Injections of Local Anesthetics into the Pharyngeal Region Reduce Trapezius Muscle Tenderness

Abstract

Background: Neck pain is a frequent reason for seeking medical advice. Neuroanatomical findings suggest a close connection between the pharynx and the trapezius region. Irritation of the pharynx may induce tenderness of this area. Specific tender points, called neck reflex points (NRPs), can be identified here with high reproducibility. We hypothesized that therapeutic local anesthesia (TLA; or neural therapy, NT) in the pharyngeal region can reduce tenderness in patients with therapy-resistant neck pain. Patients and Methods: 17 consecutive female patients with chronic cervical pain and positive trapezius NRPs received bilateral injections of 0.5 ml 1% procaine into the palatine velum. The NRPs were assessed using a 3-level pain index (PI = 0, 1, or 2) before and 3-5 min after each injection. Results: We found a significant reduction in tenderness of the NRP of the trapezius region (NRP C7) immediately after TLA/NT. 30 positive NRPs were found before therapy and only 13 after therapy (p < 0.01). The average PI of the NRP C7 was 1.24 ± 0.77 before and 0.35 ± 0.59 after therapy (right side), and 1.34 ± 0.59 before and 0.59 ± 0.69 after therapy (left side). The pre- and post-therapy PI values were significantly different on both the right and left sides of the trapezius region (p < 0.01). No adverse effects were observed. Conclusions: Pharyngeal irritation may induce and maintain therapy-resistant cervical pain in patients with chronic pharyngeal disease. These patients could benefit from remote TLA/NT injections in the pharyngeal region.

Evaluation of Neural Therapy Effects in Patients with Lateral Epicondylitis: A Randomized Controlled Trial

“…22 NT is not only a local injection, but also includes segmental and supra-segmental injections and the effect of NT in other painful musculoskeletal disorders have been shown in previous studies. 11,12 According to the authors, the effects of NT in patients with LE were shown for the first time in this study, and according to our results, NT is an effective treatment modality for LE.…”

“…The regulatory mechanisms of the nervous system are used mainly on segmental reflector processes and the interference field described as the zone that initiates and/or maintains pain and inflammation, regardless of the related segment. [11][12][13] The effect of NT was previously reported in various painful musculoskeletal disorders. 9,10 The authors claimed that NT is more effective than traditional treatment methods (including rest, bracing, non-steroidal anti-inflammatory drugs) in these patients.…”

“…9,18 Previous studies have demonstrated that NT is an effective treatment modality for painful musculoskeletal disorders. 11,12 Mardani et al reported that local anesthetic injection (only local application) was not as effective as corticosteroid injection in patients with LE. 22 NT is not only a local injection, but also includes segmental and supra-segmental injections and the effect of NT in other painful musculoskeletal disorders have been shown in previous studies.…”

Neurol Therapy Applications in Physical Medicine and Rehabilitation

“…15 Bir başka çalışmada ise faringeal irritasyonun dirençli boyun ağrısına neden olabileceği ve bu hastalarda faringeal bölgeye yapılan enjeksiyonlar sonrasında boyun ağrısının azaldığı bildirilmiştir. 16 Bel ağrısı: Kronik bel ağrısı toplumda yaygın olarak görülmektedir. İş gücü kaybının önemli nedenlerinden biridir.…”

Inter-Rater Reliability of Neck Reflex Points in Women with Chronic Neck Pain

“…They speculated a causal interrelation. Recently, the HUNTER group described an interrelation of NRP tenderness with the pharyngeal region ex juvantibus [6]. …”