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

Phase 4
Recruiting
Conditions
Myofascial Trigger Point Pain
Myofacial Pain
Interventions
Procedure: Trigger point injection with 1% lidocaine
Registration Number
NCT05151510
Lead Sponsor
University of California, Irvine
Brief Summary

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%.

Detailed 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.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
110
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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Trigger point with 1% LidocaineTrigger point injection with 1% lidocaineThe 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.
5% Lidocaine PatchLidocaine patch 5%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.
Primary Outcome Measures
NameTimeMethod
absolute change in Numerical Rating Scale (NRS) of pain0 minutes and 20-minutes post- treatment, and every 30-60 minutes thereafter until discharge or admission and we will give the patient a hand out so that they can record their pain scores for up to 5 days after their emergency department visit.

Pain on a scale of 1-10. Minimum value is 1, maximum value is 10. Higher score means higher level of pain while lower score means lower level of pain.

Secondary Outcome Measures
NameTimeMethod
disposition timesFrom initiation of the study up to the point the patient is discharged from the emergency department

Number of minutes it takes to discharge or admit the patient from first contact

use of other medications for treatment of pain including medications administeredFrom initiation of the study up to 5 days post discharge

How often and which medications did the patient require in emergency department and upon discharge to control their pain

satisfaction/experience surveys regarding their treatmentImmediately after the intervention is performed/administered

We will administer satisfaction/experience surveys to assess for any discomfort or relief from the intervention

Trial Locations

Locations (1)

Emergency Room at UCI Medical Center

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Orange, California, United States

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