Comparison of Lidocaine Injection, Therapeutic Exercise and Two of Them for Myofascial Pain Treatment (Litemyo)

Objective: To determine if the combination of blocking the Myofascial trigger point (MTP) plus a standardized therapeutic exercise program, is more effective than only the blocking or the therapeutic exercise; to relieve the pain and improve the function and the quality of life in a Group of patients con MTP in the shoulder girdle and the neck.

Methods: We propose a double blind randomized controlled clinical trial, in different health centers in Medellin. The subjects are patients with MTP in muscles of the shoulder girdle (levator scapulae, trapezius, infraspinatus) diagnosed by neck ans shoulder pain lasting langer than 6 weeks, and that have not received rehabilitation treatment and are not currently taking analgesic medications. We have calculated a sample of 45 patients in each group.

Primary outcomes: Pain 4 weeks later wich will be measured in a VAS (Visual analogue scale) a successful treatment is defined as a reduction in pain in 20% from the initial score 4 weeks after the first evaluation.

Secondary outcomes SF-36 bodily pain scale Function measured with the hand back and hand mouth maneuvers. Complications and adverse reactions Need for rescue medication.

e propose a double blind randomized controlled clinical trial, in different health centers in Medellin. The subjects are patients with MTP in muscles of the shoulder girdle (levator scapulae, trapezius, infraspinatus) diagnosed by neck ans shoulder pain lasting langer than 6 weeks, and that have not received rehabilitation treatment and are not currently taking analgesic medications. We have calculated a sample of 45 patients in each group.

Primary outcomes: Pain 4 weeks later wich will be measured in a VAS (Visual analogue scale) a successful treatment is defined as a reduction in pain in 20% from the initial score 4 weeks after the first evaluation.

Secondary outcomes SF-36 bodily pain scale Function measured with the hand back and hand mouth maneuvers. Complications and adverse reactions Need for rescue medication.

• Myofascial Pain Syndrome
• Pain
• Myofascial Trigger Point
• Anesthetics, Local
• Physical Therapy Modalities

• Other: Physical therapy
  Twelve sessions (3 per week)
  Other Name: standardized therapeutic exercise program
• Drug: Blocking the MTP with lidocaine injection
  blocking the Myofascial trigger point (MTP) with lidocaine injection, unique dose.
  Other Name: blocking the Myofascial trigger point
• Other: blocking the MTP plus physical therapy
  blocking the Myofascial trigger point (MTP) with lidocaine injection plus a standarized therapeutic exercise program (twelve sessions, 3 per week)
  Other Name: blocking plus a standarized therapeutic exercise program

• Active Comparator: Physical Therapy
  Interventions:

  • Other: Physical therapy
  • Drug: Blocking the MTP with lidocaine injection
  • Other: blocking the MTP plus physical therapy
• Active Comparator: Blocking the MTP
  Blocking the myofascial trigger point (MTP)
  Intervention: Drug: Blocking the MTP with lidocaine injection
• Experimental: Blocking the MTP plus physical therapy
  Intervention: Drug: Blocking the MTP with lidocaine injection

Inclusion Criteria:

• Cervical Pain at least six weeks
• At least 40 mm in the VAS
• They cannot been received treatment like physical therapy or analgesics
• Maximum score of PHQ 16 points

Exclusion Criteria:

• Depression
• Fibromyalgia
• Cervical Radiculopathy