Trigger Point Injections Versus Lidocaine Patch for Myofascial Pain in the Emergency Department

University of California Irvine (UCI)

Status and phase: Enrolling; Phase 4

Conditions: Myofascial Trigger Point Pain; Myofacial Pain

Treatments: Procedure: Trigger point injection with 1% lidocaine; Drug: Lidocaine patch 5%

Study type: Interventional

Funder types: Other

Identifiers

NCT05151510

UCI IRB HS# 2021-6439

Details and patient eligibility

About

The aim of this trial is to investigate the efficacy of trigger point injections with 1% lidocaine in reducing myofascial back and neck pain in the Emergency Department compared to lidocaine patches 5%.

Full description

After being informed about the study and the potential risks and benefits, all patients will be randomized into either the trigger point injection group with 1% lidocaine, or the 5% lidocaine patch group. Pain scores will be recorded while in the emergency department, and we will have a 5 day follow-up phone call to assess efficacy. Patients who present to UCI Department of Emergency medicine will be screened and recruited prospectively, and information regarding this study will be available on clinicaltrials.gov as a method of recruitment.

Enrollment: 110 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 18 years or older
• Diagnosed with myofascial pain of the posterior neck or back. *The diagnosis of myofascial pain was based on established criteria of having a palpable taut band (trigger point) that when depressed reproduced the patient's pain.

Exclusion criteria

• midline spinal tenderness
• evidence of radiculopathy
• pregnant
• have an allergy to lidocaine
• altered or deemed incapable of making informed consent
• had signs of infection or skin breakdown over the trigger point.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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110 participants in 2 patient groups

Trigger point with 1% Lidocaine

Experimental group

Description:

The physician will withdraw 1cc of 1% lidocaine in a 25g needle, sterilely prep the field with a Chloraprep applicator, use index, and middle finger to squeeze the borders of the trigger point and raise the central aspect of the trigger point, insert the needle at 90-degree angle up to 5/8' deep, inject 1cc of the 1% lidocaine after ensuring needle is not in a blood vessel, removing the needle, and then covering the insertion site with a sterile bandage.

Treatment:

Procedure: Trigger point injection with 1% lidocaine

5% Lidocaine Patch

Active Comparator group

Description:

5% lidocaine patch will be placed at the point of maximal tenderness upon palpation. Location of placement will be described and instructed by physician and placed by nursing staff.

Treatment:

Drug: Lidocaine patch 5%