Comparison of ozone and lidocaine injection efficacy vs dry needling in myofascial pain syndrome patients

J Pain Res. 2018 Jun 29;11:1273-1279. doi: 10.2147/JPR.S164629. eCollection 2018.


Purpose: Myofascial pain syndrome (MPS) is a common musculoskeletal disorder among young adults associated with presence of myofascial trigger points. We aimed to evaluate efficacy of ozone injection (OI) in MPS patients, compared with two currently used methods including lidocaine injection (LI) and dry needling (DN).

Patients and methods: In this single-blinded study, a total of 72 eligible patients were included and then randomly divided into three equal groups: DN, OI, and LI. All patients received treatment in three weekly sessions. Visual analog scale (VAS) for pain, cervical lateral flexion, pain pressure threshold (PPT), and neck disability index (NDI) were the main outcome measures, which were evaluated at baseline and at 4 weeks after injections. Analytic results were demonstrated as both within- and between-groups mean difference (MD).

Results: Sixty two patients finished the study, 20 participants in both the DN and LI groups, and 22 persons in OI group. Distribution of all demographics and baseline clinical variables were relatively similar among groups. All three interventions were remarkably effective in improving patients' pain and PPT. Significant decrease in VAS (MD=-3.6±1.4) and increase in PPT (MD=7.2±5.1) within 4 weeks follow-up confirmed this finding. Also, NDI had similar significant improvement (MD=-9.9±8.7), but lateral flexion range did not show remarkable increase. There was also a statistically significant difference among three methods' efficacy on VAS, NDI, and PPT, favoring OI and LI.

Conclusion: In summary, this data showed that in short-term follow-up, all three methods were significantly effective in MPS treatment; however, OI and LI groups had slightly better results than the DN group, with no remarkable preference between them.

Keywords: intra-muscular ozone injection; myofascial trigger points; wet needling.