title: Comparison of NSAID patch given as monotherapy and NSAID patch in combination with transcutaneous electric nerve stimulation, a heating pad, or topical capsaicin in the treatment of patients with myofascial pain syndrome of the upper trapezius: a pilot study.
abstract: OBJECTIVE
  This study compared the therapeutic effect of monotherapy with a nonsteroidal anti-inflammatory drug (NSAID) patch vs an NSAID patch combined with transcutaneous electric nerve stimulation (TENS), a heating pad, or topical capsaicin in the treatment of patients with myofascial pain syndrome (MPS) of the upper trapezius.
  
  
  METHODS
  A randomized, single-blind, controlled study of combination therapy for patients with MPS was performed.
  
  
  METHODS
  Ninety-nine patients were randomly assigned to one of four different self-management methods for treatment: NSAID patch (N = 25), NSAID patch + TENS (N = 24), NSAID patch + heating pad (N = 25), and NSAID patch + topical capsaicin (N = 25). The NSAID patch used in this study was a ketoprofen patch. All treatment groups were observed for 2 weeks, and the numeric rating scale (NRS) pain score, cervical active range of motion, pressure pain threshold, and Neck Disability Index were assessed.
  
  
  RESULTS
  There was no significant difference between the NSAID patch alone group and the three combination therapy groups with respect to decrease in NRS score from baseline (day 0) to each period of observation. In covariate analysis, although there was no difference among the groups in most of the periods, the data at day 14 indicated a trend (P = 0.057). There were no significant differences in the other variables.
  
  
  CONCLUSIONS
  We did not observe a statistical difference in improvements to the clinical variables among the four different methods. However, further studies regarding the effectiveness of a mixture of topical capsaicin and ketoprofen in patients with MPS should be considered.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Do-Hyeong
authors.initials: DH
authors.lastname: Kim
authors.forename: Kyung Bong
authors.initials: KB
authors.lastname: Yoon
authors.forename: SangHa
authors.initials: S
authors.lastname: Park
authors.forename: Tae Eun
authors.initials: TE
authors.lastname: Jin
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: An
authors.forename: Eric A
authors.initials: EA
authors.lastname: Schepis
authors.forename: Duck Mi
authors.initials: DM
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002211:Capsaicin / Q000008:administration & dosage*; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000628:therapy*; D010865:Pilot Projects; D018689:Sensory System Agents / Q000008:administration & dosage*; D016037:Single-Blind Method; D064171:Superficial Back Muscles / Q000187:drug effects; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D057968:Transdermal Patch; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018689:Sensory System Agents; D002211:Capsaicin
keywords: Capsaicin; Myofascial Pain Syndrome; Nonsteroidal Anti-inflammatory Agents; Self-Care; Transcutaneous Electric Nerve Stimulation