SAT0415 Comparison of Radial Extracorporeal Shock Wave Therapy and Local Steroid Injection Treatment in Myofascial Pain Syndrome

Abstract

Background MPS which is characterized by trigger points in muscles is the most common cause of musculoskeletal disorders. Trigger points are commonly located in upper trapezius, scalenus, sternocleidomastoid, levator scapula and quadratus lumborum muscles. Objectives In our study, we searched for whether rESWT treatment is as effective as local anesthetic (prilocain) injection or not in upper trapezius trigger point treatment. Methods Randomized, controlled, single-blind this study, included 64 patients who had trigger point in upper trapezius muscle and diagnosis of MPS. Patients are randomly divided into two study groups. In first group (injection group), we injected 2 ml of local anaesthetic substance (prilocaine). In second group (rESWT group), we applied 3 sessions of rESWT once a week. Trigger point and control trigger point evaluation was done by algometer, pain degree evaluated by Likert Pain Scale and VAS, psychosocial effects of pain evaluated by BDI, BAI, NHP parameters in both groups. Evaluations are done before treatment, 1st and 3rd months of after treatment for both groups. Results At baseline, there were no difference between groups in demographic and clinical features of patients except for VAS effects of neck pain in work (p=0.044) Within group analysis shows statistically important difference in all parameters in both 1st and 3rd month evaluations of injection group in respect of before treatment evaluations (for all other parameters p<0.05) except for 3rd month NHP social isolation parameter (p= 0.079). However, except for VAS neck pain effect on work (p=0.028), there were no statistically important difference between 1st and 3rd month evalutions (for all other parameters p>0.05). Within group analysis in rESWT group shows statistically important difference in both 1st and 3rd month evaluations in respect of before treatment evaluations except for NHP social isolation (in order of p=0.095 and p=0.100) and NHP physical mobility (in order of p=0.070 and p=0.147) (for all other parameters p<0.05). Moreover, there were not any statistically important difference, when we compare 1st and 3rd month evaluations in rESWT group (for all parameters p>0.05). In evaluations of 1st month after treatment, there were also no statistically important difference in trigger and control point measurements (p=0.240, p=0.143), Likert Pain Scale (p=0.735), VAS (for all parameteres p>0.05), NSP (for all parameteres p>0.05), BDI (p=0.808) and BAI (p=0.499), in between group analyses. In evaluations of 3rd month after treatment, except for VAS effects of pain on mood (p=0.019) and BAI (p=0.024) in favor of rESWT group, between group analysis show no statistically important difference (for all other parameters p>0.05). Conclusions This study shows rESWT is a treatment modality which as effective as local anesthetic injection in patients who have upper trapezius muscle trigger point. References Ji HM, Kim HJ, Han SJ. Extracorporeal shock wave therapy in myofascial pain syndrome of upper trapezius. Ann Rehabil M...