Local injection therapy for myofascial trigger points

ABSTRACT

In patients with myofascial pain, painful trigger points are often treated using local anaesthetics and/or steroids injections. However, the therapeutic effects of these treatment have not been quantified, and the mechanism underlying the effect is poorly understood. In a randomized clinical trial, thirty adult patients of both sexes and of an age range of 17-42 years were treated for myofascial pain in the jaws. They had presented with myofascial pain that could be traced back to trigger points in the masseter and/or the temporalis muscles. The trigger point number and distribution was mapped prior to the commencement of any treatment form. The treatment results were analyzed after a series of local anaesthetic [xylocaine] injections only of the trigger points [group A], steroid [epidron] injections only [group B] and combined injection therapy [xylocaine + epidron] [group C. Data used for evaluation and statistical analysis included 1- number of trigger points before and after treatment sessions. 2- changes in pain measuring or visual analogue scale and 3-changes in maximal interincisal distance values. Electromyographic readings were used to monitor responses to different kinds of treatment. The results show group C patients to favour a significant and remarkable drop in the median number of trigger points after two weeks of therapy. Likewise, visual analogue scale ratings for group C patients decreased significantly after the second and third weeks of treatment. As for maximal interincisal distance values, they were markedly increased after the third week of treatment in the same group of patients