Myofascial Trigger Point Pain
Conditions
Keywords
myofascial trigger point, endplate noise, dextrose.
Brief summary
Patients with an myofascial trigger point (MTrP) in their upper trapezius will be divided into three groups: Group A receiving MTrP injection with normal saline (control group), Group B with hypo-osmolar dextrose (5% dextrose), and Group C with hyper-osmolar dextrose (15% dextrose). Clinical outcomes and morphological changes will be measured before the injection, one hour after, one week after, two weeks after, and one month after the injection to delineate the therapeutic effects of dextrose injection for an MTrP.
Detailed description
This experiment is designed to evaluate the therapeutic effects of dextrose injection on an myofascial trigger point (MTrP). Patients with an MTrP in their upper trapezius will be recruited and be divided into three groups: Group A receiving MTrP injection with normal saline (control group), Group B with hypo-osmolar dextrose (5% dextrose), and Group C with hyper-osmolar dextrose (15% dextrose). Clinical outcomes (visual analog scale, pressure pain threshold, range of motion, neck disability index) will be measured before the injection, one hour after, one week after, two weeks after, and one month after the injection. Morphological changes of an MTrP before, and after the injection will also be evaluated by sonography. Through this study, the definite therapeutic effects, and the better osmolality of dextrose injection for the treatment of an MTrP will be delineated.
Interventions
OTHERnormal saline
Inject 2 ml normal saline into a myofascial trigger point and evaluate the clinical effects before and after the injection.
Inject 2 ml 5% dextrose into a myofascial trigger point and evaluate the clinical effects before and after the injection.
DRUGDextrose 15% in water
Inject 2 ml 15% dextrose into a myofascial trigger point and evaluate the clinical effects before and after the injection.
Sponsors
National Cheng-Kung University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 1). Patients should be 20 years of age or older; * 2). They are able to communicate freely; * 3). Patients have the diagnosis of myofascial pain syndrome (MPS) with a definite myofascial trigger point (MTrP) in the neck base and upper back regions (the upper trapezius muscle). The MTrP is identified based on the following criteria, as recommended by Simons \[Simons et al., 1999\]: * (a). a localized tender spot in a palpable taut band of muscle fibers, * (b). recognized pain (as the usual clinical complaint) when the tender spot is compressed, * (c). characteristic and consistent referred pain. * 4). Symptoms of MPS should be more than 3 weeks.
Exclusion criteria
* (1). acute or serious medical problems; * (2). cognitive impairment or psychiatric disorder; * (3). coagulopathy or any other bleeding disorder; * (4). taking medication of anticoagulation or antithrombolytics; * (5). sensory deficiency over the body part where MTrPs located; * (6). serum hepatitis B or acquired immunodeficiency syndrome; * (7). malignancy; * (8). pregnant or likely to be pregnant. * (9). diabetes mellitus
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| visual analog scale (VAS) | Change from Baseline visual analog scale at one hour after intervention. | To measure the pain intensity of a myofascial trigger point. The minimum value is 0, and the maximum value is 10, and higher scores mean worse outcome (more painful). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pressure pain threshold (PPT) | Change from Baseline pressure pain threshold at one hour after intervention. | To measure the change of pressure pain threshold of a myofascial trigger point. The minimum value is 0 Kg/cm2, the maximum value is 5 Kg/cm2, and higher scores mean better outcome (less painful). |
| Range of motion (ROM) of the neck | Change from Baseline range of motion (ROM) of the neck at one hour after intervention. | To measure the change of the range of motion of cervical spine. The minimum value is 0 degree, the maximum value is 90 degree, and higher scores mean better outcome. |
| neck disability index (NDI) | Change from Baseline neck disability index (NDI) at one hour after intervention. | To measure the change of neck disability index (NDI) related to the myofascial trigger point. The minimum value is 0, the maximum value is 50, and higher scores mean worse outcome (increased functional disability). |
Countries
Taiwan
Contacts
Primary ContactTa-Shen Kuan, M.D., M.S.
Backup ContactYao-Hong Guo, M.D., M.S.
Outcome results
None listed