Paraspinal stimulation combined with trigger point needling and needle rotation for the treatment of myofascial pain: a randomized sham-controlled clinical trial

Clin J Pain. 2014 Mar;30(3):214-23. doi: 10.1097/AJP.0b013e3182934b8d.

Abstract

Background: There are different types and parameters of dry needling (DN) that can affect its efficacy in the treatment of pain that have not been assessed properly.

Objective: To test the hypothesis that either multiple deep intramuscular stimulation therapy multiple deep intramuscular stimulation therapy (MDIMST) or TrP lidocaine injection (LTrP-I) is more effective than a placebo-sham for the treatment of myofascial pain syndrome (MPS) and that MDIMST is more effective than LTrP-I for improving pain relief, sleep quality, and the physical and mental state of the patient.

Methods: Seventy-eight females aged 20 to 40 who were limited in their ability to perform active and routine activities due to MPS in the previous 3 months were recruited. The participants were randomized into 1 of the 3 groups as follows: placebo-sham, LTrP-I, or MDIMST. The treatments were provided twice weekly over 4 weeks using standardized MDIMST and LTrP-I protocols.

Results: There was a significant interaction (time vs. group) for the main outcomes. Compared with the sham-treated group, MDIMST and LTrP-I administration improved pain scores based on a visual analog scale, the pain pressure threshold (P<0.001 for all analyses), and analgesic use (P<0.01 for all analyses). In addition, when comparing the active groups for these outcomes, MDIMST resulted in better improvement than LTrP-I (P<0.01 for all analyses). In addition, both active treatments had a clinical effect, as assessed by a sleep diary and by the SF-12 physical and mental health scores.

Conclusions: This study highlighted the greater efficacy of MDIMST over the placebo-sham and LTrP-I and indicated that both active treatments are more effective than placebo-sham for MPS associated with limitations in active and routine activities.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acupuncture Therapy
  • Adult
  • Analgesics / therapeutic use
  • Anesthetics, Local / therapeutic use
  • Electric Stimulation Therapy*
  • Female
  • Humans
  • Lidocaine / therapeutic use
  • Myofascial Pain Syndromes / drug therapy
  • Myofascial Pain Syndromes / therapy*
  • Needles
  • Pain Measurement
  • Pain Threshold
  • Psychological Tests
  • Quality of Life
  • Rotation
  • Self Report
  • Sleep
  • Time Factors
  • Treatment Outcome
  • Trigger Points*
  • Young Adult

Substances

  • Analgesics
  • Anesthetics, Local
  • Lidocaine