Comparison of the Effects of Physiologic Saline Interfascial and Lidocaine Trigger Point Injections in Treatment of Myofascial Pain Syndrome: A Double-Blind Randomized Controlled Trial.
Anuphan Tantanatip, Wasa Patisumpitawong, Saridpong Lee
PMID 34179755WHAT IT FOUND
At 2 and 4 weeks, pain after saline injection between muscle layers and lidocaine trigger point injection was not different enough to be sure one was better.
Only at 10 minutes did lidocaine give greater relief. Both groups were advised to stretch.
Key findings
01Both groups, who were also advised to perform upper trapezius stretching, had lower pain than before treatment at 10 minutes, 2 weeks, and 4 weeks.
02Between the injection groups, both of which were also advised to perform upper trapezius stretching, the only pain difference favoured lidocaine trigger point injection at 10 minutes; at 2 and 4 weeks the groups were not different enough to be sure one was better.
03In both injection groups, which were also advised to perform upper trapezius stretching, cervical range of motion improved in some directions, but the groups were not different enough to be sure one improved more.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The follow-up was only 4 weeks, so long-term effects were not determined. There was no placebo or sham injection, so improvement could reflect spontaneous resolution or placebo effect. All participants were advised to perform upper trapezius stretching exercises during follow-up, so the contribution of the injection alone cannot be separated from stretching. The groups received different solutions, volumes, and needle movement techniques, so the effect of any single component cannot be separated. The study enrolled patients from a single outpatient clinic and excluded several conditions, so it may not apply to all patients with neck pain.
The easy way to misread this
Do not conclude that saline interfascial injection alone is proven as effective as lidocaine trigger point injection alone. Both groups were also advised to perform upper trapezius stretching, there was no sham injection, and the two injections differed in solution, volume, and needle movement.