Presentation Title

The Efficacy of Trigger Point Injections to Treat Adult Myofascial Neck and Back Pain in the Emergency Department

Faculty Mentor

Dr. Justin Yanuck, Dr. Bharath Chakravarthy

Start Date

17-11-2018 8:00 AM

End Date

17-11-2018 8:15 AM

Location

C301

Session

Oral 1

Type of Presentation

Oral Talk

Subject Area

health_nutrition_clinical_science

Abstract

Around 78% of all Emergency Department (ED) visits have a chief complaint of pain. While the cause of pain varies greatly, chronic pain arising from the muscles - termed myofascial pain - makes up a majority of ED visits. This pain typically occurs in the lower back or neck and radiates to other areas from a taut band of muscle fibers called a trigger point. Although conventional therapy of many EDs is to prescribe opioids or nonsteroidal anti-inflammatory drugs, there is no definitive method to treat myofascial pain. Research shows that the conventional method may be ineffective and can contribute to the current prescription opioid epidemic in the United States.

Trigger point injection is a relatively new treatment for myofascial pain. In essence, when a small needle is inserted into the trigger point, tension in the muscle fibers is broken, and myofascial pain is relieved. Literature has shown this to be an effective and safe way to treat myofascial pain in the outpatient setting, and this study is the first to study it in the ED.

This study is also the first to investigate the effectiveness of trigger point injections compared to conventional therapy in the treatment of myofascial pain. While efficacy of both treatments have been researched separately, they have not been compared to each other. Our study randomizes UC Irvine Medical Center ED adult patients to receive either a trigger point injection with 1% lidocaine or the conventional therapy. Pain is then scored using the Numerical Rating Scale of Pain and the Nottingham Pain Health Profile at 20 minutes and 7-14 days post-treatment. We currently have 46 enrollments and the data will be analyzed after 100 enrollments to determine which treatment is more effective for myofascial pain. We hypothesize trigger point injection will prove more effective both immediately and long-term.

KEYWORDS: emergency department, trigger point injection, opioids, myofascial pain, chronic back pain, pain, emergency medicine, neck and back, neck pain, ED

Summary of research results to be presented

This is an ongoing study and data is still being collected. While statistical analysis has not been done at this time, the current surveys have indicated a trend of the trigger point group having quicker and greater reductions of pain values at 20 minutes and 7-14 days post treatment. However, because formal data analysis has not been done, we cannot claim significance. If we do not reach the target 100 enrollments near the time of conference, we will conduct an interval evaluation of the data and present those preliminary results.

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Nov 17th, 8:00 AM Nov 17th, 8:15 AM

The Efficacy of Trigger Point Injections to Treat Adult Myofascial Neck and Back Pain in the Emergency Department

C301

Around 78% of all Emergency Department (ED) visits have a chief complaint of pain. While the cause of pain varies greatly, chronic pain arising from the muscles - termed myofascial pain - makes up a majority of ED visits. This pain typically occurs in the lower back or neck and radiates to other areas from a taut band of muscle fibers called a trigger point. Although conventional therapy of many EDs is to prescribe opioids or nonsteroidal anti-inflammatory drugs, there is no definitive method to treat myofascial pain. Research shows that the conventional method may be ineffective and can contribute to the current prescription opioid epidemic in the United States.

Trigger point injection is a relatively new treatment for myofascial pain. In essence, when a small needle is inserted into the trigger point, tension in the muscle fibers is broken, and myofascial pain is relieved. Literature has shown this to be an effective and safe way to treat myofascial pain in the outpatient setting, and this study is the first to study it in the ED.

This study is also the first to investigate the effectiveness of trigger point injections compared to conventional therapy in the treatment of myofascial pain. While efficacy of both treatments have been researched separately, they have not been compared to each other. Our study randomizes UC Irvine Medical Center ED adult patients to receive either a trigger point injection with 1% lidocaine or the conventional therapy. Pain is then scored using the Numerical Rating Scale of Pain and the Nottingham Pain Health Profile at 20 minutes and 7-14 days post-treatment. We currently have 46 enrollments and the data will be analyzed after 100 enrollments to determine which treatment is more effective for myofascial pain. We hypothesize trigger point injection will prove more effective both immediately and long-term.

KEYWORDS: emergency department, trigger point injection, opioids, myofascial pain, chronic back pain, pain, emergency medicine, neck and back, neck pain, ED