syndrome(MPS) is characterized by a trigger point with a hyperirritable nodule and taut band of muscle or fascia. MPS was usually treated by dry needling or met needing, local anesthetics injection, to the trigger point. According to recent researches, dry and wet needling to affected muscle are effectiveness for short term and medium term pain relief. Although some researches indicated an increased viscosity at fascial layer in MPS and there are few studies of manipulation for fascial release. There is not study of injective fascial release. Investigators will include 40 patients with myofascial pain syndrome at upper trapezius. Participants will be randomized into 2 groups, fascia injection group and subcutaneous control injection group. Investigators will use algometer to measure pain threshold and peak pressure, measure the range of motion of neck and shoulder and assess the neck and shoulder function by questionnaire. The examination will be done before injection, immediately after injection, 1 week, 4 weeks and 12 weeks after injection. To our hypothesis, investigators suggest focal anesthetics injection could decrease the fascial viscosity and improved pain and quality of life.

Official Title
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Ultrasound-guided Fascial Release Injection for Myofascial Pain Syndrome in the Upper Trapezius Muscle: A Pilot Study

Conditions
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Myofascial Pain Syndrome

Intervention / Treatment
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* Procedure: Sham injection
* Procedure: Fascia injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 20-70 years old diagnosed as a myofascial pain syndrome at upper trapezium muscle trigger point taut band refer pain while taut band irritation Exclusion Criteria: Cognitive impairment. Post operation at neck and shoulder. Nerve compression at cervical region. Could not receive injection therapy, history of fainting during needling

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: Sham injection<br>Subcutaneous injection at upper trapezium muscle level | Procedure: Sham injection<br>* Injection to the subcutaneous layer at upper trapezium level<br>|
| Experimental: Fascia injection<br>Fascia injection, below upper trapezium muscle | Procedure: Fascia injection<br>* Injection to the fascia below upper trapezium muscle<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Upper back or shoulder pain | visual analogue scale(VAS), range 0-10, the higher the worse pain | Change from baseline VAS at 1 week | 
| Upper back or shoulder pain | visual analogue scale(VAS), range 0-10, the higher the worse pain | Change from baseline VAS at 4 week | 
| Upper back or shoulder pain | visual analogue scale(VAS), range 0-10, the higher the worse pain | Change from baseline VAS at 12 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Function | Shoulder Pain and Disability Index (SPADI), range 0-130, the higher the worse | Change from baseline SPADI at 1 week | 
| Function | Shoulder Pain and Disability Index (SPADI), range 0-130, the higher the worse | Change from baseline SPADI at 4 week | 
| Function | Shoulder Pain and Disability Index (SPADI), range 0-130, the higher the worse | Change from baseline SPADI at 12 week |