A Randomized Controlled Study Comparing Trigger Point Injections With 1% Lidocaine Versus 5% Lidocaine Patch for Myofascial Pain in the Emergency Department
Overview
- Phase
- Phase 4
- Intervention
- Trigger point injection with 1% lidocaine
- Conditions
- Myofascial Trigger Point Pain
- Sponsor
- University of California, Irvine
- Enrollment
- 110
- Locations
- 1
- Primary Endpoint
- absolute change in Numerical Rating Scale (NRS) of pain
- Status
- Withdrawn
- Last Updated
- 2 months ago
Overview
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.
Investigators
Jonathan B Lee
Resident Physician
University of California, Irvine
Eligibility Criteria
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
- •have an allergy to lidocaine
- •altered or deemed incapable of making informed consent
- •had signs of infection or skin breakdown over the trigger point.
Arms & Interventions
Trigger point with 1% Lidocaine
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.
Intervention: Trigger point injection with 1% lidocaine
5% Lidocaine Patch
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.
Intervention: Lidocaine patch 5%
Outcomes
Primary Outcomes
absolute change in Numerical Rating Scale (NRS) of pain
Time Frame: 0 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 Outcomes
- disposition times(From initiation of the study up to the point the patient is discharged from the emergency department)
- use of other medications for treatment of pain including medications administered(From initiation of the study up to 5 days post discharge)
- satisfaction/experience surveys regarding their treatment(Immediately after the intervention is performed/administered)