Table 1.
Outcomes data for trigger point injections with local anesthestic/steroid
| Study Author | Study Type | Study Size | Metrics | Study Question | Outcomes |
|---|---|---|---|---|---|
| Hong CZ et al,63 1994 | RCT | 58 | PS, Cervical ROM | Comparing 0.5% lidocaine TPI to dry needling in upper trapezius muscle MPS. | Lidocaine TPI resulted in more immediate soreness than dry needling. However, dry needling resulted in greater intensity and longer duration of soreness after procedure than lidocaine TPI |
| Tschopp KP et al,67 1996 | RCT | 107 | PS | Comparing 0.25% bupivacaine to 1.0% lidocaine to saline TPI for MPS. | No difference in relief between groups so long as needle hits muscle belly. |
| Hameroff SR et al,68 1981 | Crossover double-blind RCT | 15 | PS | Comparing bupivacaine to etidocaine to saline for TPI evaluating relief 7 days after injection for MPS. | Local preferred to saline alone. |
| Iwama H et al,69 2007 | RCT | 20 | PS | Comparing 0.25% to 1.0% lidocaine for TPI for MPS. | 0.25% lidocaine had less injection pain and better efficacy (14 d relief compared to 7 d) |
| Zaral idou AT et al,70 2009 | RCT | 68 | PS | Comparing ropivacaine to levobupivacaine for TPI for MPS. | No significant differences were found between groups at 2 wk out. |
| Garvey TA et al,65 1989 | Double-blind RCT | 63 | NRS | Comparing local anesthetic TPI, local anesthetic with steroid TPI, acupuncture, and cool spray with acupuncture for MPS. | No difference between types of procedural techniques was noted. Did not matter if medication was injected for procedure, both resulted in pain relief. |
| Kocak AO et al,71 2019 | RCT | 54 | VAS | Comparing NSAID and TPI for low back MPS. | TPI was superior to NSAIDs when assessed with pain relief within the first hour of intervention. |
| Roldan CJ et al,72 2020 | RCT | 48 | NRS | Comparing local anesthetic and steroid TPI to saline TPI in ED patients. | Resulted in similar change in pain relief in both groups. |
| Iwama H et al,73 2001 | RCT | 21 | PS | Testing injection pain with dilute local anesthetic in volunteers as well as using dilute local anesthetic doses in patients with MPS. | Less pain with dilute local injections. Duration relief in MPS patients not affected by using dilute local at low enough doses. |
| Krishnan SK et al,74 2000 | RCT | 30 | VAS | Comparing injection pain of bupivacaine, ropivacaine, bupivacaine with steroids, ropivacaine with steroids, and just needle insertion. | Ropivacaine was less painful (alone) compared to bupivacaine or either local anesthetic in combination with steroids. |
| Yoon SH et al,75 2007 | RCT | 77 | VAS, NDI, SF-36 | Comparing needle sizes on injection pain. | No difference was noted between sizes of needles used. |
| Ga H et al,76 2009 | RCT | 39 | VAS, FACES, PPI, GDS-SF | Comparing TPI with 0.5% lidocaine with acupuncture for MPS. | No difference between groups. |
| Mitidieri AMS et al,77 2020 | RCT | 35 | VAS, NCS, MPQ | Comparing acupuncture to TPI (local anesthetic) for pelvic pain from abdominal MPS. | No difference between outcomes when analyzed at 1 wk, 1 mo, 3 mo, and 6 mo out except for MPQ differences at 1 wk. |
Abbreviations: FACES, Wong-Baker FACES Paine Scale; GDS-SF, Geriatric Depression Scale-Short Form; MPQ, McGill Pain Questionnaire; MPS, myofascial pain syndrome; NCS, Numeric Categorical Scale; NDI, Neck Disability Index; NPAD, Neck Pain and Disability Scale; NPQ, Neck Pain Questionnaire; NRS, numeric rating score; NSAID, nonsteroid anti-inflammatory drugs; PFDI-20, Pelvic Floor Distress Inventory - 20; PPI, Pressure Pain Intensity Scores; PS, pain score (internal system); RCT, randomized controlled trial; ROM, range of motion; SF-36, Medical Outcomes Study 36 Item Short Form Health Survey; TPI, trigger point injection; VAS, visual analog score.