Different Substances and Dry-Needling Injections in Patients with Myofascial Pain and Headaches

Abstract

Trigger point injections with different solutions have been studied mainly with regard to the management of myofascial pain (MFP) patient management. However, few studies have analyzed their effect in a chronic headache population with associated MFP. The purpose of this study was to assess if trigger point injections using lidocaine associated with corticoid would be better than lidocaine alone, as in comparison with dry-needling in for the management of local pain and associated headache management. Forty-five (45) myofascial pain patients with headaches that could be reproduced by activating at least one trigger point, were randomly assigned into one of the three groups: G1, dry-needling, G2, 0.25% lidocaine, at 0.25% and G3, 0.25% lidocaine at 0.25% associated with corticoid, and were assessed during a 12 week period. Levels of pain intensity, frequency and duration, local post-injection sensitivity, obtainment time and duration of relief, and the use of rescue medication were evaluated. Statistically, all three groups showed favorable results for the evaluated requisites (p < or = 0.05), but only for post-injection sensitivity did the association of lidocaine with corticoid present the best results and ingestion of rescue medication.

Efficacy of Local Lidocaine Application on Anxiety and Depression and Its Curative Effect on Patients with Chronic Tension-Type Headache

“…Detection of higher concentrations of bradykinin, CGRP, substance P, TNF-α, IL-1b, serotonin, and norepinephrine during histopathological examinations suggested the role of trigger points in the pathogenesis of chronic TTH by these mediators [24]. Although the trigger points used in the treatment of primary headaches differ partially among individual patients, they are frequently localized on the trapezius muscle, posterior cervical paraspinal muscles, suboccipital muscles, and sternocleidomastoid muscles [25]. In our study, myofascial trigger points localized on muscles innervated by the C1-C3 vertebral nerves and trigeminal nerve (temporal, masseter, sternocleidomastoid, and posterior cervical paraspinal muscles) were used both in the control and study groups.…”

The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis

“…42 Dry needling is often used to treat myofascial trigger points (MTrPs), which are described as localized hypersensitive spots in a palpable taut band of muscle. These hyperirritable spots can be classified as active MTrPs when they produce spontaneous pain and, when palpated, reproduce a patient's familiar pain.…”

Injecction of trigger points in the temporal muscles of patients with miofascial syndrome

“…It is believed that the high percentage (100%) of patients with pain in some region of the face and/or neck occurred because of this study being specifically for the assessment of pain in this region; pain in this region is often not observed due to the lack of emphasis given by the examiner, mainly when the pain is not just a localized problem but rather a condition with generalized muscle pain like FM 10 . In these patients, sensitivity in the temporal muscle was identified by the reporting of pain at the temples or above the ears, confirming a high pain sensitivity in the temporal muscle of patients with MPS 7 . The strong presence of MMPS as well as headache confirmed the association of FM with other conditions.…”

“…Myofascial pain syndrome (MPS) is a common regional pain syndrome, considered to be the complaint of pain most present in medical practice. The painful symptoms are the result of hyperalgesia of small trigger points, which radiate pain to distant sites 6,7 . MPS can affect the orofacial region, and called masticatory myofascial pain syndrome (MMPS).…”