A prospective, randomized, double-blind evaluation of trigger-point
injection therapy for low-back pain.
by
Garvey TA; Marks MR; Wiesel SW
Address:
Department of Orthopaedic Surgery, George Washington University
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.