A Comparison of the Efficacy of Dry Needling, Lidocaine Injection, and Oral Flurbiprofen Treatments in Patients with Myofascial Pain Syndrome: A Double-Blind (For Injection, Groups Only), Randomized Clinical Trial

Abstract

Amaç: Bu çalışmada boyun ve sırt bölgesinde miyofasiyal ağrı sendromu (MAS) bulunan hastalarda kuru iğneleme, lidokain enjeksiyonu ve oral flurbiprofen tedavilerinin etkinliği karşılaştırıldı. Hastalar ve yöntemler:Bu prospektif çalışmaya toplam 60 hasta (7 erkek, 53 kadın; ort yaş 33.7 yıl; dağılım 18-50 yıl) dahil edildi. Hastalar blok randomizasyon ile üç gruba ayrıldı. Bir gruba tetik noktalara kuru iğneleme, bir gruba lidokain enjeksiyonu (çift kör) ve diğer gruba yedi gün süresince 200 mg/gün oral flurbiprofen tedavisi verildi. Ayrıca hastaların tümüne tutulan kasın gerilmesini temel alan standart bir ev egzersiz programı da verildi. Tedavi öncesi ve tedaviden sonraki üçüncü ve 14. günlerde ağrı şiddeti, görsel analog ölçeği (GAÖ) ile tetik noktaların duyarlılık derecesi algometre ile boyun ve omuz aktif eklem hareket açıklıkları gonyometre ile ve yaşam kalitesi Nottingham Sağlık Profili ile değerlendirildi. Bulgular: Üç grupta da tedaviden sonraki üçüncü ve 14. günlerde tedavi öncesine göre ağrı şiddeti, tetik nokta hassasiyeti, eklem hareket açıklıkları ve yaşam kalitesi açısından iyileşme saptandı. Tedavilerin etkinlikleri açısından gruplar arasında anlamlı fark bulunmadı.Sonuç: Miyofasiyal ağrı sendromunun tedavisinde, ev egzersizleri ile birlikte kuru iğneleme, lidokain enjeksiyonu ve oral flurbiprofen tedavilerinin tümü etkindir.Anahtar sözcükler: Kuru iğneleme; flurbiprofen; lidokain; miyofasiyal ağrı sendromu. Objectives:The aim of this study was to assess and compare the efficiency of dry needling, lidocaine injection and oral flurbiprofen treatments in patients with myofascial pain syndrome (MPS) involving the neck and back region. Patients and methods:A total of 60 patients (7 males, 53 females; mean age 33.7 years; range 18 to 50 years) were included in this prospective study. The patients were divided into three groups by block randomization. Each group was assigned to dry needling for trigger points, lidocaine injection (double blind) or oral flurbiprofen 200 mg/day over seven days. All patients were also prescribed a standardized home exercise program based on stretching of the affected muscles. Before treatment and on the third and 14 days after treatment, pain severity was assessed by visual analog scale (VAS), degree of tenderness at the trigger points by algometry, active joint range of motion of the neck and shoulders by goniometry, and the quality of life by Nottingham Health Profile.Results: There was a significant improvement in pain severity, trigger point tenderness, joint range of motion, and quality of life in all three groups on the third and 14 th days of treatment. No significant difference was found in treatment efficiency among the groups. Conclusion:Treatments with dry needling, lidocain injection and oral flurbiprofen along with home exercises are all effective in the management of MPS.

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