Effects of Radial Extracorporeal Shockwave Therapy Versus 1% Lidocaine Injection for Myofascial Trigger Points Measured with Elastic Index

Abstract

ABSTRACTPurposeTo compare the efficacy of radial extracorporeal shockwave therapy (rESWT) versus injection of 1% lidocaine for active myofascial trigger points (MTPs) at upper trapezius muscle (UTM) objectively with elastic index analysis.Patients and methodsA prospective, randomised, single-blinded clinical trial was done. 60 patients with active MTPs of UTM were randomised to receive either rESWT (n = 30); three rESWT sessions; one session per week; 2000 rESWT impulses per session; positive energy flux density = 0.10 mJ/mm2) or 1% lidocaine (4 ml) injection (n = 30) (three injections; one injection per week). The outcome measure was the elastic index of MTPs, visual analogue score (VAS score) of pain, and pressure pain threshold (PPT) three weeks after baseline.ResultsBoth rESWT and injection of 1% lidocaine resulted in statistically significant (P < 0.05) reduced elastic index and VAS of pain of UTM and PPT significantly (P < 0.05) at three weeks after baseline. The mean differences between rESWT and injection of 1%lidocaine showed no statistically siginificance.ConclusionBoth rESWT and 1% lidocaine injection had efficacy for active MTPs of UTM measured with elastic index, VAS of pain and PPT.HighlightsExtracorporeal shockwave therapy (ESWT) is an alternative to 1%lidocaine injection for myofascial trigger points (MTPs).Elastic index provides evidence for the quantitative assessment of MTPs.