Direct current therapy with/without lidocaine iontophoresis in myofascial pain syndrome.
OBJECTIVE
This study aimed to assess the effectiveness of lidocaine iontophoresis for inactivation of trigger points (TrPs) in the treatment of myofascial pain syndrome (MPS).


METHODS
Fifty-eight trigger points (cervical and/or periscapular regions) in 18 female and 2 male patients with MPS were randomly assigned to two groups. These groups were treated with: lidocaine iontophoresis using direct current (3 mA, 10 min) (n: 10, 28 TrPs) or only direct current (n: 10, 30 TrPs). Lidocaine iontophoresis or direct current, followed by stretching and strengthening exercises of each of the involved muscles and postural exercises were given in both groups once daily for ten days. Clinical assessment including cervical range of motion (ROM), TrP pain pressure threshold (PPT) measurement, and manual pain scores (PS), Visual analogue scale-pain (VAS-pain), fatigue and work disability scores were evaluated at baseline, at the end of a 10 session course of treatment and at the end of fourth week. Additionally, Hamilton depression and anxiety rating scales and Nottingham Health Profile (NHP) were used to evaluate and assess depression and anxiety and quality of life, respectively. The subjects were also asked to describe their side effects.


RESULTS
PPT, pain scores, VAS-pain were significantly improved in both groups at the end of treatment and during evaluation at fourth week. The improvement of these parameters was not significantly different between groups at the end of treatment. Quality of life (NHP scores) (p<0.016) and depression and anxiety scores (p<0.05) significantly improved with treatment in both groups.


CONCLUSIONS
Direct current therapy with/without lidocaine iontophoresis were determined to be effective treatment modalities in TrP management. These treatment modalities are non-invasive, cost effective and provide long term improvement. Thus, these modalities could be safely used in the management of MPS with minimal side effects, particularly if patients may not accept injection or other treatments (Tab. 3, Ref. 44). Full Text (Free, PDF) www.bmj.sk.
Kaya
Arzu
A
Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Firat University, Faculty of Medicine, Elazig, Turkey. drarzukaya26@hotmail.com
Kamanli
Ayhan
A
Ardicoglu
Ozge
O
Ozgocmen
Salih
S
Ozkurt-Zengin
Fatma
F
Bayik
Yilmaz
Y
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007478:Iontophoresis / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009209:Myofascial Pain Syndromes / Q000628:therapy*; D011788:Quality of Life
D000779:Anesthetics, Local; D008012:Lidocaine