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EMG needling is not a painless procedure. In recent studies it has been shown that a form of lidocaine has the efficacy which is similar to EMLA, for prevention of pain associated with EMG needling. The aim of this study was to evaluate the efficacy of Lidocaine H ointment in alleviating the pain caused by EMG needling. This study was performed on patients referred to Shohadaye Tajrish Hospital for EDx study in APR 2009- APR 2010. A double blinded, placebo controlled study was performed in 47 adult patients [94 lower limbs] to compare the pain of EMG needling into the tibialis anterior muscle after application of lidocaine-H ointment or placebo. Pain scores were obtained by using visual analog scale [VAS]. Experimental and placebo groups were compared with Mann-U-Whitney and Chi-square tests. The study was performed on 47 patients, 38.3% male and 61.7% female, mean age being 45.5 +/- 16.4years. Median VAS score was 4.66 +/- 2.14 vs. 6.11 +/- 2.07, [P<0.05]. 51.1% of patients in experimental group as compared to 21.3% in controls reported mild pain [VAS < 4], [P<0/01]. It seems that lidocaine-H ointment has beneficial effects in prevention of the pain associated with EMG needling

[Comparison of dry needling and physical therapy modalities in treatment of myofascial pain of upper trapezius muscle]

Myofascial pain syndrome of upper trapezius muscle is common; reports about successful treatment with dry needling and physical therapy have been published. This study was performed with the objective of comparing the efficacy of these two treatment modalities in relieving the symptoms in patients with myofascial pain in the trapezius referred to the Physical Medicine and Rehabilitation Center at the Shohadaye Tajrish Hospital from Apr 2009 to March 2010. It was a randomized controlled trial performed on 28 patients. After matching age, sex, duration of symptoms, pain severity, pain pressure threshold of trigger point and quality of life measures, subjects were randomly put in to subgroups of case [dry needling] or control [physical therapy]. One week and one month after receiving treatment, outcomes and intra and inter group changes in pain severity, pain pressure threshold of trigger point and quality of life measures were evaluated and compared. 28 subjects in two 14 patients groups took part in this study. After one month of both physical therapy and dry needling, there was a decrease in resting, night and activity pain levels, [p<0.05]. Pain pressure threshold of trigger point, scores of physical functioning, role limitation due to physical problems, social functioning and bodily pain were improved [p<0.05]. Results were similar in the two groups, [p<0.4]. It seems that both physical therapy modalities and dry needling have equal effect in decreasing myofascial pain of upper trapezius muscle