A prospective, randomized, double-blind evaluation of trigger-point injection therapy for low-back pain.
The efficacy of trigger-point injection therapy in treatment of low-back strain was evaluated in a prospective, randomized, double-blind study. The patient population consisted of 63 individuals with low-back strain. Patients with this diagnosis had nonradiating low-back pain, normal neurologic examination, absence of tension signs, and lumbosacral roentgenograms interpreted as being within normal limits. They were treated conservatively for 4 weeks before entering the study. Injection therapy was of four different types: lidocaine, lidocaine combined with a steroid, acupuncture, and vapocoolant spray with acupressure. Results indicated that therapy without injected medication (63% improvement rate) was at least as effective as therapy with drug injection (42% improvement rate), at a P value of 0.09. Trigger-point therapy seems to be a useful adjunct in treatment of low-back strain. The injected substance apparently is not the critical factor, since direct mechanical stimulus to the trigger-point seems to give symptomatic relief equal to that of treatment with various types of injected medication.
Garvey
T A
TA
Department of Orthopaedic Surgery, George Washington University Medical Center, Washington, D.C.
Marks
M R
MR
Wiesel
S W
SW
D015670:Acupuncture Therapy; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001416:Back Pain / Q000188:drug therapy / Q000628:therapy*; D004311:Double-Blind Method; D005018:Ethyl Chloride / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D009209:Myofascial Pain Syndromes / Q000188:drug therapy / Q000628:therapy*; D011446:Prospective Studies; D011897:Random Allocation; D014222:Triamcinolone Acetonide / Q000031:analogs & derivatives / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D005018:Ethyl Chloride; D008012:Lidocaine; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide