Comparison on Treatment Effects of Dextrose Water, Saline, and Lidocaine for Trigger Point Injection

ABSTRACT

Myofascial trigger point(TP) is characterized as an impaired energy metabolism. We hypothesized that the use of dextrose as an energy supplement for TP injection would be more effective than saline or lidocaine. Sixty four typical myofascial pain patients were treated with TP injections. Among them 23 were injected with 5% dextrose water(D/W Group), 20 with normal saline (N/S Group), and 21 with 0.5% lidocaine (Lidocaine Group). Visual analogue scale(VAS) and pressure threshold algometer(kg/cm2) were used as measuring tools before, immediately after, and 7 days after the injection therapies. Mean VAS scores were 6.78 before, 5.19 immediately after, and 3.39 seven days after the injections, and the treatment effects were greater after the second and third injections. Mean differences of pressure threshold were 0.37 before and immediately after injections, and 0.42 before and 7 days after injections. Significant elevation of threshold was noted after the second and third injections. Mean VAS were not significantly different in three groups before and immediately after injections. But after 7 days, only D/W Group showed significantly lower score of 2.39, compared to 3.85 in N/S Group and 4.05 in Lidocaine Group(P<0.01). Mean pressure threshold before and immediately after injections was not different in each group. After seven days D/W Group also showed significantly higher value of 2.49, compared to 1.91 in N/S Group and 2.07 in Lidocaine Group(P<0.05). We have concluded that 5% dextrose water would be the preferable choice for TP injection.