A prospective, randomized, double-blind evaluation of trigger-point injection therapy for low-back pain

Spine (Phila Pa 1976). 1989 Sep;14(9):962-4. doi: 10.1097/00007632-198909000-00008.

Abstract

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acupuncture Therapy*
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Back Pain / drug therapy
  • Back Pain / therapy*
  • Double-Blind Method
  • Ethyl Chloride / therapeutic use
  • Female
  • Humans
  • Lidocaine / therapeutic use*
  • Male
  • Myofascial Pain Syndromes / drug therapy
  • Myofascial Pain Syndromes / therapy*
  • Prospective Studies
  • Random Allocation
  • Triamcinolone Acetonide / analogs & derivatives
  • Triamcinolone Acetonide / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Ethyl Chloride
  • Lidocaine
  • Triamcinolone Acetonide
  • triamcinolone hexacetonide