Comparison of the efficacy of oxygen-ozone and lidocaine injections in the treatment of myofascial pain syndrome: A randomized clinical trial

Abstract

Objectives: This study aims to compare effectiveness of oxygen-ozone injection versus lidocaine injection on the trigger point in the treatment of myofascial pain syndrome (MPS). Patients and methods: Between April 2021 and December 2021, a total of 46 patients with MPS (8 males, 38 females; mean age: 44.7±10.4 years; range, 25 to 65 years) were included. The patients were randomized to either ozone injection (n=23) or lidocaine injection (n=23) groups. All injections were administered once a week for three consecutive weeks. The primary outcome measure was the pain severity assessed by Visual Analog Scale (VAS). Secondary outcome measures were cervical lateral flexion range of motion (ROM), pain score (PS), and Neck Disability Index (NDI). The measurements were performed before the treatment, and at four and 12 weeks after treatment. Results: There was a significant effect of time for VAS, PS, and NDI scores in both groups. Compared to baseline versus Weeks 4 and 12, the VAS, PS, and NDI scores significantly decreased over time in both groups (p<0.001 for all). A significant group ¥ time interaction was identified regarding the VAS scores. The mean difference in the VAS scores over time was significantly higher in the lidocaine group compared to the oxygen-ozone group (p=0.028). Conclusion: Oxygen-ozone and lidocaine injections of the trigger point can effectively improve pain and functional status. However, lidocaine injection appears to be superior in reducing pain compared to oxygen-ozone injection, but is not superior in improving function and PS.

Oxygen–Ozone Therapy of Musculoskeletal Neck Pain: A Review

“…Other parameters assessing treatment outcome (DN4, SF-36, SF-12, Japanese Orthopedic Association score, etc.) have been used non-constantly, e.g., ROM has been assessed only in studies dealing with neck MPS [ 13 , 34 ].…”

“…Due to the various beneficial biological effects of ozone (e.g., anti-inflammatory, antioxidant, and immunomodulatory), it is hypothesized that oxygen–ozone therapy could affect pain in patients with myofascial syndrome when applied to the MTrP [ 33 ]. Moreover, injection of the O 2 -O 3 mixture could contribute to the inactivation of MTrP by the mechanical influence on muscle fibers [ 19 , 34 ].…”

“…Treatment of Neck MPSKorkmaz et al[34] in a single-blind RCT compared the effectiveness of O 2 -O 3 injection versus lidocaine injection targeted to MTrP in patients with MPS. Both O 2 -O 3 and lidocaine injections were significantly effective in pain relief and in function improvement measured by VAS, pain score (by applying a pressure on trigger point), and NDI.…”