Comparison of Therapeutic Effects of Trigger Point Injection and Twin Nerve Block in Chronic Myofascial Pain Patients

Study Overview
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Brief Summary
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To see if there is there any difference in the treatment outcomes/results such as changes in pain intensity in patients with myofascial pain who have been treated with trigger point injections or twin block?

Detailed Description
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Most treatment approaches for chronic myofascial pain are not evidence-based. Studies are usually controversial. Most are short-term, non-randomized. An essential limitation has been the lack of standardization of diagnosis. Some studies do not differentiate between joint pain and muscle pain, which can significantly affect the outcome of the treatment provided. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was recently published and validated. Their protocol allows standardization of the assessment and diagnosis of patients with temporomandibular disorder, including myofascial pain. To the investigator's knowledge, no previous prospective, randomized study has been conducted demonstrating the treatment outcomes of either trigger point injections or twin block in patients with chronic myofascial pain.

Official Title
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Comparison of Therapeutic Effects of Trigger Point Injection and Twin Nerve Block in Chronic Myofascial Pain Patients

Conditions
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Myofascial Pain - Dysfunction Syndrome of TMJ, Trigger Point Pain, Myofascial, Nerve Block

Intervention / Treatment
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* Other: Injection of either twin block or trigger point injection.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients diagnosed with Myofascial pain with referral based on the DC/TMD criteria Pain on the masseter and or temporalis muscles Pain present for at least 3 months Exclusion Criteria: Generalized muscle disorder such as fibromyalgia Subjects on chronic pain medication Subjects who are known to have hypersensitivity to the local anesthetics. Pregnant women. A pregnancy test will not be given before subject enrollment. Women of childbearing ages will be asked verbally if they are pregnant. If they are unsure, then they will be excluded from the study. Subjects with cognitive problems e.g. Alzheimer's disease.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 89 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: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Twin Block Group<br>This group will receive twin block injections. | Other: Injection of either twin block or trigger point injection.<br>* Study participants will be randomized into either group and will receive the intervention.<br>|
| Active Comparator: Trigger Point Injection Group<br>This group will receive trigger point injections. | Other: Injection of either twin block or trigger point injection.<br>* Study participants will be randomized into either group and will receive the intervention.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain relief: numerical pain scale | The pain relief received from each injection will be measured using the numerical pain scale. This scale is between 0-10 with 0 meaning no pain and 10 is the most pain.Higher values represent worse pain. | 6 months |