Comparison of the Efficiency of Ultrasound-Guided Injections of the Rhomboid Major and Trapezius Muscles in Myofascial Pain Syndrome: A Prospective Randomized Controlled Double-blind Study

J Ultrasound Med. 2018 May;37(5):1151-1157. doi: 10.1002/jum.14456. Epub 2017 Oct 19.

Abstract

Objectives: We aimed to investigate the effect of ultrasound (US)-guided injections of the rhomboid major (deep) and trapezius (superficial) muscles on pain, disability, and quality of life in patients with myofascial pain syndrome.

Methods: In this prospective randomized controlled double-blind study, 65 patients with a diagnosis of myofascial pain syndrome were randomized into 2 groups. In group 1 (n = 33), US-guided rhomboid major muscle injection was performed, and in group 2 (n = 32), US-guided trapezius muscle injection was performed. The patients were assessed by a visual analog scale for pain, the Pressure Pain Threshold, the Neck Pain and Disability Scale, and Short Form 12. Data were obtained before treatment (week 0), the second week after treatment, and the fourth week after treatment.

Results: In both groups, significant improvements were observed for all parameters at both weeks 2 and 4 compared to pretreatment values (P < .05). A comparison of the groups showed significantly superior results in group 1 for all parameters at week 2 (P < .05) and for all parameters but the Physical Component Scale of Short Form 12 at week 4 (P < .05).

Conclusions: We think that US-guided deep injection of the rhomboid major muscle was more effective than superficial injection of the trapezius muscle for pain, disability, and quality of life in patients with myofascial pain syndrome.

Keywords: injections; invasive techniques; musculoskeletal (interventional); myofascial pain syndrome; rheumatology; rhomboid major muscle; trapezius muscle; ultrasound.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Local / administration & dosage*
  • Anesthetics, Local / therapeutic use
  • Bupivacaine / administration & dosage*
  • Bupivacaine / therapeutic use
  • Double-Blind Method
  • Female
  • Humans
  • Injections
  • Male
  • Myofascial Pain Syndromes / diagnostic imaging
  • Myofascial Pain Syndromes / drug therapy*
  • Prospective Studies
  • Quality of Life
  • Superficial Back Muscles / diagnostic imaging*
  • Superficial Back Muscles / drug effects*
  • Treatment Outcome
  • Ultrasonography, Interventional / methods*

Substances

  • Anesthetics, Local
  • Bupivacaine